Jabulani bloemfontein 2014 mobile health

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