Community health education through WhatsApp and mobile applications for TB prevention

This study examines whether tuberculosis (TB) prevention education delivered through WhatsApp groups and a mobile application is associated with higher completion of TB screening. Many eligible community members do not complete screening, and evidence on staged digital education in community rollout settings remains limited. A prospective stepped-wedge rollout across community clusters compared outcomes after exposure with outcomes in the pre-rollout period within the same cluster, using a fixed follow-up window ending 90 days after first contact. TB screening uptake was higher after exposure, with an adjusted absolute risk difference of 0.072 [0.029, 0.115] for completion within 90 days. Secondary analyses reported higher TB knowledge scores, high short-term engagement with messages or modules, and a smaller increase in referral completion, with a similar direction under alternative analysis choices. Interpretation is limited by incomplete linkage to screening registers and possible information sharing across clusters, but the findings may guide community TB program implementers and digital health teams.