Bangkok Workshop on the MATCH Approach to Tuberculosis Care in South & South-East Asia

Project

The Center for Applied Spatial Epidemiology (CASE) of KIT Royal Tropical Institute provided training in the MATCH Approach to tuberculosis (TB) programme staff who use data to improve programme effectiveness.

Funded by the Global Fund, The Stop TB Partnership and the WHO Global TB Program, the CASE team traveled to Bangkok to facilitate the “Regional Asia Workshop on the use of subnational and disaggregated data for strategic planning in TB.” During the workshop, CASE trained TB epidemiologists and health professionals to use Geographic Information Systems (GIS) to map and analyse data which was made available via a shared cloud database.

The MATCH Approach to TB care coverage

The MATCH Approach provides data analysts and decision makers with tools and methods to use their program data to make better informed decisions supported by local evidence. Therefore it is essential that the tools and methods are easily accessible and adopted by health professionals and epidemiologists focusing on TB prevention and care.

Prior to the workshop, CASE worked with TB experts from WHO to collect and process data to make it easily accessible for analysis and mapping using a standardised and internally consistent cloud-based database. Although the principles of the data management requirements are quite clear, in practice it was a complex process which KIT is now attempting to simplify in collaboration with District Health Information System 2 (DHIS2) and QGIS developers. The purpose of this is to remove the data management barriers preventing disease program personnel to analyse, map and use their country’s subnational data for locally differentiated programs.

Results

Together with our partners and TB experts from the nine South and South-East Asian countries, the nine steps of the MATCH Approach were applied using each country’s data. After participants learned how to map and interpret their data in Quantum GIS (QGIS), TB program management staff joined the workshop to discuss how mapped outputs could be used to inform localised planning.

Participants of the workshop produced informative and well-conceived subnational maps, demonstrating variations in TB burden and program responses. The map below produced by members of the Philippines Ministry of Health highlighted the discrepancy between diagnostic capacity and diagnostic outputs among 81 regional units in their country. This result shows, against general expectations, that the number of people with TB symptoms where the TB bacterium was actually found based on lab confirmation (bacteriologically confirmed) is low in areas where more testing services are available (Xpert). This observation raises questions about whether the patients who are referred to be tested actually have TB symptoms or whether the coverage and access to these services are sufficient. Such observations result in follow-up questions which are to be validated using information on the presence of risk groups and potential barriers preventing people to get access to TB testing services.