Community randomised evaluation of socioeconomic intervention to prevent TB

Lead Research Organisation: Imperial College London
Department Name: Dept of Medicine

Abstract

BACKGROUND. TB kills 1.5 million people each year, more than any other single infection. There is an urgent need to evaluate the impact of new interventions to strengthen TB control. Poverty is increasing globally in cities and urban areas, and is associated with factors that increase TB risk including crowding and malnutrition. Conversely, TB worsens poverty by increasing expenses and reducing income. In addition, those with TB and their families may experience stigma. Poor people have more TB and greater TB-related needs but they tend to have least access to TB care. This mismatch between need for and access to TB care undermines TB control and worsens poverty.

OBJECTIVE. We will evaluate the impact of socioeconomic interventions for reducing poverty, improving access to TB care and consequently reducing the risk of future TB.

SETTING. 24 peri-urban shantytowns in Northern Lima, Peru near the site of our TB control research since 2001. Peru has an acclaimed TB control programme but its levels of TB disease remain high and its rates of multidrug-resistant TB (MDR-TB) have doubled over the last decade to the highest levels in the Americas. The high TB and increasing MDR-TB rates are concentrated in "hotspots" such as poor peri-urban shantytowns surrounding Lima. It is these "hotspots" where we will work.

RELATED WORK. Since 2007, our on going pilot project has been "Innovative Socio-economic Interventions Against TB (ISIAT)" which involves developing and implementing socioeconomic interventions to fight poverty and increase equitable access to TB care. Early analysis of the pilot ISIAT project showed promising results with the interventions described below increasing the number of people to a) complete TB treatment b) complete preventive therapy to prevent them getting TB c) be tested for TB and d) be tested for HIV. These results were published in 2011. The improvement in awareness, prevention and treatment of TB that our work and subsequent article showed has attracted the attention of funding bodies, like the World Bank and The Bill and Melinda Gates Foundation, and policymakers such as the World Health Organisation (WHO) and its Stop-TB department. Our on going relationship and involvement of these organizations and the published results of the pilot ISIAT project are encouraging for future work. The proposed project will rigorously assess the impact of these interventions not just on poverty and access to TB care but also on actual TB control.

INTERVENTIONS AND STUDY DESIGN. The interventions will be inexpensive, involving a team of experts from different fields working with all TB-affected families. They will utilize household visit and fortnightly community meetings to implement an integrated program of social support for enhancing equitable access to TB-related healthcare and economic support to help people to afford TB care and to help them to become less poor.

We will include in the study all members of a household with a new diagnosis of TB, as assessed by the Peruvian national TB program, without age limit, who provides informed written consent.

TB-affected households in 12 intervention communities will be offered the socioeconomic intervention for 6-months whilst the TB patient is receiving TB treatment. TB-affected households in 12 other control communities will be offered no intervention (standard of TB care). We will then re-visit those households 2 years after recruitment to assess what happened to the people with TB and those people in the household exposed to TB, and if our interventions prevented TB and reduced poverty.

BENEFITS: These socio-economic 'structural' interventions will be assessed for their capacity to reduce poverty-related TB risk factors, improve access to TB care and for reducing TB treatment failure, recurrence and transmission. This has potential importance for focusing poverty reduction on those in greatest need and who have the most to benefit and preventing TB.

Technical Summary

BACKGROUND: TB kills more people than any other single infection. New interventions are needed to strengthen TB control. Poverty hampers access to care, increases vulnerability and is the main determinant of global TB rates. Socioeconomic interventions for TB control have been proposed but there is little evidence to guide how they should be used.

PRELIMINARY DATA: Socioeconomic intervention increased equitable access to TB care in our published 4-year pilot study.

HYPOTHESIS: Socioeconomic intervention prevents TB by synergistically improving access to TB care and reducing TB vulnerability.

POPULATION: impoverished shantytown households in which one resident has recently been diagnosed as having TB disease, putting the other residents at high risk of TB disease.

PROPOSAL: A community randomised-controlled study will include 12,552 members of 1,874 households in periurban Lima shantytowns with a registered population of 307,623. The impact of a complex socioeconomic intervention will be assessed by comparing 12 intervention versus 12 control shantytowns. The integrated community-based intervention was developed in our pilot study and includes a social dimension (community mobilisation for health promotion to inform care) and an economic dimension (conditional cash transfers to incentivise and enable care and reduce poverty-related TB vulnerability).

OUTCOMES: The primary outcome will be the impact of the social and economic interventions preventing TB disease assessed by combining incident TB post-intervention with a final prevalence survey of all participants. Secondary outcomes will be the impact of the interventions increasing equitable access to TB care, reducing poverty and associated TB vulnerability and reduction in community TB rates.

CONCLUSION: This study will provide the first evidence assessing the potential of socioeconomic intervention to prevent TB and its potential to expand TB care into community TB control.

Planned Impact

WHICH GROUPS WILL BE IMPACTED?
TB-affected families: This project will have a direct impact on the life of TB patients and their families. By reducing TB dissemination it should also have an indirect impact on the life of other people living in the marginalised, poor communities where TB is most common.

TB & poverty stakeholders: Knowledge generated will benefit policy makers, TB control programs, funding providers, NGOs, charities and institutions working in TB prevention, care and human development.

The project is responding to the World Health Assembly and WHO's recent call for a more integrated approach to the control of diseases disproportionately affecting developing countries. In particular, it responds to the WHO STOP-TB Department increasing interest in innovative interventions to support the current TB control strategy (which is based on case finding and treatment) (Lonnroth K, 2009).

The project will contribute to the generation of better disaggregated data on the TB burden in a peri-urban population, whose paucity represents the first challenge in the prevention of TB in informal settlements like the trial setting (David A, 2008).

The project will also benefit NGOs, charities and institutions working in human development by identifying new routes and partners to widen and enhance the impact of their activities.

HOW WILL THE PROJECT IMPACT THESE GROUPS?
TB-affected families: The project results are intended to benefit the people living with a recent TB-diagnosis in the following ways:

1. In the short term, by directly reducing poverty, improving access and use of TB care, increasing empowerment and consequently improving participants' health.

2. In the medium term, by strengthening the coordinated response of civil society and the State to tackle poverty as a means for TB control, influencing regional and national policy.

3. In the long term by influencing knowledge, understanding, policy and practice nationally and globally, this project will benefit TB-affected families in poor communities on a much greater scale.

TB & poverty stakeholders: The results have the potential to inform policy changes in TB control. TB and poverty stakeholders will be provided with preliminary evidence on the introduction of socioeconomic interventions as an integral part of TB control. This project has the capacity to inspire pragmatic actions for TB control in Peru in the short term. In the medium-longer term, we expect further increased interest from the international donors on this under-researched area, which will lead to the replication and adaptation of the project to other settings. The process evaluation will help understanding of the discrepancies between expected and observed results whilst providing insights into the role of contextual factors and project transferability.

WHAT WILL BE DONE TO ENSURE THIS IMPACT OCCURS?
TB-affected families: The project team will continue their current day-to-day interventional activities to ensure continuing impact for the project participants. The dissemination activities described in this document will ensure that the TB-affected families in other parts of Peru and other countries will similarly benefit in the medium to long term.

TB & poverty stakeholders: The earlier the engagement with policy makers in the evaluation is, the better will be the outcome (Whitehead M, 2004). Engagement of policy makers is on going with field site visits from WHO, The Bill & Melinda Gates Foundation/FIND and World Bank economists are heavily involved in the project. This early and regular engagement with stakeholders beyond the academic research community is essential for achieving global impact. Throughout the project this will increase interest in the importance of addressing social determinants of health, aims to inspire similar projects in different settings, and will guide the translation of project findings into policy and public health impact.

Organisations

Publications

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André E (2018) Patient-led active tuberculosis case-finding in the Democratic Republic of the Congo. in Bulletin of the World Health Organization

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Arriola CS (2014) New insights in cysticercosis transmission. in PLoS neglected tropical diseases

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Arroyo G (2018) Antibody Banding Patterns of the Enzyme-Linked Immunoelectrotransfer Blot and Brain Imaging Findings in Patients With Neurocysticercosis. in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America

 
Title Guide for peer mentors: "Consejeros" 
Description We have developed a short instruction guide for our peer mentors. Peer mentors are patients who are taking TB treatment or who are cured after having previously had TB. Their primary role is to provide peer support to TB affected households facilitating social empowerment through stigma reduction, accompaniment and information. The guide we produced is easy to follow and has been refined after consultation with peer mentors. 
Type Of Art Artefact (including digital) 
Year Produced 2017 
Impact Empowerment of peer mentors through including them in the development process. Many peer mentors are people who have previously been isolated and stigmatised. They have expressed gratitude for being given an opportunity to be community leaders. 
 
Title Informational Booklet for CRESIPT Families 
Description This booklet describes CRESIPT in layman's terms, provides information on prevention and detection of TB, gives access to other social programs and information on TB discrimination laws in one place. The format is accessible for those of all reading levels. It also gives CRESIPT families a sense of identity and belonging in the mini-society we have formed with our intervention, reducing negative feelings associated with TB stigma. 
Type Of Art Artefact (including digital) 
Year Produced 2017 
Impact Patients are better able to understand CRESIPT, have easy access to information about TB, and have a physical representation of belonging to a group. 
URL https://www.canva.com/design/DACF3JW4J94/5dLbIGa3lO_ugeTSiQFrnQ/edit
 
Title Peer mentor certificate and pin 
Description We developed a certificate and pin for our peer mentors. Peer mentors are patients who are taking TB treatment or who are cured after having previously had TB. Their primary role is to provide peer support to TB affected households facilitating social empowerment through stigma reduction, accompaniment and information. The certificate and pin give them formal recognition for the important work that they are involved in delivering. 
Type Of Art Artefact (including digital) 
Year Produced 2017 
Impact Empowerment of peer mentors. Many peer mentors are people who have previously been isolated and stigmatised. They have expressed gratitude for being given an opportunity to be community leaders and feel included in a civil society. The process of formally recognising peer mentors has also led to an increase in uptake of this aspect of the intervention. More TB survivors are now becoming peer mentors and more families affected by TB are willing to engage with peer mentors due to their continued and significant presence at our community events. 
 
Title Personal TB risk score leaflet 
Description We developed a simple leaflet for contacts of patients with tuberculosis that visually expresses their 10-year risk of developing tuberculosis disease. The leaflet is simple and suitable for all reading levels as the applicable sections for contacts are predominantly images. Contacts are recommended to take this leaflet to local health posts to consult with a doctor regarding tuberculosis preventive therapy. 
Type Of Art Artefact (including digital) 
Year Produced 2016 
Impact Through informing people of their tuberculosis risk in a simple and visually facilitative manner, we are empowering high risk contacts of patients with tuberculosis to access health services engage in tuberculosis prevention. 
 
Title Poverty Warriors Youtube video 
Description We are working with an independent film maker to publish on Youtube a video describing this project and its potential importance. The video is complete and is now being edited and permission sought from the participants for publication. 
Type Of Art Film/Video/Animation 
Year Produced 2016 
Impact Surprisingly, participation in the filming of this documentary was popular amongst households living with TB, despite the powerful stigma associated with TB. We are exploring the implications of this surprising finding in case helping people living with TB to video their experiences may paradoxically contribute to TB stigma reduction. 
 
Title Stigma presentation panels 
Description In order to deliver evidence based cognitive therapy to stigmatised people living with tuberculosis we have developed a system using flip charts, labels for emotions, thoughts and behaviours, and flip charts to demonstrate new facts, thoughts and behaviours. These CBT panels are transported throughout Lima to the different sites where we work. 
Type Of Art Artefact (including digital) 
Year Produced 2016 
Impact The CBT panels have facilitated the delivery of CBT to TB-affected people in a resource limited setting. 
 
Title TB Stigma Drawings Booklet 
Description Booklets containing a series of hand-drawn colored pictures depicting culture-specific, locally-relevant events, situations, or encounters in which people with TB may experience enacted, anticipated, and TB self- stigma are used in TB Clubs by people with TB and their family members to facilitate identification of emotions, thoughts, and behaviors associated with these three stigma types. Each TB club member is provided a booklet and asked to think about an event, situation, or encounter in which they personally experienced TB stigma. The drawings serve as examples and memory prompts. Club members then describe their experience of TB stigma -- the emotions, associated thoughts, and resultant behaviors. Beyond building supportive networks among club members, identifying and sharing these particular components of their experiences provides the foundation steps for employing cognitive behavior therapy techniques to then explore alternative thoughts and behaviors that serve to empower club members in achieving goals, e.g. adhering to and completing TB treatment, having family members tested for TB. 
Type Of Art Artwork 
Year Produced 2016 
Impact The impact of this research is still being evaluated as the CRESIPT study is currently in the delivery phase. 
 
Title Training Video of Production and Utilization of the Colour Test, a TB rapid diagnostic tool 
Description The Colour Test is a low-cost, low-tech rapid diagnostic tool that we have developed and utilize to diagnose patients with TB in CRESIPT. This tool is particularly useful in that it provides an alternative to high tech and/or expensive rapid diagnostic tools for TB and can find drug resistant strains of TB, which is especially useful in low-resource areas. While we have a written manuscript, we find that an accompanying visual component is helpful in understanding how to develop this tool and provides an alternative to face-to-face training here in Lima. We hope to publish this video with open-access in the Journal of Visualized Experiments, a journal dedicated to distributing accompanying video content. 
Type Of Art Film/Video/Animation 
Year Produced 2017 
Impact We aim for this video to be a useful tool for our peers abroad, so that they may be able to utilize the Colour Test in low-resource areas throughout the world. 
 
Title WORDS AND PHRASES USED BY TB-AFFECTED HOUSEHOLDS TO DESCRIBE THE STIGMA OF TB 
Description A multi-colored, 3 ft x 6 ft, digital poster summarizing the main points of an abstract of the same name, including a word cloud and 2 tables. 
Type Of Art Artefact (including digital) 
Year Produced 2019 
Impact Displayed for approximately 24 hours during the 2019 END TB Conference sponsored by the North American Region of the International Union of Tuberculosis and Lung Disease in Vancouver, BC, Canada. 
 
Title World Bank empowerment documentary 
Description Collaborators in the World Bank are preparing a video documentary showcasing success stories in empowerment in Peru. They have included several filmed interviews with one of our project participants. A TB-affected patient and household living in a peri-urban shantytown / slum who was supported by our research project to tackle social and economic challenges associated with TB disease and TB treatment. 
Type Of Art Film/Video/Animation 
Year Produced 2016 
Impact This has been a highly and surprisingly positive experience for the filmed household who have overcome, and put aside the stigma and marginalisation that cause most people living with TB in Peru to keep their contagious disease a secret. Further impacts are expected when the World Bank completes and publicises their venture. The involvement of the participant from our project is already complete. 
 
Guideline Title NICE 2016 TB Guidelines - screening of contacts of patients with extrapulmonary TB being revisited.
Description Article in Thorax being reviewed by NICE TB Guideline Committee members
Geographic Reach National 
Policy Influence Type Citation in clinical guidelines
 
Description Collaboration with Peru's National TB Strategy
Geographic Reach National 
Policy Influence Type Influenced training of practitioners or researchers
Impact Qualitative data arising from a research study that investigated the social determinants that contribute to diagnostic delay has been and is continuing to be reviewed by leaders in the National TB Strategy of Peru. This data will be used to modify and/or implement policy that may change relationships between patients and their various healthcare providers to reduce diagnostic delay of tuberculosis disease.
 
Description Contact investigation and TB preventive therapy
Geographic Reach National 
Policy Influence Type Influenced training of practitioners or researchers
Impact We have been extensively involved with the Peruvian NTP aiming to increase coverage of contact investigation and TB preventive therapy. Our data analysis and evidence presented at various meetings has led to the NTP endorsing a new policy for which contacts should receive TB preventive therapy. We are currently evaluating this policy as part of our study. This new policy aims to increase coverage of TB preventive therapy, reduce TB incidence in household contacts, and ultimately therefore improve quality of life.
 
Description Health Promotion Workers TB Training Workshop
Geographic Reach South America 
Policy Influence Type Influenced training of practitioners or researchers
Impact This important workshop for frontline health promotion workers in Ventanilla was an essential part of disseminating the results of our research in a way that directly impacted the population we serve through our work. These health workers provide regular house visits and foster relationships with the most in need communities in order to provide essential education and guidance towards accessing healthcare appropriately and promptly. We trained these individuals with a series of talks and open peer discussion with the results of our work so far around risk factors for TB, advising how to overcome the barriers to accessing healthcare and around reducing simple daily costs which could all make a significant benefit to patient and household TB outcomes as well as build the basis for future engagement and collaboration.
 
Description Implementation of the use rapid molecular DST
Geographic Reach National 
Policy Influence Type Influenced training of practitioners or researchers
Impact The patients have a screeing of MDR TB on the same day they are diagnosed by TB
 
Description International Health Unit, Imperial College London
Geographic Reach Europe 
Policy Influence Type Participation in a advisory committee
Impact Informs national and international TB policy and practice through our extensive collaborations with diverse organisations in the UK and across Europe. Key interests include: Barriers to healthcare among hard-to-reach migrants, and the impact on migrants, the endogenous population, and the NHS The relationship between the social, behavioural and psychological impact of TB and similar diseases of poverty on migrant and local populations
URL http://www.imperial.ac.uk/department-of-medicine/research/infectious-diseases/infectious-diseases-im...
 
Description Membership of National Committee for Paediatric Tuberculosis
Geographic Reach National 
Policy Influence Type Membership of a guideline committee
Impact Dr Marco Tovar (a key, leading member of our team) is now a member of the Peruvian National Advisory Committee on Paediatric TB. This expert committee is responsible for reviewing evidence and proposing changes to national tuberculosis guidelines. Dr Tovar has been advocating for changes to national guidelines based on the results of our own research.
 
Description Participation in Global TB Caucus
Geographic Reach Multiple continents/international 
Policy Influence Type Participation in a advisory committee
Impact The Global TB Caucus is a unique global network of parliamentarians united by their shared commitment to end the tuberculosis (TB) epidemic. Led by its members for its members, the Caucus aims to transform the response to TB through targeted interventions at national, regional, continental, and global levels. The Caucus is led by Dr Aaron Motsoaledi, Minister of Health for South Africa, and the Rt Hon Nick Herbert MP from the United Kingdom. Under the leadership of Dr Motsoaledi and Mr Herbert, the network has grown to one of the world's largest parliamentary networks with 2,300 members in more than 130 countries. We are involved in the Caucus in an advisory role.
URL https://www.globaltbcaucus.org
 
Description Post TB lung disease steering committee
Geographic Reach Multiple continents/international 
Policy Influence Type Participation in a advisory committee
 
Description Reducing TB patient costs and lost income during illness
Geographic Reach Local/Municipal/Regional 
Policy Influence Type Participation in a national consultation
 
Description Setting the national Peruvian TB research priorities
Geographic Reach National 
Policy Influence Type Participation in a national consultation
Impact Prof Carlton Evans, Drs Marco Tovar and Sumona Datta were involved in the "Taller determinacion de prioridades nacionales de investigacion en tuberculosis en Peru, 2018-2021", which was a working group meeting with TB researchers based in Peru, at the request of the Ministry of health, national TB program to set the 2018-2021 TB research agenda. This was as a consequence of the WHO and PAHO declaring Peru as one of their "model" TB research countries. This was held in Lima, Peru on 21st December 2017.
 
Description Task force on UHC social protection - subgroup on measurements
Geographic Reach Multiple continents/international 
Policy Influence Type Membership of a guideline committee
Impact This is part of the World Health Organisation global TB program post-2015 draft TB control strategy. Thus this group is influencing policy that will have health and economic impacts.
 
Description The New TB elimination strategy
Geographic Reach Multiple continents/international 
Policy Influence Type Citation in other policy documents
 
Description Training to principles TB laboratory focusing on tuberculosis diagnosis and biosefaty
Geographic Reach South America 
Policy Influence Type Influenced training of practitioners or researchers
Impact During this period of time, our TB laboratory in Cayetano Heredia University collaborated with the NAMRU-6 in Lima, Peru in order to implement the basic conditions to develop tuberculosis diagnosis using simple and practical conditions specially with the military laboratories from Guatemala, Belize, El Salvador, Nicaragua, Honduras, Dominican Republic, Colombia and Peru also. The useful for this kind of training was very useful to develop strategies to develop tuberculosis diagnosis and to improvement the biosafety conditions.
 
Description WHO TB Patient Costs Survey Handbook - Core Author
Geographic Reach Multiple continents/international 
Policy Influence Type Membership of a guideline committee
Impact Measurement of TB patients costs in 15 countries to date nationally. This is expanding all the time. I am running a costs survey in Nepal and potentially one in Mozambique. Identifying these costs has allowed them to be addressed more objectively. I am now working to try and develop tailored socioeconomic support packages for TB-affected households in diverse settings.
URL http://www.who.int/tb/publications/patient_cost_surveys/en/
 
Description WHO post-2015 global TB control strategy
Geographic Reach Multiple continents/international 
Policy Influence Type Citation in other policy documents
Impact International guidance calling for zero TB-affected families to incur catastrophic costs associated with TB treatment
URL http://www.who.int/tb/post2015_tbstrategy.pdf?ua=1
 
Description Wellcome Center at Imperial College London Global Health Research Steering Committee
Geographic Reach Multiple continents/international 
Policy Influence Type Membership of a guideline committee
Impact The Wellcome Trust-Imperial College Centre for Global Health Research is one of the five UK-wide centres funded by the Wellcome Trust to enhance global health research. The Centre aims to initiate and foster research that improves health, and reduces inequalities in health and healthcare, through the generation and deployment of knowledge that can lead to more effective and equitable prevention and treatment of illness, and to promoting positive health over the life course. The steering committee set the research agenda for this Centre, which has already made numerous discoveries that have changed global health policy.
URL https://www.imperial.ac.uk/global-health-innovation/global-engagement/wellcome-centre-for-global-hea...
 
Description Academy of Medical Sciences Young Investigator Award 2017
Amount £1,250 (GBP)
Organisation Academy of Medical Sciences (AMS) 
Sector Charity/Non Profit
Country United Kingdom
Start 03/2017 
End 04/2017
 
Description American Society of Tropical Medicine and Hygiene Travel Scholarship
Amount $2,000 (USD)
Organisation American Society of Tropical Medicine and Hygiene 
Sector Learned Society
Country United States
Start 11/2014 
End 11/2014
 
Description Beca Doctorado en el Extranjero
Amount $210,233 (USD)
Organisation National Council for Science, Technology and Technological Innovation (CONCYTEC) 
Sector Public
Country Peru
Start 10/2018 
End 09/2021
 
Description British Infection Association Research Project Primer Grant
Amount £5,000 (GBP)
Organisation British Infection Association (BIA) 
Sector Charity/Non Profit
Country United Kingdom
Start 09/2013 
End 03/2014
 
Description British Infection Association Travel Award
Amount £800 (GBP)
Organisation British Infection Association (BIA) 
Sector Charity/Non Profit
Country United Kingdom
Start 11/2013 
End 11/2013
 
Description CONCYTEC Grand Challenge Explorations
Amount S/.130,000 (PEN)
Funding ID 0XX-2014 
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Sector Public
Country Peru
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End 04/2016
 
Description Dorey Bequest Travel Award
Amount £600 (GBP)
Organisation Royal College of Ophthalmologists 
Sector Learned Society
Country United Kingdom
Start 02/2018 
End 07/2018
 
Description Ethicon Foundation Fund
Amount £1,500 (GBP)
Organisation Royal College of Ophthalmologists 
Sector Learned Society
Country United Kingdom
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Description Fellowship for Dr Tom Wingfield
Amount £5,000 (GBP)
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Sector Charity/Non Profit
Country Peru
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Description Gates Grand Challenges Explorations
Amount $100,000 (USD)
Funding ID OPP1118545 
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Sector Charity/Non Profit
Country United States
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Description Glasgow Liverpool Wellcome Trust Centre For Global Health Research Flexible Funding Pot
Amount £5,900 (GBP)
Organisation Wellcome Trust 
Sector Charity/Non Profit
Country United Kingdom
Start 02/2017 
End 06/2018
 
Description Global Emerging Infection Surveillance and Response ...GEISS
Amount $200,000 (USD)
Funding ID Constitutes 120,000 USD contract to our team and 80,000 for collaborative work 
Organisation United States Department of Defense via NAMRU-6 
Sector Public
Country United States
Start 10/2014 
End 10/2015
 
Description Global Emerging Infection Surveillance and Response ...GEISS
Amount $196,000 (USD)
Funding ID Constitutes 165,000 USD contract for our team research plus 31,000 USD for collaborative activities 
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Sector Public
Country United States
Start 10/2013 
End 10/2014
 
Description Grand Challenges Canada Explorations
Amount $50,000 (CAD)
Funding ID 0665-01-10 
Organisation Government of Canada 
Department Grand Challenges Canada
Sector Public
Country Canada
Start 10/2014 
End 04/2016
 
Description IFHAD Clinical Research Fellowship
Amount £5,000 (GBP)
Organisation Innovation For Health and Development (IFHAD) 
Sector Charity/Non Profit
Country Peru
Start 09/2015 
End 07/2016
 
Description Imperial College Global Health Clinical Fellowship Scheme ISSF
Amount £60,000 (GBP)
Organisation Imperial College London 
Department NIHR/Wellcome Trust Imperial Clinical Research Facility
Sector Public
Country United Kingdom
Start 10/2013 
End 12/2014
 
Description Imperial College London Wellcome Trust Infection and Global Health Research Annual Meeting: for 3 people
Amount £4,000 (GBP)
Organisation Imperial College London 
Sector Academic/University
Country United Kingdom
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End 11/2014
 
Description Innovation For Health And Development (IFHAD) PhD Fellowship
Amount £5,000 (GBP)
Organisation Innovation For Health and Development (IFHAD) 
Sector Charity/Non Profit
Country Peru
Start 02/2013 
End 08/2013
 
Description Innovation for Health and Development Clinical Research Fellowship
Amount £5,000 (GBP)
Organisation Innovation For Health and Development (IFHAD) 
Sector Charity/Non Profit
Country Peru
Start 07/2015 
End 03/2016
 
Description Innovation for Health and Development Research Fellowship
Amount $5,400 (USD)
Organisation Imperial College London 
Sector Academic/University
Country United Kingdom
Start 09/2016 
End 09/2017
 
Description Intergrated Clinical Academic Training Short Experience Fellowship
Amount £3,530 (GBP)
Organisation National Institute for Health Research 
Sector Public
Country United Kingdom
Start 02/2017 
End 11/2017
 
Description International Union against Tuberculosis and Lung Disease Travel Grant
Amount $2,000 (CAD)
Organisation International Union Against Tuberculosis and Lung Disease (The Union) 
Sector Charity/Non Profit
Country Global
Start 02/2016 
End 02/2016
 
Description Johns Hopkins Bloomberg School of Public Health - the Dean's Scholarship
Amount $2,500 (USD)
Organisation Johns Hopkins University 
Sector Academic/University
Country United States
Start 06/2015 
End 06/2016
 
Description Joint Global Health Trials stipend for research from Dr Carlton Evans' grant
Amount £28,800 (GBP)
Funding ID Joint Global Health Trials P43878 
Organisation Medical Research Council (MRC) 
Sector Academic/University
Country United Kingdom
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End 02/2015
 
Description Linacre Lecture Award
Amount £750 (GBP)
Organisation Royal College of Physicians of London 
Sector Academic/University
Country United Kingdom
Start 01/2016 
End 01/2016
 
Description Minor Field Studies Grant
Amount 27,000 kr (SEK)
Organisation Swedish International Development Cooperation Agency 
Sector Public
Country Global
Start  
 
Description National Institutes of Health Fogarty Global Health Fellowship
Amount $32,228 (USD)
Funding ID R25TW009340 
Organisation Fogarty International Centre 
Sector Public
Country United States
Start 07/2016 
End 05/2017
 
Description Overseas Development Assistance Research Seed Fund
Amount £8,980 (GBP)
Organisation Higher Education Funding Council for England 
Sector Public
Country United Kingdom
Start 02/2017 
End 04/2017
 
Description Project Primer Grant
Amount £5,000 (GBP)
Organisation British Infection Association (BIA) 
Sector Charity/Non Profit
Country United Kingdom
Start 01/2013 
End 01/2014
 
Description Royal Society of Medicine Ophthalmology Fellowship
Amount £750 (GBP)
Organisation Royal Society of Medicine 
Sector Learned Society
Country United Kingdom
Start 08/2017 
End 07/2018
 
Description TB REACH Wave 5
Amount $400,000 (USD)
Organisation Stop TB Partnership 
Sector Charity/Non Profit
Country Switzerland
Start 04/2017 
End 10/2018
 
Description TB Union North America Region Annual Conference Travel Award
Amount $1,400 (CAD)
Organisation International Union Against Tuberculosis and Lung Disease (The Union) 
Sector Charity/Non Profit
Country Global
Start 02/2013 
End 03/2013
 
Description The TB Union Travel Award (International meeting in Paris, 2013 - funded travel to present as speaker)
Amount £500 (GBP)
Organisation International Union Against Tuberculosis and Lung Disease (The Union) 
Sector Charity/Non Profit
Country Global
Start 11/2013 
End 11/2013
 
Description The travel grant to attend to the 47th Union World Conference on Lung Health Liverpool, UK: 26 October - 29 October 2016
Amount S/.7,000 (PEN)
Organisation Innovation For Health and Development (IFHAD) 
Sector Charity/Non Profit
Country Peru
Start 10/2016 
End 10/2016
 
Description The travel to attend to the 44th Union World Conference on Lung Health. Paris, France: 31 October - 4 November 2013
Amount € 2,000 (EUR)
Organisation International Union Against Tuberculosis and Lung Disease (The Union) 
Sector Charity/Non Profit
Country Global
Start 10/2013 
End 11/2013
 
Description Travel Award * 3 persons Vancouver
Amount £3,000 (GBP)
Organisation International Union Against Tuberculosis and Lung Disease (The Union) 
Sector Charity/Non Profit
Country Global
Start 02/2013 
End 03/2013
 
Description Travel Award - Bahia
Amount $2,000 (USD)
Organisation World Health Organization (WHO) 
Sector Public
Country Global
Start  
 
Description Travel Award - Paris
Amount $2,000 (USD)
Organisation International Union Against Tuberculosis and Lung Disease (The Union) 
Sector Charity/Non Profit
Country Global
Start  
 
Description Travel Grant
Amount £800 (GBP)
Organisation International Union Against Tuberculosis and Lung Disease (The Union) 
Sector Charity/Non Profit
Country Global
Start 10/2016 
End 10/2016
 
Description Travel Grant - Birmingham
Amount £750 (GBP)
Organisation British Infection Association (BIA) 
Sector Charity/Non Profit
Country United Kingdom
Start  
 
Description Travel Grant - Sao Paulo
Amount $2,000 (USD)
Organisation United States Agency for International Development 
Sector Public
Country United States
Start 01/2013 
End 01/2013
 
Description Travel Grant - Sao Paulo
Amount $1,500 (USD)
Organisation World Health Organization (WHO) 
Sector Public
Country Global
Start  
 
Description Travel Grant to attend the Joint 20th Conference of The Union North America Region and the National TB Controllers Association
Amount $2,000 (CAD)
Organisation International Union Against Tuberculosis and Lung Disease (The Union) 
Sector Charity/Non Profit
Country Global
Start 02/2016 
End 02/2016
 
Description Travel Grant to participate in The International Union Against TB & Lung Disease 46th Annual Conference
Amount £1,700 (GBP)
Organisation Innovation For Health and Development (IFHAD) 
Sector Charity/Non Profit
Country Peru
Start 12/2015 
End 12/2015
 
Description Travel Grant to work in a consultancy capacity for World Health Organisation
Amount £600 (GBP)
Organisation World Health Organization (WHO) 
Sector Public
Country Global
Start 03/2017 
End 03/2017
 
Description Travel Scholarship ASTMH
Amount $2,000 (USD)
Organisation American Society of Tropical Medicine and Hygiene 
Sector Learned Society
Country United States
Start 11/2014 
End 11/2014
 
Description Travel Scholarship International Union
Amount € 1,000 (EUR)
Organisation International Union Against Tuberculosis and Lung Disease (The Union) 
Sector Charity/Non Profit
Country Global
Start 10/2014 
End 10/2014
 
Description Travel grant to Social Protection Action Research and Knowledge Sharing (SPARKS) network meeting
Amount £700 (GBP)
Organisation Karolinska Institute 
Sector Academic/University
Country Sweden
Start 12/2016 
End 12/2016
 
Description Travel grant to attend the 21st Annual Conference of the Union - North American Region in Vancouver, BC
Amount $2,000 (CAD)
Organisation The Union North America Region 
Sector Charity/Non Profit
Country United States
Start 02/2017 
End 02/2017
 
Description Travel grant to attend to the 17th Conference of The Union North America Region. 28 February-2 March 2013
Amount $1,200 (CAD)
Organisation The Union North America Region 
Sector Charity/Non Profit
Country United States
Start 02/2013 
End 02/2013
 
Description US-CDC Travel Award
Amount £2,000 (GBP)
Organisation International Union Against Tuberculosis and Lung Disease (The Union) 
Sector Charity/Non Profit
Country Global
Start 12/2015 
End 12/2015
 
Description USAID Travel Scholarship to present at USAID and WHO catastrophic costs and universal health coverage symposium
Amount $2,200 (USD)
Organisation United States Agency for International Development 
Sector Public
Country United States
Start 04/2013 
End 04/2013
 
Description Union against TB and lung disease North American Region Conference Travel grant
Amount $2,500 (USD)
Organisation International Union Against Tuberculosis and Lung Disease (The Union) 
Sector Charity/Non Profit
Country Global
Start 02/2013 
End 02/2013
 
Description Union against TB and lung disease North American Region Conference Travel grant
Amount $2,500 (CAD)
Organisation International Union Against Tuberculosis and Lung Disease (The Union) 
Sector Charity/Non Profit
Country Global
Start 02/2016 
End 02/2016
 
Description Wellcome Trust Imperial College Centre for Global Health Research Seed Grant
Amount £9,295 (GBP)
Organisation Imperial College London 
Sector Academic/University
Country United Kingdom
Start 01/2018 
End 09/2018
 
Description Wellcome Trust Imperial College Centre for Global Health Research Travel Award
Amount £901 (GBP)
Organisation Imperial College London 
Sector Academic/University
Country United Kingdom
Start 11/2017 
End 11/2017
 
Description Wellcome Trust Institutional Strategic Support Fund for Global Health Research Fellowship
Amount £67,490 (GBP)
Funding ID PS3059_WHRP 
Organisation Imperial College London 
Sector Academic/University
Country United Kingdom
Start 09/2017 
End 08/2018
 
Description Wellcome Trust Research Training Fellowship
Amount £251,068 (GBP)
Funding ID 201251/Z/16/Z 
Organisation Wellcome Trust 
Sector Charity/Non Profit
Country United Kingdom
Start 04/2016 
End 04/2020
 
Title "5 Words" Survey 
Description A survey was conducted during a 6 month period of the initial pilot phase of the CRESIPT study in which people with TB and their family members, after having participated in TB workshops that included TB-stigma and empowerment education, were each asked to provide 5 words that best described what TB stigma and empowerment meant to them. These responses were then collated to create 2 shortened lists of the most frequently-used words to describe TB stigma and empowerment. These 2 shortened lists were then used to inform the development of a cognitive behavior therapy-based TB support group intervention to reduce anticipated and TB self-stigma, and empower people with TB and their family members to achieve TB diagnosis and cure. 
Type Of Material Physiological assessment or outcome measure 
Provided To Others? No  
Impact The impact of this research is still being evaluated as the CRESIPT study is currently in the delivery phase. 
 
Title Anticipated TB Stigma Questionnaire 
Description We have adapted the Explanatory Model Interview Catalog (EMIC) to measure anticipated TB stigma among people with TB. The EMIC is a validated research tool developed to identify patterns of distress, perceived causes, help-seeking and treatment preferences, and general illness beliefs from the experience and perspective of people directly affected by a particular illness. Our TB-adapted questionnaire is being administered to participants in both the intervention and control groups of the CRESIPT study, both pre- and post-intervention, in order to establish baseline measurements of existing anticipated TB stigma, and demonstrate the effect of an anticipated TB stigma reduction intervention. 
Type Of Material Physiological assessment or outcome measure 
Provided To Others? No  
Impact The impact of this research is still being evaluated as the CRESIPT study is currently in its delivery phase. 
 
Title Carbendazim enriched culture media for Mycobacterium tuberculosis detection 
Description Many cultures fail due to contamination. We have tried and testing the addition of carbendazim, an anti-fungal in culture media reducing contamination rates in our laboratory in Lima, Peru by 90%. 
Type Of Material Technology assay or reagent 
Year Produced 2013 
Provided To Others? Yes  
Impact Please published abstracts in the publications section. 
 
Title Catastrophic costs measurement methodology 
Description Definition of catastrophic costs for TB-affected families has been unclear. We devised a definition that was both locally-appropriate and clinically-relevant. 
Type Of Material Improvements to research infrastructure 
Year Produced 2014 
Provided To Others? Yes  
Impact We were able to develop this with the WHO working group on social protection and UHC. This has since been published in PLOS Medicine to be used as an example for other research groups. 
URL http://www.plosmedicine.org/article/info%3Adoi%2F10.1371%2Fjournal.pmed.1001675
 
Title Data Collection Instruments 
Description Data collection instruments aiming to assess the socio-economic position (poverty), depression, stigma and TB risk factors of patients and people at risk of becoming TB patients. 
Type Of Material Improvements to research infrastructure 
Year Produced 2012 
Provided To Others? Yes  
Impact This tool is in development stage, due to be piloted in the coming months. We have shared it freely with collaborators and anyone who requests it, in order to facilitate their research and work. 
 
Title Development of a household-level TB risk score 
Description We have derived and externally validated a score that can be used to identify households in which any contact, of any age, is at high risk of having tuberculosis disease within three years. This score can be used in all currently tuberculosis-affected households, including those in which the patient has extra-pulmonary tuberculosis, and can be found at this link: https://jscalc.io/calc/8xzrWJ99BMs6uCV7 
Type Of Material Model of mechanisms or symptoms - human 
Year Produced 2018 
Provided To Others? Yes  
Impact We have now begun collaborative research with the Peruvian health system in Iquitos to externally validate this tool in a different setting. 
URL http://www.ifhad.org/risk
 
Title Internalized TB Beliefs, Attitudes, and Fear of Discrimination Among People Without TB Questionnaire 
Description We have adapted the Explanatory Model Interview Catalog (EMIC) to measure negative beliefs, attitudes, and fear of discrimination related to TB among people both with and without TB. The EMIC is a validated research tool developed to identify patterns of distress, perceived causes, help-seeking and treatment preferences, and general illness beliefs from the experience and perspective of people directly affected by a particular illness. Our TB-adapted questionnaire is being administered to participants in both the intervention and control groups of the CRESIPT study, both pre- and post-intervention, in order to establish baseline measurements of these stigma components and demonstrate the effect of a TB stigma reduction intervention. In addition, non-TB-affected members of the same communities, not participating in the CRESIPT study, are also being surveyed to establish baseline measurements of these TB stigma components among this group. 
Type Of Material Physiological assessment or outcome measure 
Provided To Others? No  
Impact The impact of this research is still being evaluated as the CRESIPT study is currently in the delivery phase. 
 
Title Quality Assurance 
Description For data collection, data entry and database management, and laboratory techniques, a paired system of quality assurance has been developed and implemented. Team members are responsible for pairing monthly with another team member to monitor and evaluate if research methods adhere to team protocols. Team members follow a guided checklist of essential research methods and correct non-adherences if they appear. 
Type Of Material Improvements to research infrastructure 
Provided To Others? No  
Impact A systematic quality assurance program ensures better data collection, data entry and database management, and laboratory procedures. 
 
Title Research nurse based poverty assessment 
Description We have evaluated a nurse based poverty assessment for estimating household socioeconomic position. During a household visit, trained research nurses complete a visual analogue scale characterising their perception of household socioeconomic position. 
Type Of Material Physiological assessment or outcome measure 
Year Produced 2017 
Provided To Others? No  
Impact This tool is currently under evaluation. Initial results suggest the VAS correlates well with objective markers of poverty (e.g. income, assets, and access to services), and with TB adverse outcomes (treatment abandonment and TB disease among contacts). Evaluation of this VAS will therefore potentially significantly improve the efficiency of our data collection in the future. Currently our questionnaire is very detailed and time consuming. If the initial results and associations we observe hold true, we may significantly reduce the number of questions we ask. 
 
Title Research nurse based ventilation assessment 
Description Because reduced ventilation increases the risk of TB transmission to contacts, we have evaluated a nurse based ventilation assessment for estimating how well ventilated a household is. During a household visit, trained research nurses complete a visual analogue scale characterising their perception of household ventilation. 
Type Of Material Physiological assessment or outcome measure 
Year Produced 2017 
Provided To Others? No  
Impact The tool is currently under evaluation. Initial results suggest this VAS is a good predictor of the risk of TB disease among household contacts, independently of household socioeconomic position. In the future we hope to assess the association of this VAS with objective measures of ventilation. If the VAS were to predict objective ventilation it would provide a simple field alternative to resource intensive measures of ventilation. 
 
Title Single Step decontamination for TB cultures 
Description TB culture often is marred by contamination from comensal bacteria and fungi, often reducing the quality of results. A single step decontamination with trisodium phosphate prior to placement of TB samples into standard Lowenstein-Jensen (LJ) media, has been noted to reduce growth of contaminant fungi in TB cultures. Our lab uses a trisodium phosphate solution, where the samples are placed for 20 minutes and then transferred to the LJ media. 
Type Of Material Biological samples 
Year Produced 2016 
Provided To Others? Yes  
Impact This single step decontamination was used in the assessment of TB aerosol filters as a measure of infectivity of TB patients. In all clinical aerosol filter samples, no fungi or bacterial contamination was found following single step decontamination. In a concurrent validation experiment with fungi and TB, the single step decontamination also proved effective in decreasing fungal overgrowth. 
 
Title Supportive measures addressing mental health issues amongst TB patients 
Description Best evidence based supportive/treatment measures used to address mental health issues amongst TB patients to improve TB treatment compliance and TB outcomes. 
Type Of Material Model of mechanisms or symptoms - human 
Provided To Others? No  
Impact Initial development stage. Publication is in progress. 
 
Title TB Intermittent therapy definition 
Description At present, there is no agreed consensus defining intermittent adherence. In order to address this knowledge gap, we aimed to create an operational definition of intermittent adherence during the two phases of DOTS, characterise its association with clinical and socioeconomic risk factors and examine its association with the risk of TB recurrence. 
Type Of Material Model of mechanisms or symptoms - human 
Provided To Others? No  
Impact It is important to establish a standardized clinically-relevant threshold to classify intermittent or irregular adherence in order to allow comparison of adherence rates and clinical relevance in future studies. 
 
Title TB Self-stigma Questionnaire 
Description We have adapted the Internalized Stigma of Mental Illness Scale (ISMIS) to measure TB self-stigma among people with TB. The ISMIS is a validated research tool developed to measure self-stigma among people with psychiatric disorders. Our TB-adapted questionnaire is being administered to participants in both the intervention and control groups of the CRESIPT study, both pre- and post-intervention, in order to establish baseline measurements of existing TB self-stigma, and demonstrate the effect of a TB self-stigma reduction intervention. 
Type Of Material Physiological assessment or outcome measure 
Provided To Others? No  
Impact The impact of this research is still being evaluated as the CRESIPT study is currently in its delivery phase. 
 
Title TB knowledge questionnaire 
Description Created and implemented a TB knowledge questionnaire to highlight knowledge gaps. This is a self-rated questionnaire of multiple choice questions related to TB care, and health rights. 
Type Of Material Physiological assessment or outcome measure 
Provided To Others? No  
Impact Knowledge gaps will be addressed to tailor educational activities to improve TB control, and health related advocacy 
 
Title Thin-layer agar culture testing for TB prevalence surveys 
Description Most prevalence surveys collect sputum for microscopy testing. However, it is well known that microscopy has poor diagnostic sensitivity although cheap and appropriate for studies with high sample flows. We have implemented a simple culture technique using single step decontamination (please see entry in research tool for further explanation) and antimicrobial enriched thin-layer agar, to reduce the steps required for standard culture. This simple tool therefore is feasible for prevalence surveys, increasing the detection rates with a reduced workload and contamination rates than standard culture. This tool will be used for TB detection in the prevalence survey aspect of the CRESIPT study. 
Type Of Material Technology assay or reagent 
Year Produced 2016 
Provided To Others? No  
Impact Results from our prevalence survey have been published in abstract form, please see publication section, and full manuscripts are in preparation. 
 
Title Tool to estimate 'preventability' of direct and indirect TB related costs 
Description A mixed-methods questionnaire tool was designed, tested and developed in the field to estimate to what degree indirect and direct costs incurred by TB patients are preventable or can be reduced. 
Type Of Material Physiological assessment or outcome measure 
Provided To Others? No  
Impact First group to knowingly describe this outcome measure. Assists in the innovation of interventions to reduce these costs and prevent catastrophic costs - therefore addressing the new Stop TB and WHO priorities focussed around social protection and eradicating catastrophic costs for TB affected households. These interventions will then be carried out and evaluated, then the findings disseminated to share with other research communities globally. 
 
Title Training Video of Ventilation Methods 
Description Currently developing a training video of ventilation methods, based on the work of Richard Menzies and A. Roderick Escombe. Ventilation is crucial in the prevention of TB, a complement to isoniazid prevention therapy in TB patients household contacts. It is our hope that producing this video facilitate our peers' utilization of this low-cost, low-tech method. We hope to publish this video in the Journal of Visualized Experiments (JoVE), a journal dedicated to distributing video content to researchers. 
Type Of Material Technology assay or reagent 
Year Produced 2017 
Provided To Others? Yes  
Impact Once the video is distributed in JoVE, we hope that our peers abroad may be able to use this tool in order to prevent new infections of TB worldwide. 
 
Title Tuberculosis Patient Costs Survey Handbook 
Description Background To inform policy and practices for improved social protection of TB patients and affected households, and to reach the 2020 End TB Strategy target that no TB patient or their household should face "catastrophic total costs" due to TB, WHO is supporting countries to design, implement, analyze and translate into policy recommendations TB patient cost surveys. In 2015, the WHO Global TB Programme convened a Global task force on TB patient cost surveys and developed a field-testing protocol and survey instrument for the conduct of nationally-representative, health-facility-based surveys. The latter were used and evaluated in 10 countries ahead of a second Task Force meeting in 2017, where the survey methodology was reviewed and revised. Overview This handbook builds on lessons learned from surveys implemented 2015-2017 and advice provided by the Global task force on TB patient cost surveys. It provides a standardized methodology for conducting health facility-based cross-sectional surveys to assess the direct and indirect costs incurred by TB patients and their households. In addition, it provides recommendations on results dissemination, engaging across sectors in policy dialogue and enabling action and related research for effective modifications in care delivery models, in patient support, and wider cross-sectoral interventions. These surveys have two primary objectives: To document the magnitude and main drivers of different types of costs incurred by TB patients (and their households), in order to guide policies to reduce financial barriers to accessing care and minimize the adverse socioeconomic impact of TB. To determine the baseline and periodically measure the percentage of TB patients (and their households) treated in the national TB programme (NTP) network who incur catastrophic total costs due to TB. This information is needed to monitor progress towards one of the three high-level indicators of the End TB Strategy for which targets and milestones have been set. Audience National TB Programmes and partners involved in supporting TB programme planning, implementation, evaluation and associated operational research. WHO envisages that the Handbook will be put to use in all high TB burden countries ahead of 2020 and be used alongside other surveillance, monitoring and evaluation, and operational research tools to improve TB care and prevention and to end the epidemic. 
Type Of Material Improvements to research infrastructure 
Year Produced 2018 
Provided To Others? Yes  
Impact Rolling out TB patient costs survey in 15 countries to date globally and working with countries around the world to implement and interpret this survey. 
URL http://www.who.int/tb/publications/patient_cost_surveys/en/
 
Title Wellbeing - Tuberculosis 
Description Adapted the WHO euroHISQOL-8 questionnaire to be applicable to our participants affected by tuberculosis living in peri-urban shantytowns, in a non english speaking country. 
Type Of Material Physiological assessment or outcome measure 
Provided To Others? No  
Impact If we can show that wellbeing score can highlight the most vulnerable people, it could be used in clinical settings as screening for the most vulnerable and require extra support. 
 
Title Automated relational database 
Description We have updated our database to make it more intuitive for our data team. This includes using images of the questionnaire to facilitate easy data entry and minimise error rates. The database is relational enabling us to rapidly and easily identify key data. We have developed automated systems enabling use to facilitate rapid bank transfers to patients recruited to the intervention. We have also developed a simple and intuitive system for digitising patient TB card data that enables us to easily view and update these data. 
Type Of Material Database/Collection of data 
Provided To Others? No  
Impact We have observed a reduction in our error rates and have improved the efficiency of our complex field processes. 
 
Title CRESIPT study database 
Description This award involves collection of intrinsically complex data. Data domains include communities, households, people, illnesses, treatment episodes, interviews, diagnostic samples, diagnostic test results and most study participants have data in most of these domains on multiple occasions. We have developed a relational database that efficiently manages these complex data. In preference to tablet computer-based systems that pose too great a staff security risk in our impoverished setting, we have developed a simple unidirectional paper-based data management system with integrated quality control and double digitisation. Importantly for our setting, we have also integrated a system of daily confidential, secure data backup to the 'Cloud' to ensure data security. This is integrated with the laboratory data management system that we have developed and is described in the software section. 
Type Of Material Database/Collection of data 
Provided To Others? No  
Impact These achievements have already had a major impact on the efficiency and productivity of our research team and ongoing project. Later in the project we plan to publish and share these resources that we have developed. We have already committed to making all data from this project widely available through anonymised inclusion in an online data repository, as required by the grant conditions. 
 
Title Tablet based data collection 
Description We are currently in the process of transforming our data collection from paper to tablet based questionnaires. We have piloted this system already with great success. Data are collected in the field and automatically uploaded to the cloud when the field member has internet connection. Data can then be downloaded directly from a secure cloud service, without any digitisation. 
Type Of Material Database/Collection of data 
Year Produced 2018 
Provided To Others? No  
Impact More efficient data collection with no digitisation errors. 
 
Description CDC/NAMRU-6 collaboration to evaluate appropriate technology TB diagnositics 
Organisation United States Department of Defense via NAMRU-6
Country United States 
Sector Public 
PI Contribution We provided the protocol for the colour test, and expert microbiology advice. In addition we went on site visits to the national TB laboratories in Tblisi, Georgia and Kathmandu Nepal in 2014 for capacity building sessions with the TB programe workers and laboratory technicians. Also we held a 1-week laboratory training and infection control workshop for international delegates including national TB laboratory managers from countries such as Mali.
Collaborator Contribution They provided us with a MGIT culture machine and the geneXpert machine, the latter is used to provide rapid diagnostic results for every TB patient enrolled into the CRESIPT study. They also provided funding for this study titles "MDR/XDRTB Colour Test implementation study & training and received $117,000 for associated training program in 2012 + $196,000 renewal for expansion of an original grant in 2012/13), with ongoing academic support.
Impact The 1-week workshop. Manuscripts are currently in preparation.
Start Year 2012
 
Description CHEST study 
Organisation Karolinska Institute
Department Department of Public Health Sciences
Country Sweden 
Sector Academic/University 
PI Contribution Co-applicant, co-investigator, and consultant on the CHEST project which aims to improve linkage of TB and social care in Mozambique. We were successful in receiving funding of 500,000 euros to conduct this research. I am going out to Mozambique in April for site visits and logistical planning. I will also present to the National TB Program and Ministry of Health about addressing the social determinants of TB.
Collaborator Contribution The study is being led and coordinated by Dr Salla Atkins of the University of Tampere, Finland. Other partners include Prof Knut Lonnroth, Dr Kerri Viney, and Ms Olivia Biermann of Karolinska Institutet, with whom I collaborate closely on other projects. Dr Atkins is making a visit to Liverpool to present at our cross campus research meeting "LIV-TB" later this year and has been helpful in terms of supporting my other research ideas including those related to the Academy of Medical Sciences Research Grant.
Impact Multi-disciplinary: clinicians, social scientist, trialists, TB researchers, health economists, social workers, national TB program, implementers. The project is in its infancy and so there are no outputs at the present time.
Start Year 2017
 
Description CHEST study 
Organisation University of Tampere
Country Finland 
Sector Academic/University 
PI Contribution Co-applicant, co-investigator, and consultant on the CHEST project which aims to improve linkage of TB and social care in Mozambique. We were successful in receiving funding of 500,000 euros to conduct this research. I am going out to Mozambique in April for site visits and logistical planning. I will also present to the National TB Program and Ministry of Health about addressing the social determinants of TB.
Collaborator Contribution The study is being led and coordinated by Dr Salla Atkins of the University of Tampere, Finland. Other partners include Prof Knut Lonnroth, Dr Kerri Viney, and Ms Olivia Biermann of Karolinska Institutet, with whom I collaborate closely on other projects. Dr Atkins is making a visit to Liverpool to present at our cross campus research meeting "LIV-TB" later this year and has been helpful in terms of supporting my other research ideas including those related to the Academy of Medical Sciences Research Grant.
Impact Multi-disciplinary: clinicians, social scientist, trialists, TB researchers, health economists, social workers, national TB program, implementers. The project is in its infancy and so there are no outputs at the present time.
Start Year 2017
 
Description CRESIPT Research Network 
Organisation Cayetano Heredia University
Country Peru 
Sector Academic/University 
PI Contribution Lead research organisation of project award "Community randomised evaluation of socioeconomic intervention to prevent TB". Manage day to day running of the project. Facilitate, coordinate and initiate collaborative working within the network.
Collaborator Contribution Contributions range from active working knowledge and relations with the study communities to informing study design and relevance within the scientific community.
Impact At this early stage the Network have been finalising the project protocol.
Start Year 2012
 
Description CRESIPT Research Network 
Organisation Imperial College London
Country United Kingdom 
Sector Academic/University 
PI Contribution Lead research organisation of project award "Community randomised evaluation of socioeconomic intervention to prevent TB". Manage day to day running of the project. Facilitate, coordinate and initiate collaborative working within the network.
Collaborator Contribution Contributions range from active working knowledge and relations with the study communities to informing study design and relevance within the scientific community.
Impact At this early stage the Network have been finalising the project protocol.
Start Year 2012
 
Description CRESIPT Research Network 
Organisation Johns Hopkins University
Country United States 
Sector Academic/University 
PI Contribution Lead research organisation of project award "Community randomised evaluation of socioeconomic intervention to prevent TB". Manage day to day running of the project. Facilitate, coordinate and initiate collaborative working within the network.
Collaborator Contribution Contributions range from active working knowledge and relations with the study communities to informing study design and relevance within the scientific community.
Impact At this early stage the Network have been finalising the project protocol.
Start Year 2012
 
Description CRESIPT Research Network 
Organisation London School of Hygiene and Tropical Medicine (LSHTM)
Country United Kingdom 
Sector Academic/University 
PI Contribution Lead research organisation of project award "Community randomised evaluation of socioeconomic intervention to prevent TB". Manage day to day running of the project. Facilitate, coordinate and initiate collaborative working within the network.
Collaborator Contribution Contributions range from active working knowledge and relations with the study communities to informing study design and relevance within the scientific community.
Impact At this early stage the Network have been finalising the project protocol.
Start Year 2012
 
Description CRESIPT Research Network 
Organisation PRISMA ONG
Country Peru 
Sector Private 
PI Contribution Lead research organisation of project award "Community randomised evaluation of socioeconomic intervention to prevent TB". Manage day to day running of the project. Facilitate, coordinate and initiate collaborative working within the network.
Collaborator Contribution Contributions range from active working knowledge and relations with the study communities to informing study design and relevance within the scientific community.
Impact At this early stage the Network have been finalising the project protocol.
Start Year 2012
 
Description CRESIPT Research Network 
Organisation United Nations (UN)
Country Global 
Sector Public 
PI Contribution Lead research organisation of project award "Community randomised evaluation of socioeconomic intervention to prevent TB". Manage day to day running of the project. Facilitate, coordinate and initiate collaborative working within the network.
Collaborator Contribution Contributions range from active working knowledge and relations with the study communities to informing study design and relevance within the scientific community.
Impact At this early stage the Network have been finalising the project protocol.
Start Year 2012
 
Description Center for TB research, faculty of medicine, Johns Hopkins University 
Organisation Johns Hopkins University
Department School of Medicine Johns Hopkins
Country United States 
Sector Academic/University 
PI Contribution Collaboration and teaching at the centre for TB research directed by Prof Dick Chaisson.
Collaborator Contribution Provides external research advice and perspective for the study design and protocol for CRESIPT and associated studies carried out in our cohort, especially from Dr Jonathan Golub, Dr David Dowdy and Prof Jacque Grosset.
Impact Bi-annual regional teaching at Johns Hopkins Hospital campus.
Start Year 2012
 
Description Clinton Health Access Initiative- India 
Organisation Clinton Health Access Initiative
Country United States 
Sector Charity/Non Profit 
PI Contribution Provided expert consultation with regards to evaluating the new Indian national TB programme strategy to provide conditional cash transfers to all TB affected individuals ti improve TB disease outcomes, and reduce catastrophic costs, in line with pillar 3 of the WHO End TB Strategy
Collaborator Contribution India has the highest burden of TB disease, and therefore is trying various new strategies to control the disease. They will lead the operational on-site evaluation of the cash transfers and impact.
Impact A joint application was made to the MRC health systems strengthening call in January 2018. Council Reference: MR/S00453X/1 Proposal Title : Innovative Health Systems to End-Tuberculosis Principal Investigator : Dr Carlton Evans Organisation: Imperial College London Department : Dept of Medicine Your Reference : P74352 Proposal Scheme : MRC Jointly Funded Initiatives Outline Proposal Call/Mode/Type : Joint Health Systems Research Initiative Outline Jan 2018
Start Year 2017
 
Description Collaboration with Armstrong-James group at the National Heart and Lung Institute, UK 
Organisation Imperial College London
Department National Heart & Lung Institute (NHLI)
Country United Kingdom 
Sector Academic/University 
PI Contribution This collaboration aims to study the patients treated for pulmonary tuberculosis which have persistent negative microbiological tests results for Mycobacterium tuberculosis. By analysis of preliminary data from Ventanilla district in Lima, Peru, the CRESIPT team has shown that around 29% of patients starting treatment do not have microbiological evidence of M. tuberculosis. Between July - August 2018, blood and sputum samples were taken from 20 patients with persistent negative microbiological tests for a pilot study on burden of Aspergillus fumigatus in patients receiving treatment for pulmonary tuberculosis.
Collaborator Contribution The National Heart and Lung Institute (NHLI), through collaboration with Dr. Darius Armstrong-James group, will process blood and sputum samples using cutting-edge, high throughput technologies. The aim is to determine characteristics of Aspergillus fumigatus colonisation/infection in patients receiving treatment for pulmonary tuberculosis.
Impact The preliminary data, which has been analysed by this collaboration, has presented in the Wellcome Centre for Global Health Research Annual Meeting in 2017. This multi-disciplinary collaboration includes expertise in epidemiology, public health, clinical medicine, immunology, microbiology and molecular biology. This collaboration allowed the award of a PhD scholarship for US$ 210,000 to perform further studies on the immune characteristic of Aspergillosis in patients with history of tuberculosis.
Start Year 2017
 
Description Collaboration with CONAMUSA 
Organisation National Multisectoral Health Coordinator
PI Contribution The National Multisectoral Health Coordinator (CONAMUSA) is a coordinating body consisting of government representatives, bilateral and multilateral international cooperation, civil society and people's organizations directly affected by HIV/AIDS, Tuberculosis and Malaria in the country. The CONAMUSA tries to promote and build consensus, develop messages and shared concepts among all sectors, close the gap between the public and private sectors, and complement and strengthen what the Peruvian government is working on in the prevention of HIV/AIDS, Tuberculosis and Malaria. Members our research group are part of this body and are involved in all its activities.
Collaborator Contribution Exchange of knowledge, ideas and developments.
Impact Involvement in the approval of the final proposal of Peru to the Global Fund
Start Year 2016
 
Description Collaboration with Concytec-Fondecyt 
Organisation Imperial College London
Department National Heart & Lung Institute (NHLI)
Country United Kingdom 
Sector Academic/University 
PI Contribution A well-established cohort will provide ex-vivo samples from selected patients in Peru to support the study of mycobacterial infection on Aspergillus fumigatus infection and chronic pulmonary aspergillosis.
Collaborator Contribution Concytec-Fondecyt has granted US$ 210,000 for funding a 3-years PhD project on macrophages' immune dysfunction against Aspergillus fumigatus in Mycobacterium infection. This fund covers student's tuition fees at Imperial College London, stipends and transportation. Experimental work will be funded and performed by Armstrong-James' group at the National Heart & Lung Institute, Imperial College London. Most readouts of interest are based on pathways defined by this laboratory.
Impact This multi-disciplinary collaboration includes expertise in epidemiology, public health, clinical medicine, immunology, microbiology and molecular biology.
Start Year 2018
 
Description Collaboration with Concytec-Fondecyt 
Organisation National Council for Science, Technology and Technological Innovation (CONCYTEC)
Country Peru 
Sector Public 
PI Contribution A well-established cohort will provide ex-vivo samples from selected patients in Peru to support the study of mycobacterial infection on Aspergillus fumigatus infection and chronic pulmonary aspergillosis.
Collaborator Contribution Concytec-Fondecyt has granted US$ 210,000 for funding a 3-years PhD project on macrophages' immune dysfunction against Aspergillus fumigatus in Mycobacterium infection. This fund covers student's tuition fees at Imperial College London, stipends and transportation. Experimental work will be funded and performed by Armstrong-James' group at the National Heart & Lung Institute, Imperial College London. Most readouts of interest are based on pathways defined by this laboratory.
Impact This multi-disciplinary collaboration includes expertise in epidemiology, public health, clinical medicine, immunology, microbiology and molecular biology.
Start Year 2018
 
Description Collaboration with David Coleman, St George's Hospital, UK 
Organisation St George's Hospital
Country United Kingdom 
Sector Hospitals 
PI Contribution We provided TB strains for David's own research based in London, UK
Collaborator Contribution David helped train our laboratory in microbiological methods and infection control, whilst providing advice with the color test protocol, including the concept of including carbendazim in culture media.
Impact Published abstracts - please see publication section, and also the carbendazim enriched media, please see research tools
Start Year 2012
 
Description Collaboration with Dr Bill Pan, Duke University, USA 
Organisation Duke University
Department Duke Clinical Research Institute
Country United States 
Sector Academic/University 
PI Contribution We processed the samples collected from a TB prevalence study that was part of a larger population study that Dr Pan was carrying out in Madre de Dios, Peru.Team members also went to the study site multiple times to train Dr Pan's research nurses on sample collection and facilitate transport of sample to our laboratory in Lima, Peru.
Collaborator Contribution Dr Pan is an associate professor at Duke University and the principal investigator for a large study in the Madre de Dios district, an amazonian region of Peru that assessed the populations impacted by mining in the area, with the aim to evaluate the health impact and prevalent diseases. This study provided the data and samples for the TB prevalence study.Furthermore they communicated the results to the participants if TB was detected.
Impact Published abstracts, please see publication section. The manuscript is in preparation.
Start Year 2015
 
Description Collaboration with Dr Grant Theron at Stellenbosch University, South Africa 
Organisation University of Stellenbosch
Country South Africa 
Sector Academic/University 
PI Contribution Enquiries were made about the protocol for our fluorescein diacetate (FDA) viability microscopy used to assess TB treatment response and infectious , please see the "research tools" and "publications" section. We wrote a comprehensive summary of our optimisation work, and final protocol which we shared with them.
Collaborator Contribution The are assessing the use of our FDA microscopy to evaluate its role in monitoring treatment response and infectiousness in their local TB affected population in South Africa.
Impact Work is undergoing and therefore no outputs have been made as of yet.
Start Year 2017
 
Description Collaboration with Dr Leen Rigouts, University of Antwerp, Belgium 
Organisation University of Antwerp
Department Faculty of Sciences
Country Belgium 
Sector Academic/University 
PI Contribution Prof Evans was the sponsor for Dr Rigout's doctoral student, Francesca Barletta. The CRESIPT study cohort also provided samples, and our research laboratory processed the samples
Collaborator Contribution Dr Rgouts was the main supervisor for the student, and provided research supervision and molecular biology training for the doctoral student.
Impact Please see the article in the publication section, first author F Barletta.
Start Year 2012
 
Description Collaboration with Dr Leo Martinez, Stanford University, USA 
Organisation Stanford University
Department Division of Infectious Diseases & Geographic Medicine
Country United States 
Sector Hospitals 
PI Contribution Collaborating in data collection and sharing for an an Individual Patient Meta-analysis of Primary Progressive Disease in Child Contacts of Tuberculosis Cases: A Methodological Protocol, that is being led by Dr Leo Martinez.
Collaborator Contribution They will be leading this project.
Impact No outputs as of yet
Start Year 2018
 
Description Collaboration with Dr Mirko Zimic - Universidad Peruana Cayetano Heredia, Lima, Peru 
Organisation Cayetano Heredia University
Country Peru 
Sector Academic/University 
PI Contribution We have collaborated with Dr Zimic's new biosensor TB diagnostic test. We have provided research design advice, clinical samples and processed the samples with clinical laboratory techniques.
Collaborator Contribution Dr Zimic's group processes the samples with the biosensor test, and leads the analysis and write up.
Impact The manuscript is under review with Science Translational Medicine
Start Year 2017
 
Description Collaboration with Dr Nathan Furukawa University of Washington, USA 
Organisation University of Washington Medical Center
PI Contribution Prof Evans provided research mentorship Dr Furukawa, and the team provided him with our costs data generated from cohort data prior to CRESIPT.
Collaborator Contribution Due to the CRESIPT study, and published papers on catastrophic costs and social interventions, Dr Furukawa approached our research group, and proposed his research question and analysis strategy. Dr Furukawa set up the analysis of our cohort data to assess the cost effectiveness of social protection for TB.
Impact Current manuscript is submitted to Social Science and Medicine journal.
Start Year 2015
 
Description Collaboration with Dr Patricia Sheen - Universidad Peruana Cayetano Heredia 
Organisation Cayetano Heredia University
Country Peru 
Sector Academic/University 
PI Contribution Prof Carlton Evans provides research consultation to their ongoing studies involving Mycobacterium tuberculosis pyrizinamide resistance
Collaborator Contribution They lead the studies, analysis and research dissemination.
Impact please see joint publication in the publications section.
Start Year 2009
 
Description Collaboration with IMPACT TB study team 
Organisation Liverpool School of Tropical Medicine
Country United Kingdom 
Sector Academic/University 
PI Contribution The research of our team and our outputs from the CRESIPT study have directly informed the IMPACT TB team. IMPACT TB is an international study involving collaborations with LSTMed, Karolinska Institutet, KNCV, and the National TB Programs of Nepal and Vietnam, examining active case finding.
Collaborator Contribution Using methodology developed by our research team, including measurement of TB patient costs and socioeconomic interventions to mitigate such costs, we have been able to develop some add-on studies for IMPACT-TB which will bring added value to their work and disseminate/broaden the impact of the CRESIPT study.
Impact 1) Presentation on CRESIPT findings at IMPACT-TB meeting in Liverpool March 2017 2) Further presentations and workshops with Nepal and Vietnam National TB Programs planned for late March 2017 3) Funding applications for add-on studies ongoing.
Start Year 2017
 
Description Collaboration with Ohio State University to evaluate the Colour Test 
Organisation Ohio State University
Department Department of Medical Microbiology
Country Nigeria 
Sector Private 
PI Contribution Collaboration with Drs Jordi Torelles and Shu-Hua Wang, who wanted to evaluate the colour test, which our group developed, in an international multi-site project. Went on site visits eg. Panama in November 2013 with this team.
Collaborator Contribution They led the research and are disseminating the results
Impact A manuscript that is in press in Journal of Clinical Microbiology
Start Year 2013
 
Description Collaboration with Peruvian Ministry of Development and Social Inclusion (MIDIS) 
Organisation Ministry of Development and Social Inclusion
Country Peru 
Sector Public 
PI Contribution We have begun collaborating with the Peruvian Ministry of Development and Social Inclusion (MIDIS), providing advice and consultation about how social protection might be scaled up within Peru based on our own experiences.
Collaborator Contribution MIDIS have provided us with informative insights on how we might improve and refine our own interventions to make them more nationally applicable. We have been able to benefit from their understanding of the bureaucratic systems in place within the Peruvian government.
Impact MIDIS
Start Year 2017
 
Description Collaboration with Peruvian National Institute of Health 
Organisation National Institute of Health of Peru
PI Contribution We regularly meet with representatives form the Peruvian NIH to discuss research agendas and priorities. We are frequently invited to arrange training for laboratory workers working with TB samples. We collaborate with local NIH laboratories regarding the MODS assay.
Collaborator Contribution Sharing of research agendas and priorities. Dissemination of research results. Use of resources and venues.
Impact The principal output from this collaboration is knowledge sharing and transfer.
Start Year 2012
 
Description Collaboration with Professor Joseph Zunt, University of Washington, USA 
Organisation University of Washington
Country United States 
Sector Academic/University 
PI Contribution Prof Evans and his research team are hosting Prof Zunt's student Renee Newby. We are supervising her in the laboratory and processing her samples for the evaluation of PCR, microscopy and culture TB diagnostic techniques for CSF in TB meningitis, from patiented in Hospital Dos de Mayo, Lima, Peru.
Collaborator Contribution Prof Zunt's team will be providing research supervision and training to Renee who is leading this study.
Impact A study protocol was designed and the study is now in progress. Due the direct actions of this study, we were able to diagnose multiple patients with TB meningitis, and ensure that they were started on the correct therapy.
Start Year 2017
 
Description Collaboration with Public Health England 
Organisation Public Health England
Country United Kingdom 
Sector Public 
PI Contribution 1) Work on a project categorising the risk of LTBI/active TB in contacts of patients with EPTB - Thorax publication and multiple presentations 2) Work on categorising patient risk of poor clinical outcome on TB treatment using the locally-adapted enhanced case management scale - BMC Public Health publication and presentation 3) New project looking at catastrophic costs of TB for patients in England, with a pilot study in the north west (pending funding)
Collaborator Contribution Dr Paul Cleary, Dr Peter MacPherson, and Dr Angela Tucker supported me in the write up of project 1. Dr Paul Cleary has supervised all the work and given overall advice. Dr Dominik Zenner is supporting project 3 in the hope that it will end up a national survey of catastrophic costs of TB patients
Impact High prevalence of TB disease in contacts of adults with extrapulmonary TB. Wingfield T, MacPherson P, Cleary P, Ormerod LP. Thorax. 2017 Nov 16. pii: thoraxjnl-2017-210202. doi: 10.1136/thoraxjnl-2017-210202. [Epub ahead of print] PMID: 29146867 Quantifying the need for enhanced case management for TB patients as part of TB cohort audit in the North West of England: a descriptive study. Tucker A, Mithoo J, Cleary P, Woodhead M, MacPherson P, Wingfield T, Davies S, Wake C, McMaster P, Bertel Squire S. BMC Public Health. 2017 Nov 15;17(1):881. doi: 10.1186/s12889-017-4892-5. PMID: 29141600
Start Year 2016
 
Description Collaboration with the Municipality of Lima 
Organisation Municipality of Lima
Country Peru 
Sector Private 
PI Contribution We provide educational workshops to multidisciplinary health professionals in the municipality of Lima.
Collaborator Contribution Our partners provide us with a platform to present our work and allow us to use their resources and venues to carry out the educational workshops.
Impact Through this collaboration we have established the Multisectoral Committee to Combat Tuberculosis. This working group is involved in outlining the priorities of the municipality for strengthening TB cure, care and prevention.
Start Year 2015
 
Description Collaboration with the Social Protection Action and Research Knowledge Sharing (SPARKS) network 
Organisation Karolinska Institute
Department Department of Public Health Sciences
Country Sweden 
Sector Academic/University 
PI Contribution SPARKS is an international collaboration of researchers, policy makers, and stakeholders looking to provide a platform to propel the social protection research agenda forward
Collaborator Contribution The CRESIPT team presented their methods, preliminary findings, and future plans at the SPARKS inaugural meeting at Karolinska Institutet, Stockholm, Sweden, December 2016. Members of the CRESIPT team are involved as part of the secretariat of SPARKS and in furthering this collaboration.
Impact 1) SPARKS mission statement and agenda
Start Year 2016
 
Description Collaborative group on the impact of digital technologies on TB 
Organisation World Health Organization (WHO)
Country Global 
Sector Public 
PI Contribution Contributed to a paper titled "Digital health technologies for active TB treatment support: A cost-effectiveness analysis" as part of the collaborative group, led by WHO
Collaborator Contribution WHO lead the collaborative group
Impact One publication submitted to a journal
Start Year 2017
 
Description IMPALA study 
Organisation Liverpool School of Tropical Medicine
Country United Kingdom 
Sector Academic/University 
PI Contribution I have been invited to become involved with the IMPALA program as a consultant. I will go out to the first meeting about this in Durban in April 2018. The International Multidisciplinary Programme to Address Lung Health and TB in Africa "IMPALA" is a four-year collaborative programme funded by the National Institute of Health Research under the first Global Health Research Programme call launched in 2016. LSTM was successful in securing funding under this call to establish an Africa-focused NIHR Global Health Research Unit for lung health and tuberculosis (TB) that will generate new scientific knowledge and implementable solutions for these high burden, under-funded and under-researched health problems. IMPALA will achieve this through multi- disciplinary collaborative work involving clinical, social, health systems, health economics and implementation scientists from Africa and the UK. IMPALA will be hosted by LSTM, a world leader in applied global health research to improve the health of the world's poorest people in low- and middle-income countries (LMICs). It will build on a unique critical mass of internationally excellent clinical and applied health scientists who are experts in lung health and TB in the tropics and on the momentum behind the LSTM-led Collaboration for Applied Health Research and Delivery (CAHRD): A global applied health research network with strong representation from LMICs that aims to strengthen health systems and the design, delivery and scale- up of practice- and policy-ready solutions to the health needs of the world's poor.
Collaborator Contribution See above.
Impact none yet
Start Year 2018
 
Description Inter-American Training for Innovations in Emerging Infectious Diseases 
Organisation Tulane University
Department School of Public Health Tulane
Country United States 
Sector Academic/University 
PI Contribution Prof Evans was a co-investigator for this Fogarty funded training program, and provided mentorship to IATIEID fellows who were undertaking research in Tuberculosis. The main objective of this program is to provide post-doctoral trainees with mentored training experiences and opportunities to work together as a team to identify problems in the diagnosis, management, or control of infectious diseases. Emerging infectious diseases, such as tuberculosis, malaria, and Chagas disease, present major public health problems in resource-limited countries and are an increasing problem in more developed countries.
Collaborator Contribution The Tulane school of public health administered the grant, facilitated the ethics, and execution of the studies. Professor Richard Oberhelman and Dr Valerie Paz Soldan mentored and supervised all IATIED fellows who led the studies and analysis.
Impact Please see published abstracts and articles by IATIED supervisors and fellows: Richard Oberhelman, Valerie Paz Soldan, Gwen Lee, and German Comina.
Start Year 2012
 
Description Massachusetts supra-national tuberculosis reference laboratory - Dr Alex Sloutsky 
Organisation University of Massachusetts
Country United States 
Sector Academic/University 
PI Contribution Collaboration to assess the MGIT culture for TB diagnostics.
Collaborator Contribution Dr Sloutsky provided expert microbiology advice for all our labortaory techniques and research projects.
Impact outputs are in process
Start Year 2013
 
Description NAMRU-6 in Peru 
Organisation GENETUP
Country Nepal 
Sector Charity/Non Profit 
PI Contribution 1) Collaborative work concerning design of novel TB diagnostics 2) Implementation of novel TB diagnostics in resource-constrained settings
Collaborator Contribution 1) Our team has provided formal training in laboratory methodology during the past three years for a NAMRU-6 led training course held at el laboratorio de investigacion y desarrollo at the Universidad Peruana Cayetano Heredia 2) Involvement in team research meetings for the past three years
Impact 1) Development of the Color Test for TB diagnosis in low-resource settings 2) Formalised training of physicians and associated healthcare professionals in laboratory methodology with an emphasis on biohazard and biosecurity in mycobaterial diagnosis
Start Year 2007
 
Description NAMRU-6 in Peru 
Organisation Henry M. Jackson Foundation for the Advancement of Military Medicine (HJF)
Country United States 
Sector Academic/University 
PI Contribution 1) Collaborative work concerning design of novel TB diagnostics 2) Implementation of novel TB diagnostics in resource-constrained settings
Collaborator Contribution 1) Our team has provided formal training in laboratory methodology during the past three years for a NAMRU-6 led training course held at el laboratorio de investigacion y desarrollo at the Universidad Peruana Cayetano Heredia 2) Involvement in team research meetings for the past three years
Impact 1) Development of the Color Test for TB diagnosis in low-resource settings 2) Formalised training of physicians and associated healthcare professionals in laboratory methodology with an emphasis on biohazard and biosecurity in mycobaterial diagnosis
Start Year 2007
 
Description NAMRU-6 in Peru 
Organisation National TB Reference Laboratory, Tbilisi, Georgia
Country Georgia 
Sector Private 
PI Contribution 1) Collaborative work concerning design of novel TB diagnostics 2) Implementation of novel TB diagnostics in resource-constrained settings
Collaborator Contribution 1) Our team has provided formal training in laboratory methodology during the past three years for a NAMRU-6 led training course held at el laboratorio de investigacion y desarrollo at the Universidad Peruana Cayetano Heredia 2) Involvement in team research meetings for the past three years
Impact 1) Development of the Color Test for TB diagnosis in low-resource settings 2) Formalised training of physicians and associated healthcare professionals in laboratory methodology with an emphasis on biohazard and biosecurity in mycobaterial diagnosis
Start Year 2007
 
Description NAMRU-6 in Peru 
Organisation Naval Medical Research Center Unit-6
Country Peru 
Sector Public 
PI Contribution 1) Collaborative work concerning design of novel TB diagnostics 2) Implementation of novel TB diagnostics in resource-constrained settings
Collaborator Contribution 1) Our team has provided formal training in laboratory methodology during the past three years for a NAMRU-6 led training course held at el laboratorio de investigacion y desarrollo at the Universidad Peruana Cayetano Heredia 2) Involvement in team research meetings for the past three years
Impact 1) Development of the Color Test for TB diagnosis in low-resource settings 2) Formalised training of physicians and associated healthcare professionals in laboratory methodology with an emphasis on biohazard and biosecurity in mycobaterial diagnosis
Start Year 2007
 
Description NAMRU-6 in Peru 
Organisation United States Air Force
Country United States 
Sector Public 
PI Contribution 1) Collaborative work concerning design of novel TB diagnostics 2) Implementation of novel TB diagnostics in resource-constrained settings
Collaborator Contribution 1) Our team has provided formal training in laboratory methodology during the past three years for a NAMRU-6 led training course held at el laboratorio de investigacion y desarrollo at the Universidad Peruana Cayetano Heredia 2) Involvement in team research meetings for the past three years
Impact 1) Development of the Color Test for TB diagnosis in low-resource settings 2) Formalised training of physicians and associated healthcare professionals in laboratory methodology with an emphasis on biohazard and biosecurity in mycobaterial diagnosis
Start Year 2007
 
Description NAMRU-6/PROMELA collaboration for laboratory strengthening in Latin America 
Organisation United States Department of Defense via NAMRU-6
Country United States 
Sector Public 
PI Contribution Provided capacity building to various latin american TB program laboratories including Belize in 2013
Collaborator Contribution They facilitated the collaboration with the national TB programs in Latin America, and application for the Global Emerging Infectious Diseases (GEIS) research grant, where Prof Evans is a investigator, please see further funding for the "Collaborative Assessment of Regional MDR-TB Surveillance Enhancement by Use of both the Xpert MTB/RIF Assay and Colour Tests for Enabling More Timely Drug Sensitivity Testing in Diverse Settings."
Impact Capacity building in Belize, Guatamala, Columbia and Honduras.
Start Year 2012
 
Description NGO SAVICS providing software solutions for TB laboratory platforms 
Organisation Savics
PI Contribution We are evaluating their DatatoCare platform with every patient sample provided by CRESIPT study participants for the Cepheid GeneXpert machine and software.
Collaborator Contribution SAVICS is an NGO based in Brussels, Belgium. They have developed the software, and provide ongoing technical assistance.
Impact Manuscript in process with regards to the use of geneXpert cycle time data in clinical care.
Start Year 2016
 
Description Peru TB Control Strategy 
Organisation Callao Regional Directorate of Health
Country Peru 
Sector Charity/Non Profit 
PI Contribution Actively working with the local government and civil society TB interest groups to design the study to be of most use and relevance to the communities we are working with.
Collaborator Contribution Provide local data and knowledge. Raising the profile of the project with local policy makers and the study communities.
Impact Community workshops for individuals and families of TB patients.
Start Year 2012
 
Description Peru TB Control Strategy 
Organisation Peruvian Association of Persons Affected by Tuberculosis (ASPAT)
Country Peru 
Sector Charity/Non Profit 
PI Contribution Actively working with the local government and civil society TB interest groups to design the study to be of most use and relevance to the communities we are working with.
Collaborator Contribution Provide local data and knowledge. Raising the profile of the project with local policy makers and the study communities.
Impact Community workshops for individuals and families of TB patients.
Start Year 2012
 
Description Peru TB Control Strategy 
Organisation Regional Government of Callao
Country Peru 
Sector Public 
PI Contribution Actively working with the local government and civil society TB interest groups to design the study to be of most use and relevance to the communities we are working with.
Collaborator Contribution Provide local data and knowledge. Raising the profile of the project with local policy makers and the study communities.
Impact Community workshops for individuals and families of TB patients.
Start Year 2012
 
Description Peruvian Ministry of Health - National TB Program 
Organisation National Tuberculosis Control Program
Country Peru 
Sector Public 
PI Contribution Updating with research findings, processing samples, training
Collaborator Contribution Support, policy, training, exchange of ideas
Impact Presentations at the Peruvian National TB conference
Start Year 2012
 
Description Public Health partners 
Organisation World Health Organization (WHO)
Department Global TB Program
Country Switzerland 
Sector Public 
PI Contribution Research papers, membership of working groups, presentations at WHO Global TB program meetings
Collaborator Contribution Input into study design and dissemination of research outputs.
Impact Membership of advisory committees, invitation to speak at conferences and meetings.
Start Year 2012
 
Description Tulane University, Health Office for Latin America (HOLA) 
Organisation Tulane University
Country United States 
Sector Academic/University 
PI Contribution This group has provided lab and experimental design support for the development and assessment of TB aerosol filters to assess infectivity of TB patients. All clinical samples were processed within our facility, as well as the validation experiement of the filters to test threshold of detection of the filters.
Collaborator Contribution Fellows associatied with the HOLA office have designed and conducted the project, notably the enrollment of participants, collection of clinical samples, and subsequent data analysis of results.
Impact Current results of the TB aerosol filter study are to be presented at the European Congress of Clinical Microbiology & Infectious Diseases. Partners involved are physicians/medical students, applied physicists, and epidemiologists.
Start Year 2016
 
Description Universite catholique de Louvain - laboratory connectivity 
Organisation Catholic University of Louvain
Country Belgium 
Sector Academic/University 
PI Contribution Survey coordinator and international collaborator for the "TB laboratory connectivity" study.
Collaborator Contribution Overall coordination of the international survey, and central server to collect data.
Impact multidisciplinary: researcher, policy makers, clinicians, microbiologists, laboratory technicians and software programmers
Start Year 2017
 
Description WHO Global Task Force on Catastrophic Costs and Universal Health Coverage 
Organisation World Health Organization (WHO)
Country Global 
Sector Public 
PI Contribution Involved in strategic meetings to take forward research and agenda on catastrophic costs
Collaborator Contribution Part of the task force
Impact Catastrophic costs section of the post-2015 global TB control strategy framework
Start Year 2013
 
Description World Bank 
Organisation World Bank Group
Country United States 
Sector Private 
PI Contribution The World Bank has been involved in the planning and development of our socioeconomic intervention to prevent TB.
Collaborator Contribution Regular strategic meetings, contribution to World Bank organised educational and scientific research events, and study site visits by the World Bank and affiliated partners
Impact 1) Multi-disciplinary collaboration between World Bank staff and our research team in the planning and implementation of a socioeconomic intervention to prevent TB
 
Description World Health Organisation Task Force on Catastrophic Costs of Tuberculosis 
Organisation World Health Organization (WHO)
Country Global 
Sector Public 
PI Contribution Members of the CRESIPT team are part of the WHO Task Force on Catastrophic Costs. Previous publications by our team and the ongoing work on the CRESIPT study represent ground-breaking research relating to identifying and addressing catastrophic costs of TB-affected households. We are continuing to work with WHO to roll out their TB Patient Costs Tool, which draws heavily on our previous methods and employs our catastrophic costs threshold which has been endorsed by WHO in their End TB Strategy.
Collaborator Contribution Previous publications by our team and the ongoing work on the CRESIPT study represent ground-breaking research relating to identifying and addressing catastrophic costs of TB-affected households. We are continuing to work with WHO to roll out their TB Patient Costs Tool, which draws heavily on our previous methods and employs our catastrophic costs threshold which has been endorsed by WHO in their End TB Strategy. Tom Wingfield is involved in implementing the Costs Tool in Nepal, Vietnam, and Mozambique.
Impact 1) WHO Global Catastrophic Costs Guidance 2) WHO TB Patient Costs Tool
Start Year 2014
 
Title Buscadores: TB finders 
Description TB finders are TB survivors who are trained to become active community case finders, screening community members for TB. TB finders are trained to target high-risk community members who have TB risk factors or symptoms. 
Type Preventative Intervention - Behavioural risk modification
Current Stage Of Development Late clinical evaluation
Year Development Stage Completed 2017
Development Status Actively seeking support
Impact Some TB finders have become government approved health workers. Furthermore, TB finders have been responsible for diagnosing multiple community members with TB. Once diagnosed the TB finder becomes that person's peer mentor. 
 
Title CRESIPT cash transfer intervention 
Description As part of this study, we are currently evaluating a cash transfer intervention to incentivise and enable access to TB care. This specific economic intervention has evolved through various consultations, planning meetings and experience in the field and continues to evolve up until the time of writing (March 2018) 
Type Preventative Intervention - Behavioural risk modification
Current Stage Of Development Late clinical evaluation
Year Development Stage Completed 2016
Development Status Under active development/distribution
Clinical Trial? Yes
Impact This intervention is currently under evaluation. 
 
Title Colorimetric thin-layer agar test to diagnose TB in resource-constrained settings (The Color Test) 
Description TB is difficult to diagnose in low-resource settings that have limited access to laboratories with adequate biosafety. The Colour Test is a low-cost and low-intensity method of diagnosing TB and resistant TB using thin layer agar colour plates. We aim to be able to roll-out the Colour Test to relevant areas for assessment and do not intend to patent this product. 
Type Diagnostic Tool - Non-Imaging
Current Stage Of Development Late clinical evaluation
Year Development Stage Completed 2013
Development Status Actively seeking support
Impact The Colour Test findings have been presented at international meetings and published in international journals (see below). Assessment and evaluation is still ongoing. 
URL http://www.ncbi.nlm.nih.gov/pubmed/22762424
 
Title IFHAD score 
Description We have developed a simple TB risk score that can predict which contacts of patients with TB are at high risk of disease: the IFHAD score. We are currently evaluating, validating and refining this score using prospectively collected data. 
Type Preventative Intervention - Behavioural risk modification
Current Stage Of Development Late clinical evaluation
Year Development Stage Completed 2016
Development Status Under active development/distribution
Impact Identification of TB risk factors among household contacts. 
 
Title Methods to Providing Social Support 
Description Qualitative and quantitative research was done to explore the most essential components of providing social support to persons affected by tuberculosis. Focus groups with international researchers, field team nurses responsible for operational functions of CRESIPT, contacts of persons diagnosed with TB, and persons diagnosed with TB were conducted. Additionally, each of these groups were asked to write and rank what they believed were the three most essential components of providing social support. This knowledge has been used in guiding the delivery of social support in the CRESIPT study. 
Type Therapeutic Intervention - Psychological/Behavioural
Current Stage Of Development Initial development
Year Development Stage Completed 2017
Development Status Under active development/distribution
Impact The impact of this research is still being evaluated as the CRESIPT study is currently in its delivery phase. 
 
Title Peer Mentors 
Description Peer mentors -- people with TB who are participants in the CRESIPT study and are no longer infectious -- provide support to people with TB and their family members newly-enrolled in the CRESIPT study. Peer mentors receive basic orientation in TB disease, transmission, diagnosis and treatment; sputum sample collection and transportation; TB stigma; and how to conduct TB clubs. Peer mentors perform home visits; accompany individuals and their families in obtaining testing for TB; collect and deliver TB sputum samples; assist people with TB to adhere to and complete TB treatment; inquire about TB medication side-effects; and conduct educational workshops and TB stigma reduction and empowerment support groups that are a part of TB clubs. This intervention is currently in the implementation and evaluation stage at multiple sites with large numbers of participants. Funding for this project falls under that provided for CRESIPT. 
Type Preventative Intervention - Behavioural risk modification
Current Stage Of Development Late clinical evaluation
Year Development Stage Completed 2016
Development Status Under active development/distribution
Impact The impact of this research is still being evaluated as the CRESIPT study is currently in the delivery phase. 
 
Title Qualitative Background on Reducing Stigma 
Description Collection of qualitative data on the social determinants that contribute to diagnostic delay of tuberculosis has been completed. This data has been used to help develop and refine TB Clubs aimed to reduce the social stigma surrounding tuberculosis disease. The principle source of funding for this work has been a research fellowship granted for Lily Bonadonna by the Innovation for Health and Development (IFHAD) group. 
Type Health and Social Care Services
Current Stage Of Development Refinement. Non-clinical
Year Development Stage Completed 2016
Development Status On hold
Impact The development of these TB clubs has shown us the important use and need for qualitative data while designing social interventions. 
 
Title Socio-economic support package for people living with TB 
Description Socio-economic support package to be offered to TB patients alongside the standard medical care that is already offered in Peru. The socio-economic support package is being assessed as to its value for reducing bad outcomes for TB patients and reducing risk factors within TB affected households. 
Type Health and Social Care Services
Current Stage Of Development Initial development
Year Development Stage Completed 2013
Development Status Under active development/distribution
Impact Still under development due to begin testing in the coming months. 
 
Title TB Club Educational Workshops (TBCEW) 
Description Educational TB workshops, guided by peer mentors, employ interactive group participation activities to create a safe, non-judgemental environment and sense of cooperative group identity in which to communicate basic information regarding TB disease, transmission, diagnosis, treatment, and prevention; nutritional supplementation; and TB-related stigma. This intervention is currently in the implementation and evaluation stage at multiple sites with large numbers of participants. Funding for this project falls under that provided for CRESIPT. 
Type Preventative Intervention - Behavioural risk modification
Current Stage Of Development Late clinical evaluation
Year Development Stage Completed 2016
Development Status Under active development/distribution
Impact The impact of this research is still being evaluated as the CRESIPT study is currently in the delivery phase. 
 
Title TB Club Support Groups (TBCSG) 
Description Mutual support groups, guided by peer mentors, employ TB Stigma Drawings Booklets (see entry in "Artistic and Creative Products" section) and an interactive TB Stigma Reduction Program (see entry in "Medical Products & Interventions" section) to support people with TB and their family members in identifying and resisting TB stigma, adhering to and completing TB treatment, and having family members tested for TB. Through sharing common experiences, emotions, and thoughts, a sense of common identity and solidarity may emerge, forming a supportive social network that through peer mentor guidance may serve as a foundation for a TB civil society organization (see entry in "Other Outputs & Knowledge/Future Steps" section) to further support and empower people with TB and their family members. This intervention is currently in the implementation and evaluation stage at multiple sites with large numbers of participants. Funding for this project falls under that provided for CRESIPT. 
Type Therapeutic Intervention - Psychological/Behavioural
Current Stage Of Development Late clinical evaluation
Year Development Stage Completed 2016
Development Status Under active development/distribution
Impact The impact of this research is still being evaluated as the CRESIPT study is currently in the delivery phase. 
 
Title TB Clubs 
Description TB Clubs, guided by peer mentors, meet weekly at multiple sites throughout local communities in which the intervention limb of the CRESIPT study is being conducted. TB Clubs include both an educational workshop component and a support group component (see respective entries in "Medical Products, Interventions, and Clinical Trials" section). Overall objectives of the TB Clubs include educating participants about TB; reducing TB stigma; facilitating TB treatment adherence and completion among people with TB and TB testing of family members; creating a common identity, solidarity, and social support network among local community TB Club participants; and establishing a TB civil society organization to empower people with TB and their families at the local, departmental, and national levels. This intervention is currently in the implementation and evaluation stage at multiple sites with large numbers of participants. Funding for this project falls under that provided for CRESIPT. 
Type Preventative Intervention - Behavioural risk modification
Current Stage Of Development Late clinical evaluation
Year Development Stage Completed 2016
Development Status Under active development/distribution
Impact The impact of this research is still being evaluated as the CRESIPT study is currently in the delivery phase. 
 
Title TB Stigma Reduction Program (TBSRP) 
Description The TB Stigma Reduction Program, based on cognitive behavior therapy techniques, serves as the foundation for the CRESIPT TB Club Support Groups (see entry in "Medical Products, Interventions and Clinical Trials" section). This interactive program is designed to guide people with TB and their family members through a series of predetermined questions and self-selected responses to aid them in identifying emotions, thoughts, and behaviors associated with their personal experience of TB stigma, and explore alternative thoughts and behaviors intended to empower them in identifying and resisting TB stigma, adhering to and completing TB treatment, and having family members tested for TB. Peer mentors conduct the support groups and facilitate members' use of the program. The TB Stigma Drawings Booklet (see entry in "Artistic and Creative Products" section) is employed in conjunction with the program. This intervention is currently in the implementation and evaluation stage at multiple sites with large numbers of participants. Funding for this project falls under that provided for CRESIPT. 
Type Therapeutic Intervention - Psychological/Behavioural
Current Stage Of Development Late clinical evaluation
Year Development Stage Completed 2016
Development Status Under active development/distribution
Impact The impact of this research is still being evaluated as the CRESIPT study is currently in the delivery phase. 
 
Title Viability microscopy 
Description Using an old technique of viability assessment with Flouerscein diacetate now adapted to be used with Mycobacterium tuberculosis, we are assessing its role in monitoring treatment response and infectiousness screening in tuberculosis. We have improved the protocol so it can be used in all resource constraint settings, to highlight those not responding to treatment within days of commencement. This will be the first tool of it's kinds, and appropriate from rural to industrialised settings. 
Type Diagnostic Tool - Non-Imaging
Current Stage Of Development Refinement. Clinical
Year Development Stage Completed 2015
Development Status Under active development/distribution
Impact Please see papers below: 1. Datta S, Sherman JM, Bravard M, Valencia T, Gilman RH, Evans CA. Clinical Evaluation of Tuberculosis Viability Microscopy for Assessing Treatment Response. Clin Infect Dis 2014;ciu 1153.: 2. Lawn SD, Nicol MP. Editorial commentary: dead or alive: can viability staining predict response to tuberculosis treatment? Clin Infect Dis 2015;60:1196-8. 
 
Title Appropriate technology TB diagnostic laboratory result management system 
Description The award involves a marked, and challenging increase in TB diagnostic testing by our laboratory, providing participants and the research with TB screening and TB drug-resistance testing. In trying to address this challenge, we noted that our lab team actually spend much longer handling information than handling samples. Checking a sample is quick, finding the right place to record and collate the information is more time consuming. This is because each sample has several tests, each checked on multiple days, so the information flow is quite complex. We were not the first to note this challenge and several companies have developed elegant computerised systems but these are expensive and just as importantly, inflexible. They would require us to fly in an expert programmer from the company every time we change our procedures, which would be inappropriate for a research team like ours. We are therefore developing and plan to publish an 'open access' data management system for diagnostic laboratories. Although developed for TB, it will likely be valuable for other diseases too. 
Type Of Technology Software 
Year Produced 2016 
Open Source License? Yes  
Impact We have completed the first phase. All data associated with a sample is now attached on a miniature paper form to the test. This simple, but highly usual step, means that parallel systems for tests and forms are eliminated. For example, 500 TB diagnostic cultures in our incubators are no longer associated with 500 paper forms in folders that have to be found, cross-checked and updated several times each week for 6 weeks. Rather, all data is now attached to the ongoing culture in the incubator, and can be updated in a moment each time the culture is checked. Although this sounds simple, it is highly unusual or unique in TB laboratories and relies upon the second innovation, that these potentially contaminated, potentially infectious forms are then digitally photographers that the digital image is digitised, without exposing administrative staff to any infection risk. These simple innovations have remarkably increased efficiency and increased capacity to provide research diagnostic information for more participants. The current second phase is developing a flexible, simple, open access 'freeware' tablet computer system for replacing the paper forms. We have obtained independent research funding for this venture ($20,000 USD) and this is in progress with collaborators in NAMRU-6. 
 
Title Household TB risk score 
Description A webpage version of a household level score to predict risk of TB among contacts of patients with TB 
Type Of Technology Webtool/Application 
Year Produced 2018 
Impact Freely available to other research groups and public health programs wishing to implement this score. 
URL https://jscalc.io/calc/8xzrWJ99BMs6uCV7
 
Title Monitoring activities of research nurses 
Description We have used ODK collect (android based freeware), to develop a cloud based system of monitoring the working hours and activities of our research nurses. This has enabled us to implement a more transparent reimbursement policy and accurately summarise the activities of each of our field nurses. 
Type Of Technology Webtool/Application 
Year Produced 2019 
Impact Improvements to our field procedures. 
 
Title Personal TB risk score 
Description A web page version of the IFHAD score 
Type Of Technology Webtool/Application 
Year Produced 2017 
Impact We are currently in the process of developing this app and will evaluate its potential for field use. 
URL https://jscalc.io/calc/qoLectXm5TiopbbD
 
Description Oral presentation and panel discussion - National TB Program - annual conference (Lima, Peru) 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact Presenting recent research findings to the audience including national policy makers, sparking discussion and debate about future policies in Peru.
Year(s) Of Engagement Activity 2014,2015
 
Description Oral presentation and panel discussion - Chagas, TB and HIV conference (Santa Cruz, Bolivia) 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact Chagas, TB and HIV conference (Santa Cruz, Bolivia) - A conference run in collaboration with Universidad Catholica, Santa Cruz, Bolivia and Johns Hopkins, USA. Dr Datta was asked to present a lecture of TB diagnostics and her research findings. Many people were interested in the work, and new collaborations have been made.
Year(s) Of Engagement Activity 2016
 
Description 2° Seminario internacional enfermedades infecciosas - Santa Cruz, Bolivia. 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Professional Practitioners
Results and Impact Involved in a Johns Hopkins University School of Public Health hosted regional research training event, discussing the ethics, study design, study protocol, writing, and dissemination aspects of research. The main objective was to provide capacity building to local health care workers and researchers in public health research in the Santa Cruz district of Bolivia.
Year(s) Of Engagement Activity 2017
URL http://www.ucbscz.edu.bo/es/seminario_internacional_enfermedades_infecciosas
 
Description Abstract and poster presentation at 2019 END TB Conference, the Union-NAR, Vancouver, BC. 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact I presented a 15 minute talk to a group of approximately 20 people, summarizing our abstract and poster, which described our work documenting TB-affected household members' personal definitions and descriptions of TB stigma, and the types of TB stigma these definitions and descriptions may have reflected. After the talk I responded to approximately different 6 conference attendees who were either about to conduct their own stigma-related research and had study design and implementation questions, or who were interested in more in-depth discussion of our study findings.
Year(s) Of Engagement Activity 2019
 
Description Article for The Conversation 
Form Of Engagement Activity Engagement focused website, blog or social media channel
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Public/other audiences
Results and Impact Article about the social determinants of health to "The Conversation" in line with World Tb Day. The Conversation is an independent source of news and views, sourced from the academic and research community and delivered direct to the public.
Year(s) Of Engagement Activity 2018
URL https://theconversation.com/uk
 
Description CRESIPT TB Club Film Documentation 
Form Of Engagement Activity A broadcast e.g. TV/radio/film/podcast (other than news/press)
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Currently developing plans to film the CRESIPT TB Clubs, which will demonstrate the CRESIPT approach to holding social support workshops. The video will feature our team interacting with our participants through a series of activities, including but not limited to: assessment of treatment progression with patients and their families, discussing stigma and discrimination in small groups, educational games, and a group meal. We intend this video to be most useful for our peers, but the video's format will be accessible for the general public as well.
Year(s) Of Engagement Activity 2017
 
Description Capacity Building Workshop in DIRESA Callao 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Professional Practitioners
Results and Impact Two day capacity building and teaching workshops designed and delivered by members in the research team to a mixed group of delegates from the Regional Health Administrative Centre in Callao. We received positive feedback regarding the open style of teaching and the 'building your own research question' discussion with all members of the team, from fieldwork nurses to experienced senior researcher.
Year(s) Of Engagement Activity 2015
 
Description Capacity building - Santa Cruz, Bolivia 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Professional Practitioners
Results and Impact TB, HIV, Chronic infections training day in Santa Cruz, Bolivia. The objective was to share experiences, teach students and capacity build budding researchers.
Year(s) Of Engagement Activity 2016,2017
 
Description Civil society of patient and ex-patient consultation and focus group discussions 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Participants in your research and patient groups
Results and Impact Discussion and feedback on conditional cash transfers for TB affected families.

Set conditional cash transfer size, frequency and duration
Year(s) Of Engagement Activity 2013,2014
 
Description Community workshops for people living with TB 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Type Of Presentation Workshop Facilitator
Geographic Reach Local
Primary Audience Participants in your research and patient groups
Results and Impact Patients and TB patient groups attended workshops to discuss stigma and depression and how to best address these barriers in TB care locally.

On going activities. The findings are to be used to inform the design of the socio-economic intervention offered to TB patients within the activities of the project.
Year(s) Of Engagement Activity 2012,2013
URL http://more information available at www.ifhad.org
 
Description Debate: socioeconomic support versus biomedical interventions for tuberculosis control 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Policymakers/politicians
Results and Impact A debate was held at the World Conference on Lung Health in Cape Town 2015. The debate sparked intense and fruitful discussion among all participants and was very well received by audience members.
Year(s) Of Engagement Activity 2015
 
Description Editorial - Infectious diseases news (USA) 
Form Of Engagement Activity A press release, press conference or response to a media enquiry/interview
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Public/other audiences
Results and Impact Interview on our recent article that was published in clinical infectious diseases.
Year(s) Of Engagement Activity 2015
URL http://www.healio.com/infectious-disease/respiratory-infections/news/online/%7Ba41b0a57-3cc5-4c25-a2...
 
Description Ending tuberculosis: "Miradas y Compromisos Multisectorales" 
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 A multisectoral expert meeting organised by the Peruvian Ministry of Health and CONAMUSA (both our collaborators). This meeting was convened to help set the national agenda for tuberculosis research in Peru.
Year(s) Of Engagement Activity 2017
 
Description European Congress of Clinical Microbiology & Infectious Diseases 2017 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Mycobacterium tuberculosis (TB) aerosol droplets pose significant occupational risks, particularly to healthcare workers, who in low and middle-income countries (LMICs) have presented with at least a three-times higher incidence of TB. Assessing the infectiousness of TB patients is particularly challenging, especially in LMICs. Improvement of infectivity detection could have broad impacts on global TB control.
Material/methods:
We enrolled subjects with suspected TB, with 2+ or 3+ auramine smear, in Lima, Peru and collected clinical, microbiological, radiographic, and cough frequency data. In addition, air-sampling was performed over a 15 minute period of maximally induced cough via a portable 2L/minute vacuum pump onto a PTFE filter with 0.3m pores. Air-sampling was taken on day 0 and 14 of treatment. Air was sampled at 1m distance from the patient's face in an airborne infection isolation room.
In parallel, we performed serial dilutions of 1 McFarland TB suspension overlaid on filter material, to define the limits of detection of TB on this medium.

The filters were subsequently tested with GeneXpert PCR, standard Microscopic Observation Drug Susceptibility (MODS) assay, MODS with a single-step disinfectant, and MODS with NaOH decontamination. Cultures were assessed up to 8 weeks or until positivity.
Results:
5 subjects, so far, have been enrolled and completed the two air-samplings. 4 subjects were 3+ on auramine smear at diagnosis, and 1 subject was 2+. All subjects were found to have positive MODS sputum cultures from their day 0 collection. The average time to positive culture was 8.4 days (95% CI: 4.82 to 11.98). Only 1 subject had a positive day 14 MODS culture, which presented after 6 days. All subjects were drug-sensitive on MODS, in all cultures.
The filters of subjects revealed no positive GeneXpert PCR, nor any positive cultures of MODS with or without disinfectant. Nonetheless, none of the filters developed fungal or bacterial contaminant cultures.
Results of serial dilution reveals GeneXpert PCR can identify H37RB TB up to 1: 104 McFarland dilution on these filters. It can be assumed that our clinical samples have no greater than this dilution of TB in their aerosol sample.
Conclusions:
Low-cost effective tests for infectivity of TB patients is needed within LMIC healthcare settings for a quick risk assessment of TB aerosols. Our device, so far, has not shown presence of TB aerosols, despite the subjects having active TB on sputum culture. This could be a result of desiccation of mycobacteria on the filter or TB aerosols being below the threshold of detection. No contamination of cultures reveals the efficacy of the disinfectant, as contamination remains a problem in prior studies.
The concurrent laboratory study will find the threshold of detection of these filters. These studies combined will elucidate the applicability and efficacy of this device. Prior studies have used unique models to measure TB transmission. Current limitations include small sample size. Future studies will further improve low-cost tests for TB infectivity.
Year(s) Of Engagement Activity 2016,2017
 
Description Focus group discussions with Peruvian National TB Program 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact 1) Deciding on activity and work in parallel with the healthposts
2) Streamline project activities including collection of patients' sputum samples

1) Refinement of the socioeconomic intervention
2) Discussion of how best to collect and process sputum samples
3) Concerns raised about conditional cash transfers and future sustainability of the project
Year(s) Of Engagement Activity 2014
 
Description Focus group discussions with participants 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Participants in your research and patient groups
Results and Impact 1) Informing and education
2) Participant feedback
3) Refinements of the intervention
4) Responding to participants' issues

1) Refinement of the socioeconomic intervention
2) Set up of facilitator training for participants to assist us in our intervention
Year(s) Of Engagement Activity 2014
 
Description Health personnel capacity building 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Professional Practitioners
Results and Impact We have been involved in extensive capacity building with health personnel working at government health posts who deliver TB care. This has predominantly focussed on TB prevention but has also involved TB diagnosis and management of MDR-TB and contacts of MDR-TB. We have received repeated invitations for further capacity building events at these health posts.
Year(s) Of Engagement Activity 2016,2017,2018
 
Description Interview - New Scientist 
Form Of Engagement Activity A press release, press conference or response to a media enquiry/interview
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Public/other audiences
Results and Impact Fresh air and sunshine: The forgotten antibiotics written by Frank Swain for New Scientist, 13 December 2013. Interview of Prof Evans about his guinea pig studies and the findings that UV light and fresh air were the best interventions to reduce TB transmission in healthcare settings.
Year(s) Of Engagement Activity 2013
URL https://www.newscientist.com/article/mg22029470.700-fresh-air-and-sunshine-the-forgotten-antibiotics...
 
Description Interview - Science News 
Form Of Engagement Activity A press release, press conference or response to a media enquiry/interview
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Public/other audiences
Results and Impact Article "A new way to make bacteria glow could simplify TB screening" written by Maria Temming. We were interviewed to explain the potential of a new trehalose test on TB diagnosis and the the limitations of the research published was after the publication Sci Translational Med. 2018 Feb 28;10(430) by Kamariza M et al.
Year(s) Of Engagement Activity 2018
URL https://www.sciencenews.org/article/new-way-make-bacteria-glow-could-simplify-tb-screening
 
Description Interview - The Wire, India 
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 Article "Microscopy-based TB detection gets a much-needed make-over" written by Sarah Iqbal. We were interviewed to explain the potential of a new trehalose test on TB diagnosis and the the limitations of the research published was after the publication Sci Translational Med. 2018 Feb 28;10(430) by Kamariza M et al.
Year(s) Of Engagement Activity 2018
 
Description Interview national Peruvian television 
Form Of Engagement Activity A broadcast e.g. TV/radio/film/podcast (other than news/press)
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Other audiences
Results and Impact Interview on national television during the National Peruvian TB research conference. Presented our findings in TB diagnostic delay, stigma, mitigating TB related costs.
Year(s) Of Engagement Activity 2016
 
Description Interview with Contagion Live 
Form Of Engagement Activity A press release, press conference or response to a media enquiry/interview
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Interview given to online infectious diseases news website regarding recent publication in Lancet Infectious Diseases.
Year(s) Of Engagement Activity 2018
URL http://www.contagionlive.com/news/researchers-create-scoring-system-to-predict-tb-risk-in-adults
 
Description Keynote speakers at Universidad de Ciencias y Humanidades, Lima, Peru 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Undergraduate students
Results and Impact Carlton Evans, Sumona Datta and Matthew Saunders all gave 45 minute keynote presentations at this event, which aimed to promote the importance of research among undergraduate students. The university reported the presentations were very well received and led to an increased interest in research from their students.
Year(s) Of Engagement Activity 2018
 
Description Meeting with JUNTOS national conditional cash transfer scheme in Peru 
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 1) Shared experiences with JUNTOS concerning their roll-out nationally of a poverty-reduction conditional cash transfer scheme

1) Devised conditional cash transfers scheme for our intervention
2) Were able to narrow down appropriate bank providers for the conditional cash transfers
Year(s) Of Engagement Activity 2014
 
Description NIHR health protection research unit (HPRU) evening symposia Key Note Speaker. 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact Professor Carlton Evans gave a talk titled "MDR TB - A Peruvian Experience." This was during the 2 day London advanced TB course, hosted by the NIHR Health Protection Research Unit in Respiratory Infections at Imperial College London. The course was help from 16-17 November 2017 for TB practitioners and public health researchers in the South England region.
Year(s) Of Engagement Activity 2017
 
Description National TB Program consultation and focus group discussions 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact Feedback from Peruvian National TB program on acceptability and feasibility of conditional cash transfers for Tb-affected families

Began pilot project of cash transfers that was rolled out to 32 communities, working alongside the Peruvian National TB Program
Year(s) Of Engagement Activity 2013,2014
 
Description Nature microbiology community 
Form Of Engagement Activity A magazine, newsletter or online publication
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Behind the paper - Mystery patients reveal weakness in tuberculosis care in China written by Dr M Pai, McGill university who discusses the arguments made by our Perspective piece "Improving tuberculosis diagnosis: Better tests or better healthcare? Datta S, Saunders MJ, Tovar MA, Evans CA. PLoS Med. 2017 Oct 17;14(10):e1002406. This was in response to new data his group had generated with regards to health system strengthening for better TB care in China.
Year(s) Of Engagement Activity 2017
URL https://naturemicrobiologycommunity.nature.com/users/20892-madhukar-pai/posts/21403-mystery-patients...
 
Description Official Facebook page 
Form Of Engagement Activity Engagement focused website, blog or social media channel
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Public/other audiences
Results and Impact To provide an overview about the project and to communicate relevant information about tuberculosis for lay-people.
Information published has been viewed and shared by over 1400 people.
Year(s) Of Engagement Activity 2018,2019
URL https://www.facebook.com/Innovation-For-Health-and-Development-820440131489541/
 
Description Oral presentation - Royal Free Hospital, Infectious diseases meeting (London, UK) 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Professional Practitioners
Results and Impact Discussion of personal research findings and update on ongoing TB research within our group
Year(s) Of Engagement Activity 2013
 
Description Oral presentation and panel discussion - Imperial College London - Global Health Meeting (London) 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Postgraduate students
Results and Impact Annual international meeting for Global Health and Innovations at Imperial College London, asked to present recent research findings , and take part in a debate session afterwards with other experts in global health.
Year(s) Of Engagement Activity 2013,2014
URL https://www.imperial.ac.uk/global-health-innovation/global-engagement/wellcome-centre-for-global-hea...
 
Description Participation in Peruvian TB program research priorities 2018 - 2021 
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 Working group of TB researchers in Peru to set a national research agenda and priorities for the years 2018-2021.
Year(s) Of Engagement Activity 2017
 
Description Participation in TB and mental health working group 
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 Discussion and dialogue about pushing forward the agenda of helping relieving the strain of poor mental health in TB affected persons. This working group was held at the 2017 annual world UNION against TB and Lung Disease conference in Guadalajara, Mexico.
Year(s) Of Engagement Activity 2017
 
Description Presentation Belgian NTP - Social Protection 
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 To share our experiences in socio-economic protection, and discuss ideas to improve TB care and socio-economic support for the national TB program in Belgium
Year(s) Of Engagement Activity 2017
 
Description Presentations at the annual Peruvian TB program conference 
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 Policymakers/politicians
Results and Impact Keynote speakers at the annual Peruvian TB conference that also lead to television interviews that were streamed live and on the ministry of health website.
Year(s) Of Engagement Activity 2018
URL https://www.gob.pe/institucion/minsa/noticias/19836-mas-de-1000-profesionales-de-salud-participan-en...
 
Description Press release in National Peruvian Newspaper 
Form Of Engagement Activity A magazine, newsletter or online publication
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Public/other audiences
Results and Impact Press release in Correo Online, a online supplement for the national Peruvian newspaper Correo prior to keynote presenattion at the Shircon 2018 conference.
Year(s) Of Engagement Activity 2018
URL https://diariocorreo.pe/salud/proponen-nuevo-metodo-para-detectar-mas-rapido-la-tuberculosis-en-el-p...
 
Description Radio Interview on National Station 
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 Jimena Castellanos Aguirre was interviewed on national radio program, "Encuentro con la ciencia," hosted by Modesto Montoya about work with IFHAD.
Year(s) Of Engagement Activity 2016
URL https://www.youtube.com/watch?v=yp7t2JVBxro
 
Description Research training capacity building programme 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Professional Practitioners
Results and Impact Members of our research group delivered talks as a part of a research training capacity building programme to local government members and practitioners.
Year(s) Of Engagement Activity 2016
 
Description Shircon 2018:III CONGRESO INTERNACIONAL DE INVESTIGACIÓN EN CIENCIAS Y HUMANIDADES 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Undergraduate students
Results and Impact Keynote speakers for the Annual Shiron conference at Universidad de Ciencias y Humanidades, Lima Peru
Year(s) Of Engagement Activity 2018
URL http://congreso.uch.edu.pe/shircon/expositores
 
Description Talk at Universidad Científica del Sur about training in clinical research 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Undergraduate students
Results and Impact A talk to undergraduate students at Universidad Científica del Sur has been scheduled for May 2018. A talk about the clinical research training of a Peruvian graduate in the UK and his current activities within the CRESIPT project. This activity aims to provide medical students with an overview about clinical research training, discussing different medical career paths, and to highlight the importance of research on public health.
Year(s) Of Engagement Activity 2018
 
Description UK Academics for TB 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Policymakers/politicians
Results and Impact We are a group of academics and clinicians working together to eliminate TB - the world's deadliest infectious disease. We joined forces in early 2018 so that we could combine our research and experience to inform the UN General Assembly meeting that is being organised specifically to tackle this worldwide issue.
Year(s) Of Engagement Activity 2018
URL http://ukatb.org/
 
Description University of Minnesota Grand Challenges: Toward Conquest of Disease - A Brief History of Tuberculosis and the CRESIPT Study 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Undergraduate students
Results and Impact Approximately 30 undergraduate students enrolled in a "Grand Challenges" curriculum course at the University of Minnesota entitled "Towards Conquest of Disease" (GCC 3007/5007), attended a one hour lecture that presented an overview the history of tuberculosis (TB), it's socioeconomic determinants, and factors involved in both the decline of TB in high-income countries and the ongoing TB pandemic in low- and middle-income countries. The design and implementation of the Community Randomized Economic and Social Intervention to Prevent TB study (CRESIPT) was described. Challenges that arose during the design and implementation phases, and steps taken to resolve these issues were also discussed. The course professor later remarked that a number of concepts presented stimulated ongoing class discussions, and several specific issues regarding CRESIPT design and implementation directly impacted students projects.
Year(s) Of Engagement Activity 2017
 
Description Visiting Lecture - Summer Institute, Tropical Medicine, Johns Hopkins (Baltimore, USA) 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Postgraduate students
Results and Impact Giving a talk to Masters students on TB diagnostics, was asked to focus mainly on our research activities.
Year(s) Of Engagement Activity 2014,2015
 
Description Visiting Lecture - Winter Institute Tropical medicine, Johns Hopkins (Baltimore, USA) 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Postgraduate students
Results and Impact Giving a talk to Masters students on TB diagnostics and was asked to focus mainly on our research activities.
Year(s) Of Engagement Activity 2015,2016
 
Description WHO Global TB Symposium presentation - Fighting poverty to control TB 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Policymakers/politicians
Results and Impact The WHO Symposium on 10 October 2017 was co-organised by the WHO, The Union and the Pan American Health Organization/AMRO. Professor Evans was invited by Dr Diana Weil and Dr Priya Shete, to present to this audience of key stakeholders, ministers, national TB program managers from around the globe, and United Nations representatives to present our results on socioeconomic interventions to control TB and foster multisectoral research to end TB . This meeting's objective was to discuss the top outcome areas of the WHO Global Ministerial Conference on Ending TB in the Sustainable Development Era: A Multisectoral Response in 2017 and in advance of the first UN General Assembly High-Level Meeting on TB in 2018.
Year(s) Of Engagement Activity 2017
URL http://guadalajara.worldlunghealth.org/programme/official-pre-conference-and-side-events/who-global-...
 
Description Weekly TB clubs. 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Patients, carers and/or patient groups
Results and Impact In the 16 communities receiving the intervention described, we hold weekly community meetings called TB clubs. Approximately 100 TB patients and their family members attend each of these clubs where we discuss multiple aspects of TB prevention, care and cure. These meetings have been very well received with participants frequently attending multiple events.
Year(s) Of Engagement Activity 2017,2018,2019
 
Description Working meeting - Peruvian president P. Kuczynski 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Policymakers/politicians
Results and Impact The then Presidential candidate requested a meeting with the Prof Carlton Evans and Dr Sumona Datta to present their research, experiences with the TB and the Peruvian health system and discuss ways to improve TB related social protection.
Year(s) Of Engagement Activity 2015
 
Description World TB Day 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Public/other audiences
Results and Impact Every year our research group helps to organise and take part in community activities to raise awareness for World TB day in March. These activities involve marches, street "markets" where information on TB is readily accessible to the general public, and engagement with local media.
Year(s) Of Engagement Activity 2013,2014,2015,2016,2017
 
Description Zero TB initiative two day training event for health professionals 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Professional Practitioners
Results and Impact Members of our research group participated in and gave presentations at this training days set up by the Zero TB initiative.
Year(s) Of Engagement Activity 2017
URL https://www.zerotbinitiative.org/new-blog/2018/1/25/momentum-builds-at-zero-tb-event-in-lima-peru