Team Treatment-Buddies and TB
Tuberculosis claims nearly 2 million lives annually. The vast majority of these deaths occur in the developing world, where lack of drug adherence leads to new and deadly drug-resistant strains. TB fatalities arise not from a lack of scientific knowledge—effective treatment was developed in 1946—but in the last mile of treatment. Figuring out where treatment has failed and how to best address it is what MIT students Kathleen Cui (Course 14, ’08) and Shelly Manber (Course 18, ’08) set out to do last spring in response to the IDEAS Competition Yunus Challenge.
Through research and discussions with various experts, Shelly and Kathleen discovered that patient mentality was a key factor in determining drug adherence. A cumbersome drug regimen coupled with a distrust and misunderstanding of the treatment and social stigma lead many patients to drop out of treatment before completion. The side effects of the treatment continue long after the symptoms of the disease are alleviated, making treatment uncomfortable as well as seemingly unnecessary, and most do not know the dangers of non-adherence. Social stigma is also a powerful disincentive; patients diagnosed with TB are often ostracized by the community as well as their own family. Kathleen Cui and Shelly Manber formed Team Treatment-Buddy (TTB), a patient support group program that provides education and support for patients during their difficult 6-8 months of treatment. TTB is working with the Prajnopaya Foundation, an India-based NGO, to improve upon the DOTS (Directly Observed Treatment, Short-course) program offered by the Prajnopaya Foundation.
Upon winning a $2,500 IDEAS Competition award, Kathleen and Shelly received a grant from the PKG Center that enabled them to travel to India over IAP. In partnership with The Prajnopaya Foundation, they trained community members to lead the pilot program scheduled for April 2008. The week-long workshop in Dhanurua, a local village in the Indian state of Bihar, trained the group of 25 to become effective TB support group leaders, among whom seven were selected to become future trainers.
Throughout the week, volunteers participated in brainstorms, role playing and discussions. Shelly and Kathleen learned about the lives of those living in the village, information that will be useful in planning TTB support groups. “We are becoming more and more convinced that TB support groups have the power to change the mentality of both the patient and the community,” Shelly and Kathleen report. At least one of the team members will be returning in late March, shortly before the TB support groups are slated to begin. The team looks forward to their return, heartened by what they saw in January. “I was touched by their genuine desire to work to educate about TB,” says Shelly.