TB Research Technical Working Group (TBR TWG)

Background

Zimbabwe is a high-burden country for TB, MDR-TB as well as TB/HIV co-infection (World Health Organization, 2019). Zimbabwe ranks 17th among the world’s high TB burden countries and 4th according to incidence per capita. As of 2018, per 100 000 population, total TB incidence was estimated at 210 (155-272), with an incidence of 130 (96-169) in the HIV positive subgroup. In the same year 2018, the MDR/RR-TB incidence was 10 (7.4-14) per 100 000 population (WHO, 2018). Also, in 2018, the estimated proportion of TB cases with MDR/RR-TB was 3.9% (3.5-4.3) for new cases and 14% (8.9-20) in previously treated cases. In 2017, treatment success was at 83% for new, relapse and previously treated cases (WHO, 2018). The government of Zimbabwe is committed to ending TB by 2030. By 2025, the National TB Program aims to reduce TB incidence and mortality by 80% (Ministry of Health and Child Care, 2017).

Intervention-based research and routine data collection using robust sampling methods is essential in measuring progress. Phase one of the technical working group drafted the national TB research agenda. The formation of a technical working group of experts was a major milestone in the country. The national TB research agenda drafted in phase one is expected to provide evidence for program performance, decision making and planning. However, support is needed to scale-up the implementation of the national TB research agenda. This TCG seeks to steer operational research based on the priorities document drafted in Phase 1.

Notably, the 2021-2025 NSP notes the strengths and weaknesses in TB operational research in the country (Ministry of Health and Child Care, 2020). Key strengths include the availability of a comprehensive TB recording and reporting system incorporated into the DHIS2 tool and the availability of more TB data following the successful completion of the TB prevalence survey in 2014/2015. However, the 2017-2018 NSP notes the limited capacity for program-based operations research. Some of the agenda items already identified in the NSP include the need to conduct operations research to understand unique factors to TB among the migrant population; and determine HIV related causes of high mortality among TB patients on treatment.

The vision of the National TB Program is to achieve 80% reduction in TB incidence and mortality by 2025.

Purpose of the TBR TWG

The NTP’s relevant operational plan in achieving this goal has the following targets:

  • Formulate a national TB research agenda (This was done in Phase 1)
  • Conduct operational research training.
  • Conduct national research open day (The first Open Day was done in Phase 1)

Anticipated outputs, outcomes, results and impact

The major outcome is the national TB research agenda that will set the stage for operational research with the capacity to provide evidence for TB programme performance, decision making and planning. The resultant research activity is expected to improve services, making them more patient-centered and addressing barriers to care, while improving client flow or turn-around time from sample submission to diagnostic result communication. The technical working group for this activity is also an important step in promoting collaborative synergies between the NTP and implementing partners, private sector, donors and research institutions, with potential spinoffs being better quality TB data produced, nuanced TB policies and enhanced research output dissemination. The resultant research agenda with clear priority levels will enhance resource allocation and may attract more targeted research funds for the agenda items. 

The milestones of this activity are in line with the NTP’s relevant operational plan (National Tuberculosis Control Programme, 2013), namely:

Activity 1: Notify the Director – AIDS & TB Unit via email on NTP’s move to TB Research TWG to Phase 2

Activity 2: Recruit a technical assistant (TA) to provide assistance on operational research and assist in all TB research (TBR) activities in the TCG.

Activity 3: Meetings to disseminate the TB research priorities and rally researchers on key operational research areas [half-day meetings]; meetings to be conducted every Friday over 4 weeks

Activity 4: Conduct a capacity building training for key provincial cadres on TB operational research; the training to have theory and practical sessions on use of available data in operational research; Training to also provide TA on how to write mini proposals on operational research

Activity 5: Conduct a one-day conference on TB research in Zimbabwe                                       

Activity 6: Conduct Quarterly TB Research Technical Working Group (TBR TWG) meetings