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Medical management of tuberculosis (TB) patients involves a comprehensive approach that includes diagnosis, treatment, and monitoring. The specific strategies can vary depending on the type of tuberculosis (latent or active), the patient's overall health status, and other considerations.
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Tuberculosis, often called TB, is a contagious illness primarily caused by Mycobacterium tuberculosis. It mainly affects the lung parenchyma but can also impact other body parts.
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Tuberculosis, more commonly referred to as TB, is an infectious disease stemming from Mycobacterium tuberculosis. While it primarily impacts the lungs, TB can also affect other body areas. Given its severity and global impact, timely and accurate diagnosis is crucial for controlling its spread and improving patient outcomes.
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Comprehensive & Cost Effective Laboratory Monitoring of HIV/AIDS: an African Role Model
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Text messaging to decrease tuberculosis treatment attrition in TB-HIV coinfection in Uganda.

Sabine M Hermans1,2,3,4, Sawsan Elbireer5, Harriet Tibakabikoba1

  • 1Department of Research, Infectious Diseases Institute, Makerere University College of Health Sciences, Kampala, Uganda.

Patient Preference and Adherence
|September 19, 2017
PubMed
Summary

A mobile health intervention using SMS reminders did not significantly reduce loss to follow-up in tuberculosis patients in Uganda. While highly rated, technological barriers hinder large-scale implementation for improving treatment completion.

Keywords:
AfricaUgandaadherencecellular phonee-healthmHealthmobile technologyshort message servicetelemedicinetext messagingtuberculosis

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Area of Science:

  • Public Health
  • Infectious Diseases
  • Digital Health

Background:

  • Low tuberculosis (TB) treatment completion in sub-Saharan Africa fuels multidrug resistance.
  • Mobile technology shows promise for improving adherence to HIV therapy in the region.
  • This study investigated SMS interventions to reduce TB patient loss to follow-up (LFU).

Purpose of the Study:

  • To assess the impact of a short-message service (SMS) intervention on reducing loss to follow-up (LFU) among tuberculosis patients.
  • To evaluate patient-reported helpfulness and identify barriers to SMS intervention use.
  • To determine if SMS reminders improve short-term TB treatment adherence.

Main Methods:

  • A quasi-experimental study in Uganda involving HIV-infected TB patients with mobile phone access.
  • Patients received SMS adherence and appointment reminders and educational quizzes during the initial 8 weeks of TB treatment.
  • LFU rates were compared between the intervention group and a preintervention control group using logistic regression.

Main Results:

  • The SMS intervention group had a lower LFU rate (0.5%) compared to the control group (2.0%), though not statistically significant (RR 0.27, P=0.22).
  • 96% of patients rated the SMS intervention as very helpful.
  • Key barriers included interrupted phone access and difficulties with SMS responses; quiz response rates were below 10%.

Conclusions:

  • The SMS reminder service did not demonstrate a clear effect on short-term LFU, potentially due to study underpowering.
  • The intervention was well-received, with no reported breaches of confidentiality.
  • Technological challenges identified have implications for scaling up mobile health interventions for TB and other diseases.