Impact assessment of diagnostic tools for multi-drug resistant and (MDR-TB) drug sensitive tuberculosis (TB) in the Philippines
Lead Research Organisation:
Liverpool School of Tropical Medicine
Department Name: Clinical Sciences
Abstract
While the Philippines has made great strides in Tuberculosis (TB) control, it continues to be the 6th largest cause of mortality and morbidity in the country. There are around 27,000 deaths annually and an estimated 290,000 new cases of TB each year at an incidence rate of 292 per 100,000. The percentage of TB cases with Multi-drug resistance (MDR-TB) is 2% for new cases and 21% for retreatment cases. The World Health Organization (WHO) estimate that only 12-16% of actual MDR-TB cases are detected of which only two-thirds are successfully treated. In the largest province in the country (Cavite) case detection rates have been improving, however only 35% of the estimated smear-positive MDR-TB cases are currently detected.
Improvement in access to accurate diagnosis is necessary to reduce further the burden of TB/MDR-TB. Encouragingly there is a pipeline of new diagnostic tools becoming available. For example, Xpert MTB/RIF is a new technology recommended by the World Health Organization that has the potential to make a significant difference to diagnosis of TB and MDR-TB in high burden countries like the Philippines. At the present time there are just 16 sites that perform the Xpert MTB/Rif test scattered over the different regions of the country. If the benefits of these developments are to be realized in the Philippines it is essential an appropriate strategy on scale-up is developed. However, more work is needed on the data to go beyond test accuracy in order to promote rational, evidence-based decision-making on uptake and implementation. TB diagnostics are not implemented in isolation, but are always part of an algorithm that operates in conjunction with other diagnostic approaches, such as empirical treatment or radiology. Computer modelling is an approach that can bring together the published and national data to provide policy makers with the evidence they need to support rational decisions.
In this study a number of alternative diagnostic options will be researched using an innovative modelling approach to project patient and health system outcomes including understanding the cost effectiveness of alternative options. Working with the National TB programme (NTP) of the Philippines these projections will be used to develop a strategy on scale up of new diagnostics in the largest province of the Philippines (Cavite). Filipino researchers from the De la Salle Health Sciences Institute (DLSHSI) will also be trained and equipped to conduct research in other provinces and on other diagnostic tools as they become available.
Our aim is to equip Filipino researchers and the NTP of the Philippines with a tested impact assessment approach that can be used to project the impact of new diagnostic tools and algorithms for MDR-TB and TB. Thus enabling policy makers to make rational and appropriate decisions on the scale-up of new diagnostic tools across the country. The approach used in this study has the potential to be applied in many other contexts around the world where TB and MDR-TB is a major barrier to public health and therefore economic development.
Improvement in access to accurate diagnosis is necessary to reduce further the burden of TB/MDR-TB. Encouragingly there is a pipeline of new diagnostic tools becoming available. For example, Xpert MTB/RIF is a new technology recommended by the World Health Organization that has the potential to make a significant difference to diagnosis of TB and MDR-TB in high burden countries like the Philippines. At the present time there are just 16 sites that perform the Xpert MTB/Rif test scattered over the different regions of the country. If the benefits of these developments are to be realized in the Philippines it is essential an appropriate strategy on scale-up is developed. However, more work is needed on the data to go beyond test accuracy in order to promote rational, evidence-based decision-making on uptake and implementation. TB diagnostics are not implemented in isolation, but are always part of an algorithm that operates in conjunction with other diagnostic approaches, such as empirical treatment or radiology. Computer modelling is an approach that can bring together the published and national data to provide policy makers with the evidence they need to support rational decisions.
In this study a number of alternative diagnostic options will be researched using an innovative modelling approach to project patient and health system outcomes including understanding the cost effectiveness of alternative options. Working with the National TB programme (NTP) of the Philippines these projections will be used to develop a strategy on scale up of new diagnostics in the largest province of the Philippines (Cavite). Filipino researchers from the De la Salle Health Sciences Institute (DLSHSI) will also be trained and equipped to conduct research in other provinces and on other diagnostic tools as they become available.
Our aim is to equip Filipino researchers and the NTP of the Philippines with a tested impact assessment approach that can be used to project the impact of new diagnostic tools and algorithms for MDR-TB and TB. Thus enabling policy makers to make rational and appropriate decisions on the scale-up of new diagnostic tools across the country. The approach used in this study has the potential to be applied in many other contexts around the world where TB and MDR-TB is a major barrier to public health and therefore economic development.
Technical Summary
The objective of the research is to support the cost-effective roll-out of new tools and algorithms for the diagnosis of tuberculosis (TB) and multi-drug resistant TB (MDR-TB) in the Philippines. This will lead to improvements to TB/MDR-TB case detection and cure in the Philippines and promote the economic development and welfare of the country. The tools investigated will include the molecular test Xpert MTB/RIF and new point of care tests under development. The research programme will have 5 components:
1. Data collation- Data on the infrastructure, performance, and costing of the processes for TB and MDR-TB diagnosis and treatment will be collated. The sequence of events that patients follow in order to be diagnosed and start appropriate treatment will be mapped.
2. Model development- A computer model of the patient pathways using the innovative Virtual Implementation modelling approach will be developed. The approach produces a dynamic and visual representation of the pathways and will be used to project patient and health system outcomes. The model will be tested using data from Cavite province.
3. Cost effectiveness analysis- Outputs from the model will be used to estimate the incremental cost effectiveness of alternatives (Cost per Disability Adjusted Life Year (DALY) averted).
4. Strategy development - Working with policy makers from the National TB Programme (NTP) a strategy for the scale-up of new diagnostic tools and algorithms will be developed for Cavite province that takes account of the projected impacts and cost effectiveness of each option.
5. Capacity Building & Dissemination- An easy to use version of the model will be made available to the NTP and the De la Salle Health Sciences Institute (DLSHSI) using WITNESS software (www.lanner.com/en/). Training and support will be provided so researchers and the NTP can develop a strategy for new diagnostics in other provinces of the Philippines. Manuscripts will be submitted for publication.
1. Data collation- Data on the infrastructure, performance, and costing of the processes for TB and MDR-TB diagnosis and treatment will be collated. The sequence of events that patients follow in order to be diagnosed and start appropriate treatment will be mapped.
2. Model development- A computer model of the patient pathways using the innovative Virtual Implementation modelling approach will be developed. The approach produces a dynamic and visual representation of the pathways and will be used to project patient and health system outcomes. The model will be tested using data from Cavite province.
3. Cost effectiveness analysis- Outputs from the model will be used to estimate the incremental cost effectiveness of alternatives (Cost per Disability Adjusted Life Year (DALY) averted).
4. Strategy development - Working with policy makers from the National TB Programme (NTP) a strategy for the scale-up of new diagnostic tools and algorithms will be developed for Cavite province that takes account of the projected impacts and cost effectiveness of each option.
5. Capacity Building & Dissemination- An easy to use version of the model will be made available to the NTP and the De la Salle Health Sciences Institute (DLSHSI) using WITNESS software (www.lanner.com/en/). Training and support will be provided so researchers and the NTP can develop a strategy for new diagnostics in other provinces of the Philippines. Manuscripts will be submitted for publication.
Planned Impact
The following groups will benefit from this research:-
1. Filipino research organisations - Through the research, new skills and approaches to impact assessment will be developed. Training will be provided. New models will be deployed that can be used in the future as new diagnostic technologies are developed. De La Salle Health Institute (DLSHSI) will be involved in writing manuscripts and publishing the research of this project.
2. The National TB programme (NTP) and policy makers within the Ministry of Health in the Philippines - The research will result in the development of a strategy for the roll-out of new diagnostics in Cavite province and beyond. The strategy will be supported by evidence of impact on patients and the health system.
3. Patients in the Philippines with TB/MDR-TB that need to access rapid diagnostic tests - The implementation of the strategy developed will improve access to rapid diagnostics for TB/MDR-TB in the Philippines. This will likely to start in Cavite province and then move onto the rest of the country.
4. Developers of new diagnostics for TB/MDR-TB - Demand for those diagnostics that are identified as being cost effective in the Filipino context will be created. Evidence will be presented which helps other developers to identify the key characteristics necessary to maximise cost effective impact.
5. Economic development of the Philippines - Among the 8 disease priority areas in this Call, it is tuberculosis that has the biggest impact in terms of mortality, morbidity ,economic costs and burden of disease (exceeding 1.3 million DALYs per year) afflicting the poorest as well as the most productive age groups. Access to quick and accurate diagnosis remains the biggest challenge especially among MDR-TB and smear-positive cases. Among the top 10 countries globally with the highest MDR TB burden, the Philippines ranked 7th with 8,500 estimated MDR TB cases among notified cases3. This project's objective of developing a model for assessing the deployment of new diagnostics including Xpert MTB/RIF in Cavite, the most populous province in the Philippines, will greatly advance TB control in the Philippines. Early detection would reduce treatment delay, save thousands of lives and improve the economic plight of hundreds of thousands of Filipinos.
6. The wider research community in Asia-Pacific region and beyond - Research will be published in high impact journals that will act as a stimulus to further productive research into TB/MDR-TB, XDR-TB, diagnostics, and the use of patient pathway modelling in TB and other priority diseases.
1. Filipino research organisations - Through the research, new skills and approaches to impact assessment will be developed. Training will be provided. New models will be deployed that can be used in the future as new diagnostic technologies are developed. De La Salle Health Institute (DLSHSI) will be involved in writing manuscripts and publishing the research of this project.
2. The National TB programme (NTP) and policy makers within the Ministry of Health in the Philippines - The research will result in the development of a strategy for the roll-out of new diagnostics in Cavite province and beyond. The strategy will be supported by evidence of impact on patients and the health system.
3. Patients in the Philippines with TB/MDR-TB that need to access rapid diagnostic tests - The implementation of the strategy developed will improve access to rapid diagnostics for TB/MDR-TB in the Philippines. This will likely to start in Cavite province and then move onto the rest of the country.
4. Developers of new diagnostics for TB/MDR-TB - Demand for those diagnostics that are identified as being cost effective in the Filipino context will be created. Evidence will be presented which helps other developers to identify the key characteristics necessary to maximise cost effective impact.
5. Economic development of the Philippines - Among the 8 disease priority areas in this Call, it is tuberculosis that has the biggest impact in terms of mortality, morbidity ,economic costs and burden of disease (exceeding 1.3 million DALYs per year) afflicting the poorest as well as the most productive age groups. Access to quick and accurate diagnosis remains the biggest challenge especially among MDR-TB and smear-positive cases. Among the top 10 countries globally with the highest MDR TB burden, the Philippines ranked 7th with 8,500 estimated MDR TB cases among notified cases3. This project's objective of developing a model for assessing the deployment of new diagnostics including Xpert MTB/RIF in Cavite, the most populous province in the Philippines, will greatly advance TB control in the Philippines. Early detection would reduce treatment delay, save thousands of lives and improve the economic plight of hundreds of thousands of Filipinos.
6. The wider research community in Asia-Pacific region and beyond - Research will be published in high impact journals that will act as a stimulus to further productive research into TB/MDR-TB, XDR-TB, diagnostics, and the use of patient pathway modelling in TB and other priority diseases.
Publications
Tomeny EM
(2020)
Patient-cost survey for tuberculosis in the context of patient-pathway modelling.
in The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease
Description | Many findings came about through the modelling in a few key areas. Three are detailed below, in concordance with our first three publications from the project: TB diagnostic panels are not functioning in Philippines as they could be - they are understaffed and they are much less specific than they could be if properly staffed. Patient costs collection tools are likely underestimating the true scale of the burden. Due to the high levels of clinical diagnosis and Empiric treatment of Tuberculosis in Philippines, rolling out GeneXpert is unlikely to greatly increase the number of DS tb sufferers correctly placed onto treatement, and dependent on loss to follow-up rates, may even cause a decrease in correctly treated DS patients. That said, the number of DR infected patients who would be correctly treated would significantly increase with Xpert rollout. |
Exploitation Route | We are currently working on further publications from our modelling which will be published in 2020. Regarding the three points above, already members of the DOH in the Philippines are considering our findings re the Xpert Panel, and are considering improvements that could be made. The patient cost survey modelling results show that perhaps patient cost surveys ought to be asked in a different way to elicit higher quality answers. Finally, our modelling has highlighted the high level of CD, and has shown that Active Case Finding is necessary in the Philippines as a means of tackling TB. |
Sectors | Healthcare,Pharmaceuticals and Medical Biotechnology |
Description | Already we have been receiving feedback from clinicians that they are considering their diagnostic decisions a little differently, and we have already secured funding to investigate how ACF should be implemented in Philippines to find additional previously unreported cases. Furthermore, they have fed directly into policy making teams within the national tuberculosis program. |
First Year Of Impact | 2017 |
Sector | Healthcare |
Impact Types | Policy & public services |
Description | Strategy on implementation of Xpert MTB/RIF in the Philippines |
Geographic Reach | Asia |
Policy Influence Type | Influenced training of practitioners or researchers |
Impact | The training workshops, presentations to TB practitioners and reports have influenced the policy makers in the Philippines in relation to the roll-out of Xpert MTB/RIF in the country. In particular in relation to understanding of the major impacts of Xpert in the Philippines being focussed on MDR-TB diagnosis and patient costs rather than improvements to drug sensitive TB identification. The study has shown which algorithms using Xpert are cost-effective and also shown how the new tools being developed (i.e. ULTRA and OMNI) may actually provide a greater benefit. |
Description | Niche Centers in the Regions for R&D (NICER) Program - Call for Proposals |
Amount | ₱16,112,933 (PHP) |
Funding ID | DOST-DLSMHSI-PCHRD19-000361 |
Organisation | Government of the Republic of the Philippines |
Department | Department of Science and Technology |
Sector | Private |
Country | Philippines |
Start | 02/2019 |
End | 01/2022 |
Title | Patient Pathway modelling |
Description | Patient pathway modelling allows researchers to project the outcomes of alternative diagnostic tools taking into account the operational characteristics of the context - these tools have been developed specifically for use of researchers and the TB program in the Philippines |
Type Of Material | Improvements to research infrastructure |
Year Produced | 2018 |
Provided To Others? | Yes |
Impact | Researchers and the NTP in the Philippines can project impact of new diagnostic tools for TB in their own context by collecting and entering data into the model and running for alternative strategies |
Title | WHO Protocol for survey to determine direct and indirect costs due to TB and to estimate proportion of TB-affected households experiencing catastrophic total costs due to TB |
Description | Used the tool to assess cost impacts for patients in Cavite province of diagnosis and treatment for Tuberculosis |
Type Of Material | Improvements to research infrastructure |
Provided To Others? | No |
Impact | Ongoing |
Title | Health System and Patient cost data for TB diagnosis in Bulacan and Davao |
Description | No of cases split presumptive, new, previously treated, bacteriologically confirmed and clinically diagnosed Health System costs Patient Costs |
Type Of Material | Database/Collection of data |
Year Produced | 2018 |
Provided To Others? | No |
Impact | The impact of new diagnostics will be different between provinces (and sites), in part because the proportion of TB cases that are bacteriologically confirmed is highly variable |
Title | Health system data for 8 sites in Cavite province where TB diagnosis takes place |
Description | No of cases split presumptive, new, previously treated, bacteriologically confirmed and clinically diagnosed |
Type Of Material | Database/Collection of data |
Provided To Others? | No |
Impact | High levels of clinically diagnosed suggesting over diagnosis of TB |
Title | Patient cost data for TB diagnosis |
Description | Collection from patients of the impact of TB diagnosis and treatment on their direct and indirect costs |
Type Of Material | Database/Collection of data |
Provided To Others? | No |
Impact | Further analysis necessary |
Title | Virtual Implementation Modelling |
Description | Operational modelling of TB diagnostics using discrete event simulation |
Type Of Material | Computer model/algorithm |
Provided To Others? | No |
Impact | Assist in impact assessment of new diagnostic algorithms for TB |
Description | Collaboration with Lanner Software Company |
Organisation | Lanner Group |
Country | United Kingdom |
Sector | Private |
PI Contribution | We showcase Lanner's software through our use in Virtual Health System modelling, including links to their software in appropriate outputs and presentations. We have established strong links with Lanner, with frequent communication and sharing of software and workings. |
Collaborator Contribution | Our partners give us favourable access to their software licences for use in advancing global health |
Impact | Our modelling in both TB-FIT and continued TB-FIT2 projects, and all additional simulation modelling outputs are due to this collaboration. |
Start Year | 2014 |
Description | De La Salle Health Sciences Institute |
Organisation | De La Salle University |
Country | Philippines |
Sector | Academic/University |
PI Contribution | Experience in impact assessment and operational modelling to assist in policy decision on new diagnostics for Tuberculosis |
Collaborator Contribution | Access to data and knowledge of the Filipino health system in particular for TB diagnosis |
Impact | Ongoing |
Start Year | 2016 |
Description | Department of Health in Philippines |
Organisation | Philippines Department of Health |
Country | Philippines |
Sector | Public |
PI Contribution | Multiple meetings over the years, met most recently 7th August 2022 |
Collaborator Contribution | Ongoing discussions relating to TB-control in Philippines |
Impact | Discussions have been ongoing since the TB-FIT project began, with exchange of information and strategies. |
Start Year | 2016 |
Title | Virtual Implementation Modelling |
Description | Operational modelling of new diagnostic algorithms for TB and MDR-TB in Cavite province |
Type Of Technology | Software |
Year Produced | 2017 |
Impact | The model has now been used to project impacts of new diagnostics for TB in Cavite province including cost effectiveness. The analysis suggests that an effective policy for new TB diagnostics in Cavite province which could be implemented with currently available technology would be full roll-out of Xpert MTB/RIF. Furthermore, at the point when the Ultra cartridge becomes available, this would provide additional benefits. Finally, while being the most expensive strategy modelled, point of care testing with Omni at Barangay health stations has the potential to extend the benefits even further.would provide the largest benefit I both diagnosis of TB and reduced patient costs, and is shown to be the most cost-effective. |
Description | De La Salle Expo TB-FIT Booth |
Form Of Engagement Activity | Participation in an activity, workshop or similar |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Undergraduate students |
Results and Impact | The De La SAlle Medical and Health Sciences Institute Research Division held a whole day Exposition on November 13th 2019. It was attended by 200 Participants both international and local. LSTM Exhiibited a booth, showing our institution and research. There was also a booth specifically for the TB-FIT project. |
Year(s) Of Engagement Activity | 2019 |
URL | https://www.dlsu.edu.ph/research/publishing-house/other-journals/likha/ |
Description | Expert Panel Discussion |
Form Of Engagement Activity | A formal working group, expert panel or dialogue |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Postgraduate students |
Results and Impact | The Linking Innovations Health and Arts forum was hosted by De La Salle Medical and Health Sciences institute. Ewan Tomeny, the lead modeller from the TB-FIT project sat on a panel and discussed among other things the outputs of the project. |
Year(s) Of Engagement Activity | 2019 |
Description | Interview of key study staff for CNN Philippines |
Form Of Engagement Activity | A press release, press conference or response to a media enquiry/interview |
Part Of Official Scheme? | No |
Geographic Reach | National |
Primary Audience | Public/other audiences |
Results and Impact | Ewan Tomeny and Bertie Squire were interviewed about the project and the wider implications. These interviews were broadcast on CNN Philippines |
Year(s) Of Engagement Activity | 2018 |
Description | Kick - off meeting in Das Marinas - Feb 2016 |
Form Of Engagement Activity | Participation in an activity, workshop or similar |
Part Of Official Scheme? | No |
Geographic Reach | National |
Primary Audience | Study participants or study members |
Results and Impact | Agree overall objectives and work plan for the project Begin reviewing patient pathways Agree plan for data collation Produce and agree detailed plan for year 1 Engage and enthuse whole project team |
Year(s) Of Engagement Activity | 2016 |
Description | LSTM REF Seminar Panel Discussion |
Form Of Engagement Activity | A formal working group, expert panel or dialogue |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Professional Practitioners |
Results and Impact | A panel discussion relating to advancing the treatment of MDR-TB. Hosted by LSTM in conjunction with their 2021 REF submission. Chaired by Prof Squire, including presentations from three TB-FIT staff and with Dr Charles Yu on the panel. |
Year(s) Of Engagement Activity | 2021 |
URL | https://www.lstmed.ac.uk/advancing-the-clinical-and-public-health-management-of-multi-drug-resistant... |
Description | Meeting with DoH in Manila to discuss project and policy implications |
Form Of Engagement Activity | A formal working group, expert panel or dialogue |
Part Of Official Scheme? | No |
Geographic Reach | National |
Primary Audience | Policymakers/politicians |
Results and Impact | Discussion with colleagues from department of Health National Tuberculosis Program in Manila. |
Year(s) Of Engagement Activity | 2019 |
Description | Model Building Training Workshop |
Form Of Engagement Activity | Participation in an activity, workshop or similar |
Part Of Official Scheme? | No |
Geographic Reach | Local |
Primary Audience | Professional Practitioners |
Results and Impact | Intensive model building workshop for colleagues working on TB-FIT2 project |
Year(s) Of Engagement Activity | 2022 |
Description | PHILCAT 2017 - August 2017 |
Form Of Engagement Activity | A talk or presentation |
Part Of Official Scheme? | No |
Geographic Reach | National |
Primary Audience | Professional Practitioners |
Results and Impact | Presentation of the projects of impact of 11 alternative diagnostic algorithms for TB in Cavite province including a cost effectiveness analysis |
Year(s) Of Engagement Activity | 2017 |
URL | http://www.philcat.org/PDFFiles/TBFITMODELLING8.29.17.pdf |
Description | Patient costing seminars - Nov 2016 and Oct 2017 |
Form Of Engagement Activity | Participation in an activity, workshop or similar |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Professional Practitioners |
Results and Impact | Discussions concerning patient data collection and analysis for TB research and in support of WHO target of eliminating catastrophic costs for patients with TB |
Year(s) Of Engagement Activity | 2017 |
Description | Poster presentation of work at Union World Conference on Lung Health |
Form Of Engagement Activity | A talk or presentation |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Professional Practitioners |
Results and Impact | Poster presentation of our modelling at the Union Conference for Tuberculosis (virtual) |
Year(s) Of Engagement Activity | 2020 |
URL | https://conf2020.theunion.org/ |
Description | Presentation at PHILCAT Annual Convention 2018 |
Form Of Engagement Activity | A talk or presentation |
Part Of Official Scheme? | No |
Geographic Reach | National |
Primary Audience | Policymakers/politicians |
Results and Impact | Presentation to all staff involved in the TB program in the Philippines focusing on patient cost impacts of TB diagnosis and treatment. |
Year(s) Of Engagement Activity | 2018 |
URL | https://www.philcat.org/25thconvention.html |
Description | Presenting of our work to the Department of Clinical Sciences Away Day |
Form Of Engagement Activity | Participation in an activity, workshop or similar |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Professional Practitioners |
Results and Impact | We presented findings of our work and described the methodologies to LSTM research staff in clinical sciences at our annual away day. |
Year(s) Of Engagement Activity | 2021 |
Description | Press release |
Form Of Engagement Activity | A press release, press conference or response to a media enquiry/interview |
Part Of Official Scheme? | No |
Geographic Reach | National |
Primary Audience | Industry/Business |
Results and Impact | A press release written about our work for the manufacturer of the software we build our models in. |
Year(s) Of Engagement Activity | 2019 |
URL | https://www.lanner.com/en-us/insights/news/lanner-s-simulation-technology-deployed-to-help-eradicate... |
Description | Progress meeting in Dasmarinas - July 2016 |
Form Of Engagement Activity | Participation in an activity, workshop or similar |
Part Of Official Scheme? | No |
Geographic Reach | National |
Primary Audience | Study participants or study members |
Results and Impact | Review of patient pathways Detailed review of all data collected Meet with NTP stakeholders Plan next stage |
Year(s) Of Engagement Activity | 2016 |
Description | Project Meeting Training Workshop |
Form Of Engagement Activity | A talk or presentation |
Part Of Official Scheme? | No |
Geographic Reach | National |
Primary Audience | Policymakers/politicians |
Results and Impact | A presentation of our project to clinicians,policy makers and charities. A big discussion on the next stage of the project and how to approach this |
Year(s) Of Engagement Activity | 2019 |
Description | Project Presentation in Dasmarinas - November 2016 |
Form Of Engagement Activity | A talk or presentation |
Part Of Official Scheme? | No |
Geographic Reach | National |
Primary Audience | Policymakers/politicians |
Results and Impact | Presntation at the De La Salle Health Sciences Institute to staff, clinicians, nurses, students, project members and National TB Program managers |
Year(s) Of Engagement Activity | 2016 |
Description | Project meetings and workshops 2018 |
Form Of Engagement Activity | Participation in an activity, workshop or similar |
Part Of Official Scheme? | No |
Geographic Reach | National |
Primary Audience | Study participants or study members |
Results and Impact | Project workshops and meetings in April, August and Dec 2018 in the Philippines to finalize the model, calibrate the model for 2 new regions (Bulacan and Davao) and to record interviews for online and radio transmission. |
Year(s) Of Engagement Activity | 2018 |
Description | Project meetings in the Philippines - 2017 |
Form Of Engagement Activity | Participation in an activity, workshop or similar |
Part Of Official Scheme? | No |
Geographic Reach | Regional |
Primary Audience | Study participants or study members |
Results and Impact | Project meetings took place in the Philippines in April, August, December 2017 and January 2018 |
Year(s) Of Engagement Activity | 2017 |
Description | Project team meeting in Dasmarinas - April 2016 |
Form Of Engagement Activity | Participation in an activity, workshop or similar |
Part Of Official Scheme? | No |
Geographic Reach | National |
Primary Audience | Study participants or study members |
Results and Impact | Understand policy decision making for TB diagnostic algorithms in two ways: What criteria are important? 7 What processes are used to weigh up different criteria? Finalise patient pathway mapping Diagnostic site visits Diagnostic site visits Review data collation for Cavite and the 6 sites to be modelled in detail Discuss the patient costing model and data collection Download the modelling software onto 2 computers in Philippines Detailed plan for next 8 months (up to Dec 2016) Agree timing of next visit |
Year(s) Of Engagement Activity | 2016 |
Description | TB-FiT 2 Virtual Online Project Workshop |
Form Of Engagement Activity | Participation in an activity, workshop or similar |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Professional Practitioners |
Results and Impact | Three day Modelling workshop conducted between UK and Philippines timezones. |
Year(s) Of Engagement Activity | 2020 |
Description | The World Lung Health Conference 2017 - Guadalajara Oct 2017 |
Form Of Engagement Activity | A talk or presentation |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Policymakers/politicians |
Results and Impact | Presented the outcome of detailed patient cost data collected as part of TB-FIT study, including estimates of the proportion of patients suffering catastrophic costs in Cavite province as a result of TB diagnosis and treatment. |
Year(s) Of Engagement Activity | 2017 |
Description | Training in virtual implementation modelling - January 2016 |
Form Of Engagement Activity | Participation in an activity, workshop or similar |
Part Of Official Scheme? | No |
Geographic Reach | National |
Primary Audience | Study participants or study members |
Results and Impact | Training study members and members of the National TB program in how to use Virtual Implementation modelling for impact assessment of new TB diagnostic algorithms |
Year(s) Of Engagement Activity | 2017 |
Description | Training workshop - Jan 2018 |
Form Of Engagement Activity | Participation in an activity, workshop or similar |
Part Of Official Scheme? | No |
Geographic Reach | National |
Primary Audience | Study participants or study members |
Results and Impact | Training workhop to enable De La Salle Medical and Health Sciences Institute colleagues and members of the National TB Program of the Philippines to use the developed Virtual Implementation model to assess impact of new diagnostics for Tuberculosis in the Philippines (Principally focused on 3 provinces - Cavite, Davao and Bulacan) |
Year(s) Of Engagement Activity | 2018 |
Description | Virtual Implementation Training Workshop Part 3 |
Form Of Engagement Activity | Participation in an activity, workshop or similar |
Part Of Official Scheme? | No |
Geographic Reach | National |
Primary Audience | Study participants or study members |
Results and Impact | Training members of the De La Salle Medical and Health Sciences Institute and the National TB Program to use the developed models to project impacts on TB yield, Health systems and patient costs including cost-effectiveness |
Year(s) Of Engagement Activity | 2018 |