Table 2.

Examples of Implementation Science Research Questions for Tuberculosis (TB) and HIV Infection

Research area, evidence-based intervention	Priority implementation research agendas	Disciplines required
Prevention
IPT	Long-term efficacy, adherence, and drug resistance surveillance during IPT implementation	Biomedical science, epidemiology, modeling
Intensified TB case finding	Determination of optimal TB screening method for all patients presenting to HIV clinics	Medical informatics, decision analysis, epidemiology, anthropology
Infection control	Comparison of administrative interventions (triage) to reduce nosocomial transmission in outpatient waiting rooms and inpatient wards; modification or construction of HIV and TB clinics to maximize ventilation or incorporate UVGI	Architecture, engineering, environmental health, biomedical science, epidemiology, business management
Diagnosis
Expedited, point-of-care TB diagnostics	Comparison of strategy of country- and/or region-wide dissemination of existing TB nucleic acid amplification testing vs capacity-building for specimen transportation to centralized reference laboratories (with an emphasis on rural and hard-to-reach communities)	Business and/or economics, education and/or training, biomedical science, modeling, engineering
MDR-TB screening	Development of TB DST surveillance networks and determination of the optimal algorithm for obtaining DST in TB and HIV–coinfected patients	Epidemiology, biomedical science, education and/or training, modeling
Treatment
Treatment for HIV infection and TB	Community- and/or region-wide comparison of colocation vs coordination of TB and HIV care (including assessment of nosocomial transmission, stigma, adherence, drug supply, cost, convenience, adverse events, and drug interactions); adherence support in primary TB treatment and its impact on prevention of MDR and XDR	Biomedical science, behavioral science, public policy, business and/or economics, epidemiology, anthropology
Treatment for MDR- and XDR-TB	Assessment of efficacy and feasibility of home-based vs hospital- and/or clinic-based DOT; assessment of household transmission vs nosocomial transmission of MDR- and XDR-TB with different treatment strategies	Ethics, behavioral science, economics, modeling, environmental health

NOTE. DOT, directly observed therapy; DST, drug-susceptibility testing; IPT, isoniazid preventative therapy; MDR, multidrug resistant; UVGI, ultraviolet germicidal irradiation; XDR, extensively drug resistant.