Directed Reading: Tuberculosis Prevention and Care
Tuberculosis (TB) prevention and care serves as the fundamental knowledge to understand public health foundations in disease control. TB is a historically deadly disease having killed over 1/6 people in England in the 1900s. Since DOTS has been approved as the most cost-effective treatment and control strategy in 1970s, TB has become a curable disease with treatment per case less than $10. Thanks to the paramount international efforts dedicated to TB control, global TB incidence rate has fallen by an average of 1.5% per year since 2000, and TB death rate has dropped nearly half between 1990 and 2015. However, TB is a disease of poverty, and has global health importance. TB still remains NO 1 infectious disease killer globally (1.5 million deaths and 9.6 million cases in 2014). It is declared as a global public health threat by the World Health Organization in the 1990s due to the emergence of multi-drug resistant TB, and the widespread of HIV/TB co-infections. Low and middle income countries (LMIC) except BRICKS countries rely heavily on international donors/agencies for their national TB control programs. This course will introduce TB from microbiological, clinical, public health and health policy perspectives. It will discuss TB pathology, epidemiology, TB control programs evolution, policies and practices both at local and global levels. Social, ethical and health system issues of TB control will be explored in the context of TB control. Examples of epidemiological, clinical, social science, spatial and operational research on TB will be given.
Prerequisites: Students should have completed either a quantitative or qualitative research method course, or with permission of the instructors. This course is intended for Master students who have taken research method courses, or any year of PhD students. This course is open to both PHS and IHPME students.
The goal of this course is to provide students a solid understanding of the interactions of clinical and public health in the context of TB prevention and care. Both students from the Public Health Sciences (PHS) and Health Policy Management and Evaluation (HPME) will be welcomed to join and will benefit from the cross-disciplinary learning. Students will be exposed to different study skills relevant in TB control context, such as quantitative (e.g., epidemiological, and interventional) and qualitative (e.g., social science) studies, policy evaluations, operational research and spatial analysis (geographical information system, GIS). Students will have the opportunities to learn from each other’s expertise and insights. By the end of the study, students will acquire the skills to critically evaluate disease control programs at local or national levels.
Specifically, by the end of the course, students should
- Have a solid knowledge on the essential elements of clinical and public health in TB control that is fundamental to public health approaches;
- Understand the historical evolution of TB control programs and policies in Canada and internationally;
- Understand ethical, social and health system issues in TB control and their interactions;
- Understand how different research skills can be applied in TB studies, such as cohort analysis, social science, trials, operational research, genotyping and GIS;
- Gain insights of TB prevention and care in various settings, including countries of low TB burden (e.g., Canada) and different high TB burden settings (e.g., China, Russia, South Africa); and
- Be able to critique country TB control programs and design operational studies.