Abstract
Tuberculosis (TB) is an infectious disease which records 1 to 1.5 million deaths every year. Persons affected by TB have increased mortality and morbidity, despite advances made in treatment options. This thesis investigated several avenues which could enhance TB clinical care. These avenues include digital health, therapeutic drug monitoring (TDM), interventions geared towards enhancing quality of life, and enhancing policies concerning TB screening and prevention.
Concerning digital health, results presented in the thesis indicate that it could be a cost-effective, feasible, and welcomed addition by both medical professionals and persons suffering from TB, to standard of care in multiple steps of the TB care cascade, from screening, to follow up. Concerning TDM, which is a personalised medicine technique informing clinicians of accurate drug dosages (usually) in blood, an international survey described in the thesis indicates that worldwide experts would recommend integrating this technique in standard of care and a retrospective study presents, in a contextualised manner, which patients would best benefit from this technique. This thesis, furthermore, presents an observational study on persons with TB quality of life and wellbeing, in order to quantify the magnitude of effects of TB during, but also after treatment completion so that future interventions could have this crucial human aspect in mind. Last, but not least, part of this thesis research focused on vulnerable persons affected by TB, namely migrants, and how the screening for TB infection is performed on an European level, in order to set the groundwork for future European consensus.
Overall, results of this thesis indicate that greater care should be offered to persons at risk of developing side effects of TB or of the treatment for TB and more research should be involved in implementing personalised medicine techniques at all levels of the clinical care cascade.
Concerning digital health, results presented in the thesis indicate that it could be a cost-effective, feasible, and welcomed addition by both medical professionals and persons suffering from TB, to standard of care in multiple steps of the TB care cascade, from screening, to follow up. Concerning TDM, which is a personalised medicine technique informing clinicians of accurate drug dosages (usually) in blood, an international survey described in the thesis indicates that worldwide experts would recommend integrating this technique in standard of care and a retrospective study presents, in a contextualised manner, which patients would best benefit from this technique. This thesis, furthermore, presents an observational study on persons with TB quality of life and wellbeing, in order to quantify the magnitude of effects of TB during, but also after treatment completion so that future interventions could have this crucial human aspect in mind. Last, but not least, part of this thesis research focused on vulnerable persons affected by TB, namely migrants, and how the screening for TB infection is performed on an European level, in order to set the groundwork for future European consensus.
Overall, results of this thesis indicate that greater care should be offered to persons at risk of developing side effects of TB or of the treatment for TB and more research should be involved in implementing personalised medicine techniques at all levels of the clinical care cascade.
| Original language | English |
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| Qualification | Doctor of Philosophy |
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| Award date | 20-Sept-2023 |
| Place of Publication | [Groningen] |
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| Publication status | Published - 2023 |