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