Operation ASHA is pleased to announce a new collaboration with USAID.
Multi-Drug Resistant Tuberculosis (MDR-TB) is the emerging man made epidemic. It takes a huge toll on human lives, and the costs associated are astronomical. Prevention of MDR-TB is critical, also because each case of MDR-TB breathes out bacteria that spread MDR-TB to at least 12 other innocent persons. According to the Stop TB Partnership, by 2013 there will be 1.3 million cases of MDR-TB in the world, requiring $16 billion. Patient lapses in first-line tuberculosis treatment, an intense regimen of over 60 visits to treatment centers (DOTS) in six months, are a key cause of MDR-TB.
USAID has agreed to fund a large scale randomized control trial to establish the efficiency and cost effectiveness of the biometric identification system used by Operation ASHA in preventing drug-resistance. This will be achieved by lowering missed doses and enhancing compliance during the long and tedious treatment regimen for TB.
Using fingerprint technology to track patient adherence
The biometric identification system eDOTS, now rechristened as eCompliance used by Operation ASHA, registers the presence of patients and staff at treatment centers through fingerprints, updates this information to a server, and sends daily updates to the concerned counselor and program manager through sms. The message is also relayed to the patients after obtaining consent. Many patients do not agree to this so they can keep their TB status confidential. This is necessary because of the terrible stigma that is attached to the disease, which is known as a “curse from God’ among the illiterate and the disadvantaged.
Information provided in sms enables our counselor and supervisory team to provide targeted counseling to TB patients who begin to lapse on their treatments. eCompliance tracks every dose taken by TB patients, thus preventing default and the dreaded MDR-TB. The system also improves productivity, maintains and archives data electronically, increases transparency, and eliminates human error and gaming.
Potential impacts, cost effectiveness, and implications
A recent pilot tested the eCompliance system with nearly 1,300 TB patients at 17 treatment centers and showed a reduction in the default rate of patient treatment lapses. With a Stage 2 grant from DIV, OpASHA – in collaboration will take the next step of rigorously testing the system at 138 DOTS centers with over 12000 patients. This work will compare the effectiveness and low-cost of eCompliance to conventional methodology.
This project was made possible by the generous support of the American People.
About USAID: The United States Agency for International Development (USAID) is the United States federal government agency primarily responsible for administering civilian foreign aid.