ICT-enabled community engagement models for early tuberculosis detection

Tuberculosis (TB) has been a major health issue of concern globally, where timely diagnosis has been a major factor in spreading the disease and causing death, especially in underprivileged environments. The aim of the presented study was to construct and analyze an Information and Communication Technology (ICT)-enabled model of engaging communities in the effort of increasing the rates of early TB detection by means of increased community engagement and simplified diagnostic routes. It was a prospective, quasi-experimental study that was carried out in twelve community health centers in three districts over a period of eighteen months where ICT-enabled intervention sites (n = 6) were compared with the conventional screening sites (n = 6). ICT framework also incorporated a mobile health application to the community health worker, automated short message service (SMS) to monitor the symptoms, cloud-based case management, and geographic information system (GIS) to monitor the hotspots. One thousand eight hundred four hundred and seventy seven presumptive TB cases were registered where 923 were ICT-enabled and 924 were control sites. Findings indicated that ICT-enabled sites recorded much higher rates of case detection (78.4% vs. 52.1, p < 0.001), median time to diagnosis was lower (12.3 ± 4.2 days vs. 28.7 ± 8.9 days, p < 0.001), and higher rates of treatment initiation within 48 h were recorded (89.2% vs. 61.4, p < 0.001). The efficiency of community health workers increased by 43.6 and there was 2.8 fold greater number of household contacts screened by the worker per monthly. ICT-enabled model had better performance with regard to the facilitance of early TB detection using enhanced community engagement, which is a cost-effective and scalable solution to TB control programs fortification.