Data Suggest Demise of Tuberculosis Is Slowing. But Tech Offers Hope.

Jack Murtha

Why telehealth could help the CDC and other healthcare stakeholders decimate the disease.

Tuberculosis (TB), it seems, has a special link with medical innovation, and it has since the mid-1900s, when scientists began to discover drugs capable of taming what was previously uncontrollable. Although TB may not command the headlines and anxieties it once did, it is still very much a problem—and it is still very much connected to cutting-edge healthcare technologies.

First, the bringer of bad news: data. Last week, the CDC released numbers suggesting that although TB cases continue to decline in the United States, the rate has slowed, meaning it won’t be eliminated by the year 2100. Americans reported 9093 new cases of TB in 2017, a decrease from the prior years, according to the CDC. But the TB rate “remains at levels 28 times higher than the TB elimination target rate,” the agency noted.

So, at least for the time being, this country is forced to grapple with a disease that much of the public might assume is no longer a threat. The data and analytics, as they often do, spotlighted a problem that otherwise might go overlooked.

“I had hoped we would eliminate TB in my children’s lifetime, but the goal is elusive,” said Jonathan Mermin, MD, who heads the CDC’s National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention. “Nine thousand TB cases in this country is far too many. Each case represents a human and financial burden shouldered by those with TB, their families, and the nation’s healthcare system.”

Still, the same data that brought last week’s bad news also offered cause for applause: The tally amounted to the fewest cases and lowest rates on record, according to the CDC.

New technologies that could elevate the campaign against TB, meanwhile, are in the works. And some are already in use.

For starters, the CDC is using electronic directly observed therapy to “make TB treatment less expensive and more convenient for patients and staff.” Public health officials have already employed this telemedicine technique to combat outbreaks and aid far-flung communities and institutions.

In Puerto Rico, for instance, the use of mobile video to observe therapy fostered greater medication adherence and eased the burden on healthcare organizations. That helped clinicians clamp down on a dangerous situation that might have worsened once a hurricane hit the island. A similar use of tech-driven video observation also helped ensure that 97% of TB patients in Texas didn’t miss a single medication dose when Hurricane Harvey pounded the area.

The CDC is also promoting a shorter treatment regimen, a better and quicker diagnostic blood test, and a more vigilant, population health-focused mind set for providers dealing with patients who are at increased risk of TB.

“Challenges remain and progress to elimination is slower than we would like,” said Philip LoBue, MD, who leads CDC’s Division of Tuberculosis Elimination. “The good news is that the path to accelerated progress is clear: expanded implementation of testing and treatment of latent TB infection and a commitment to the research of newer, more efficient diagnostic tools.”

Equally encouraging is the wide range of projects, focused on tackling TB through tech, stemming from the private and academic worlds. Internet of Things evangelists are targeting the disease, and deep-pocketed start-ups have also analyzed TB and the development of potential treatments.

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