# Tracking tuberculosis patients in Ukraine to understand pathways through care and the impact of geographic movements

> **NIH NIH R03** · BOSTON UNIVERSITY MEDICAL CAMPUS · 2022 · $82,500

## Abstract

PROJECT SUMMARY
Tuberculosis (TB) caused 1.45 million deaths globally in 2018. Given that TB incidence is decreasing by only
2% annually, achieving the World Health Organization’s ENDTB goal of TB elimination by 2050 will require
innovations in our TB control approach. Previous elimination strategies for other diseases were only successful
once spatial variation in disease incidence was identified and locally relevant interventions implemented. TB
elimination strategies require longitudinal TB cohorts that incorporate detailed spatial information. Ukraine is an
ideal setting for our proposal with its high rifampin resistant (RR) TB burden (eighth highest globally), one third
of Europe’s HIV/TB co-infected cases, centralized collection of demographic, laboratory, clinical and spatial
data on all patients diagnosed with TB nationally (“eTB Manager”), and generalizability of results to other
Former Soviet Union (FSU) countries. We will develop a six-year national TB cohort to track patients
longitudinally and spatially including TB drug resistance and HIV status data, using eTB Manager. We
hypothesize that eTB Manager data can be used to identify key metrics in the TB care cascade, at the district
level, and evaluate the association between population movement and TB/RRTB care cascade gaps and
burden. In aim 1a, we will compile a six-year cohort of ~180,000 TB patients diagnosed in Ukraine 2015-2020.
In aim 1b, we will estimate key metrics in the TB care cascade and treatment pathways stratified by drug
resistance profiles and HIV status. In aim 1c, we will examine the TB care cascade by district to identify spatial
variation in care cascade metrics. In aim 2, we will map patient movements and understand the relationship
between movements and key care cascade metrics and TB outcomes, stratified by drug resistance profile and
HIV status. In aim 2, we will also quantify the association between population movement and TB/RRTB
burden, allowing for development of targeted interventions to reduce TB morbidity and mortality. This
contribution is significant because it will develop a national six-year cohort of TB patients tracking them
longitudinally and spatially during treatment, enabling local public health professionals to develop locally
appropriate interventions to close gaps in the TB care cascade and understand the impact of interventions and
new TB diagnostics. The proposed work is innovative because it will provide the first cohort of this kind in a
FSU country, with the longitudinal and spatial nature of these data allowing for unique assessment of TB care
and the impact of interventions. This will allow policy makers to design locally-relevant interventions targeting
specific gaps in TB care and migrant populations, preventing further spread and ultimately reducing disease
and mortality due to TB. By using routinely collected data, our model adds minimal financial costs and can be
adapted for similar settings with routinely-collected TB data. T...

## Key facts

- **NIH application ID:** 10421461
- **Project number:** 5R03AI164123-02
- **Recipient organization:** BOSTON UNIVERSITY MEDICAL CAMPUS
- **Principal Investigator:** Helen E. Jenkins
- **Activity code:** R03 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $82,500
- **Award type:** 5
- **Project period:** 2021-06-07 → 2024-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10421461

## Citation

> US National Institutes of Health, RePORTER application 10421461, Tracking tuberculosis patients in Ukraine to understand pathways through care and the impact of geographic movements (5R03AI164123-02). Retrieved via AI Analytics 2026-05-26 from https://api.ai-analytics.org/grant/nih/10421461. Licensed CC0.

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