Can mobile message reminders help in treating TB in Pakistan?

Highlights

This brief is based on an impact evaluation that examines the impact of a mobile-based health intervention on the treatment outcomes of people with treatable TB in Karachi, Pakistan. Wh​ile 85 per cent of the TB patients who were enrolled to receive SMS reminders responded to the reminder system at least once, the response rate of all participants during their six-month treatment course was low. ​The study found no difference in the treatment success rate between the group that received the SMS reminder and the comparison group. The intervention did not contribute to the participants’ physical or psychological well-being.​

Although tuberculosis (TB) is a curable infectious disease, it remains a major public health burden in the world. There are over nine million people diagnosed annually with TB, of which one third are neither accurately diagnosed nor effectively treated. In 2015, Pakistan was among the 30 countries with a high TB burden, with an estimated 510,000 cases.

Treating TB involves following a six-month World Health Organization-mandated, directly observed therapy regimen. TB patients often miss doses, which drastically affects their treatment outcome and disease transmission. Mobile phones-based health (m-health) interventions are increasingly used as a cost-effective way of communicating with patients to promote treatment adherence. However, limited evidence exists on the efficacy of such interventions, particularly on TB treatment.

There have been limited attempts at integrating m-health into TB control programmes, most of which have not moved beyond the pilot stage. To bridge this gap, 3ie funded a randomised evaluation conducted by researchers at Interactive Research and Development (IRD). The study gauged the impact of the Zindagi (which means life) intervention, a two-way short message service (SMS) reminder system, on the treatment outcomes of people with treatable TB in Karachi, Pakistan.