Project Summary According to the World Health Organization (WHO), the global burden of tuberculosis peaked in 2000 and has since declined by 2.0% per year. Although this progress is encouraging, tuberculosis remains a leading cause of death, as over 1.4 million people die per year of the disease. Moreover, low- and middle-income countries especially in sub-Saharan Africa and Southeast Asia bear a disproportionately high burden of tuberculosis compared to other parts of the world. The overarching goal of this proposal is simple: to reduce the burden of tuberculosis in sub-Saharan Africa, in particular Uganda. To reach this goal, we believe that we need new metrics for tuberculosis burden that lead to actionable steps to reduce transmission or prevent progression of infection to disease. We also need better ways to manage the disease by ensuring proper adherence to effective treatment regimens to achieve desired clinical outcomes. The current proposal is built upon the premise that digital mobile technologies, that were not developed with health purposes in mind, may be leveraged in imaginative and novel ways to provide useful information about tuberculosis transmission, infection, and disease. Indeed, over the past decade, we have developed a portfolio of research projects using cellular telephone metadata, GPS-enabled watches, and smartphone video apps to study central questions about tuberculosis persistence in Kampala and Uganda more broadly. These projects have generated large, complex and interconnected databases that require a high level of quantitative skills and sophistication to manage and analyze. Yet, the expertise to design studies and analyze these types of data currently lies in a small group of researchers from diverse disciplines, such as epidemiology, geography, network science, computing, machine learning and artificial intelligence, among others. To realize the full potential of digital mobile technologies in measuring useful health information, we propose to build a critical mass of researchers with expertise across two or more disciplines who are dedicated to applying new methods to study the longstanding and stubborn questions about the persistence of tuberculosis in Africa. To create this critical mass of researchers in Uganda, we propose the following Specific Aims: 1. To train two Ugandan pre-doctoral trainees at the University of Georgia (UGA) in epidemiology, one with a special focus on geography of tuberculosis and the other with focus on machine learning and artificial intelligence to enhance digital adherence technology; 2. To train two to three master’s students per year enrolled at Makerere University by supporting their master’s thesis research in topics related to tuberculosis and geography, computer science, or modern digital technologies; 3. To conduct non-degree training to build and strengthen research capacity in digital mobile technologies and tuberculosis through annual recess-term short courses on relevant topics, monthly research seminars, and modern digital health technologies symposia at the Ugandan Society of Health Scientists’ annual conference.
PI: Christopher Whalen