Jabulani bloemfontein 2014 mobile health

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Tuberculosis (TB) crisis in S. Africa: Innovative solutions needed urgently Jabulani Ncayiyana Bloemfontein November 09, 2014


Burden of TB •  World: 9 million TB cases. •  sub-Saharan Africa: 2.6 million (29%). •  South Africa: 45 0000 cases notified

WHO (2014)


Current TB control strategy •  WHO: TB a global health emergency in 1993; –  drawing the attention of policy makers, donors & innovators.

•  2004: Global TB incidence decline •  South Africa: TB incidence increasing:

WHO (2006)


Why limited success in TB control?

•  The reasons are manifold. •  Two of the major shortcomings of TB control measures. •  early diagnosis and treatment •  TB70% (69%)detection and 85% (77%) cure rates –  patients not sticking to their treatment regimen •  World’s average is 5% •  In South Africa, the figure is as high as 20%.

•  Results: MDR and XDR-TB


Innovative approach needed •  Opportunity: mobile health (m-Health) •  Mobile phones coverage, 90% of world’s population

ITU, 2012


Applications of m-phones in Health •  Span all aspects of health care, –  prevention, diagnosis, adherence monitoring and surveillance.

•  TB has not exploited the potential of mHealth. •  Stop TB Partnership –  a strong evidence is needed.


Success story


Can m-Health to improve TB control?

•  Education, prevention and case finding

–  text messages to increase public awareness about TB.

•  Diagnostics –  SMS alert sent to clinic and patient.

•  Telemedicine –  Expert support (Diagnosis & Mx) to remote facility.

•  Adherence monitoring and visit reminders –  Improve DOT.


PROJECT CONCEPT •  to assess effectiveness of mobile phonesupported SMS messaging aimed at improving adherence and retention in care in population receiving TB treatment •  Aim 1: To determine the level of adherence among patients receiving mobile phone messages. •  Aim 2: To determine the level of retention in care among patients receiving mobile phone messages.


Thank you


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