Digital health for the End TB Strategy: developing priority products and making them work

Falzon, Dennis; Timimi, Hazim; Kurosinski, Pascal; Migliori, Giovanni Battista; Gemert, Wayne van; Denkinger, Claudia M.; Isaacs, Chris; Story, Alistair; Garfein, Richard S.; Bastos, Luis Gustavo do Valle; Yassin, Mohammed A.; Rusovich, Valiantsin; Skrahina, Alena; Hoi, Le Van; Broger, Tobias; Abubakar, Ibrahim; Hayward, Andrew; Thomas, Bruce; Temesgen, Zelalem; Quraishi, Subhi; Delft, Dalene von; Jaramillo, Ernesto; Weyer, Karin; Raviglione, Mario

doi:10.1183/13993003.00424-2016

Cited by 75 publications

(76 citation statements)

References 67 publications

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“…Digital or electronic health applications to manage multidrug resistant tuberculosis (MDR-TB) can contribute to large-scale implementation of new diagnostics and novel medicines, particularly in resource-constrained countries [2]. One such electronic, web-based system is e-TB Manager, which manages much of the information needed by a country's national TB control programme.…”

Section: Introductionmentioning

confidence: 99%

User experience analysis of e-TB Manager, a nationwide electronic tuberculosis recording and reporting system in Ukraine

2017

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Ukraine has successfully implemented e-TB Manager nationwide as its mandatory national tuberculosis registry after first introducing it in 2009. Our objective was to perform an end-of-programme evaluation after formal handover of the registry administration to Ukraine's Centre for Disease Control in 2015.We conducted a nationwide, cross-sectional, anonymous, 18-point user experience survey, and stratified the registry's transaction statistics to demonstrate usability.Contrary to initial implementation experience, older users (aged >50 years), often with limited or no computer proficiency prior to using the registry, had significantly better user experience scores for at least six of the 12 measures compared to younger users (aged 18–29 years). Using the registry for >3 years was associated with significantly higher scores for having capacity, adequacy of training received and satisfaction with the registry. Of the 5.9 million transactions over a 4-year period, nine out of 24 oblasts (regions) and Kiev city accounted for 62.5% of all transactions, and corresponded to 59% of Ukraine's tuberculosis burden. There were 437 unique active users in 486 rayons (districts) of Ukraine, demonstrating extensive reach.Our key findings complement the World Health Organization and European Respiratory Society's agenda for action on digital health to help implement the End TB Strategy.

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Section: Introductionmentioning

confidence: 99%

User experience analysis of e-TB Manager, a nationwide electronic tuberculosis recording and reporting system in Ukraine

2017

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“…6 Effect of mobile-phone messaging on TB TSR sub-grouped by model of phone messaging phones as a health care intervention tools for TB patients [56]. Mobile Health is now inevitable to play big role to end the global TB epidemic [57]. In this review majority of the studies were obtained from Asia followed by Africa.…”

Section: Discussionmentioning

confidence: 99%

Does phone messaging improves tuberculosis treatment success? A systematic review and meta-analysis

et al. 2020

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Background: Compliance to anti-TB treatment is crucial in achieving cure and avoiding the emergence of drug resistance. Electronic health (eHealth) interventions are included in the strategy to end the global Tuberculosis (TB) epidemic by 2035. Evidences showed that mobile messaging systems could improve patient adherence to clinic appointment for diagnosis and treatment. This review aimed to assess the effect of mobile-phone messaging on anti-TB treatment success. Methods: All randomized controlled trial (RCT) and quasi-experimental studies done prior to August 26, 2019 were included in the review. Studies were retrieved from PubMed, EMBASE, Cochrane and ScienceDirect databases including, grey and non-indexed literatures from Google and Google scholar. Quality of studies were independently assessed using Cochrane Risk of Bias Assessment Tool. A qualitative synthesis and quantitative pooled estimation were used to measure the effect of phone messaging on TB treatment success rate. PRISMA flow diagrams were used to summarize article selection process. Results: A total of 1237 articles were identified, with 14 meeting the eligibility criteria for qualitative synthesis. Eight studies with a total of 5680 TB patients (2733 in intervention and 2947 in control groups) were included in metaanalysis. The pooled effect of mobile-phone messaging revealed a small increase in treatment success compared to standard of care (RR 1.04, 95% CI 1.02 to 1.06), with low heterogeneity (I 2 = 7%, p < 0.0002). In the review, performance, detection and attrition biases were reported as major risk of biases. Conclusions: Mobile-phone messaging showed a modest effect in improving anti-TB treatment success; however, the quality of evidence was low. Further controlled studies are needed to increase the evidence-base on the role of mHealth interventions to improve TB care. Protocol registration number: CRD420170744339.

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“…In 2015, WHO established a Global Task Force on Digital Health for TB and, together with the European Respiratory Society, published an agenda detailing how digital health interventions could be promoted and integrated into national operational plans to implement the End TB Strategy . During this consultation, several ‘target product profiles’ were developed to define the features of desired digital health solutions and stimulate further interest from potential developers . These include interventions to improve patient care; support disease surveillance and monitoring; facilitate program management; and provide platforms for eLearning.…”

Section: Introductionmentioning

confidence: 99%

Mobile phone interventions for tuberculosis should ensure access to mobile phones to enhance equity – a prospective, observational cohort study in Peruvian shantytowns

Saunders

Wingfield

Tovar

et al. 2018

Tropical Med Int Health

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ObjectivesMobile phone interventions have been advocated for tuberculosis care, but little is known about access of target populations to mobile phones. We studied mobile phone access among patients with tuberculosis, focusing on vulnerable patients and patients who later had adverse treatment outcomes.MethodsIn a prospective cohort study in Callao, Peru, we recruited and interviewed 2584 patients with tuberculosis between 2007 and 2013 and followed them until 2016 for adverse treatment outcomes using national treatment registers. Subsequently, we recruited a further 622 patients between 2016 and 2017. Data were analysed using logistic regression and by calculating relative risks (RR).ResultsBetween 2007 and 2013, the proportion of the general population of Peru without mobile phone access averaged 7.8% but for patients with tuberculosis was 18% (P < 0.001). Patients without access were more likely to hold a lower socioeconomic position, suffer from food insecurity and be older than 50 years (all P < 0.01). Compared to patients with mobile phone access, patients without access at recruitment were more likely to subsequently have incomplete treatment (20% vs. 13%, RR = 1.5; P = 0.001) or an adverse treatment outcome (29% vs. 23% RR = 1.3; P = 0.006). Between 2016 and 2017, the proportion of patients without access dropped to 8.9% overall, but remained the same (18%) as in 2012 among the poorest third.ConclusionAccess to mobile phones among patients with tuberculosis is insufficient, and rarest in patients who are poorer and later have adverse treatment outcomes. Thus, mobile phone interventions to improve tuberculosis care may be least accessed by the priority populations for whom they are intended. Such interventions should ensure access to mobile phones to enhance equity.

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Digital health for the End TB Strategy: developing priority products and making them work

Cited by 75 publications

References 67 publications

User experience analysis of e-TB Manager, a nationwide electronic tuberculosis recording and reporting system in Ukraine

User experience analysis of e-TB Manager, a nationwide electronic tuberculosis recording and reporting system in Ukraine

Does phone messaging improves tuberculosis treatment success? A systematic review and meta-analysis

Mobile phone interventions for tuberculosis should ensure access to mobile phones to enhance equity – a prospective, observational cohort study in Peruvian shantytowns

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