NIHR Post-TB CARE (Centre for Assessment and Research Excellence)

An estimated 155 million survivors of tuberculosis are alive today at high risk of biological, psychosocial and economic residual impairments, including death. Despite this need, post-TB care is mostly absent in low and middle income countries, which carry most of the burden. Pivotal knowledge gaps prevent effective assessment of post-TB impairment, or the design of feasible care that meets patient needs.

Our NIHR Global Health Research Group Post-TB CARE will work across South Africa and Cambodia to address major knowledge gaps and disseminate findings across high-burden, resource-limited settings while establishing a post-TB centre of excellence. Aim: To improve post-TB care in high-burden, resource-limited settings

Objective 1. Develop an operational multidimensional assessment tool which can quantify impairment in TB survivors to accurately assess post-TB care needs.

Objective 2. Design an effective, appropriate and sustainable post-TB care package for resource-limited settings, using principles of good clinical governance. Objective 3. Create a knowledge sharing and advocacy platform for post-TB in high-burden TB settings.

Objective 4. Develop a multi-disciplinary centre of excellence for post-TB research, care and community engagement in South Africa to enable sustainable, collaborative south-south and north-south research partnerships in post-TB.

We will use patient-guided research, linking of networks, and the establishment of a collaborative centre of excellence for post-TB research care and community engagement in South Africa. Our research team includes TB survivors, clinicians and relevant academic research disciplines, who will work together to complete the following work packages:

Work package 1: Assess the range and extent of biological, psychosocial, and economic impairment in a TB survivor cohort including Early and Late post-TB periods to inform development and refinement of an operational multidimensional assessment tool.

Work package 2: Conduct discrete choice experiments and in-depth qualitative research with TB survivors and care providers in South Africa and Cambodia to design an effective, appropriate, and sustainable post-TB care package for resource-limited settings

Work package 3: Convene online and in-person meetings between post-TB communities, researchers, and policy makers from high TB burden settings to create a knowledge sharing and advocacy platform for post-TB.

Work package 4: Enhance human and material research infrastructure through training in clinical and socio-behavioural research, community engagement, and administrative support to develop a multi-disciplinary centre of excellence for post-TB in South Africa

By completion of the four-year project our results will provide post-TB communities, care providers, researchers and policy makers with the vital foundational empirical evidence required to appropriately assess the multidimensional care needs of TB survivors, and develop a patient and provider-led template for post-TB care in resource-limited settings. The established knowledge sharing and advocacy platform and multi-disciplinary centre of excellence will form the scaffold for ongoing collaborative research networks to interact and develop post-TB interventions and policies.

It will enable urgently needed locally-led funding applications and multi-country operational trials in post-TB, continuing to improve post-TB care for the millions of TB survivors and their communities in need today.