What do the following facts have in common?
- Vietnam has 90 million people and roughly 120 million mobile subscriptions (a 130 percent saturation rate).
- Cases of multidrug-resistant tuberculosis are rising in Vietnam, 23 percent of which are retreatment cases.
Here’s the answer: The former is battling the latter in an innovative pilot program that’s shown promise in treating tuberculosis (TB). And a good portion of the work is literally in the hands of health workers and their patients.
Tuberculosis remains one of the world’s deadliest communicable diseases
The World Health Organization’s Global Tuberculosis Report 2014 affirms that globally, TB is the second-leading infectious disease, infecting over nine million people in the past year. Although Vietnam has achieved a high TB treatment success rate (over 90 percent), there’s still a great deal of work to be done.
PATH, working alongside the National TB Program, supports patients by helping them stick with their TB care plans through a project currently funded by The Global Fund for AIDS, Tuberculosis and Malaria. The objective? To improve adherence of TB care plans without further burdening public health resources.
PATH hopes to improve patient care and reduce the administrative costs associated with tuberculosis. Photo: PATH/Nguyen Ba Quang.
A novel coverage plan
Patients who do not closely follow their TB care plans are less likely to be cured or complete their full course of treatment. As a result of this behavior, the treatment success rate can drop and the multidrug-resistant tuberculosis (MDR-TB) rate can rise.
PATH’s TB team capitalized on the high level of mobile phone coverage in Vietnam by implementing a pilot mobile health application (mHealth app) that could access patient phone records through the national TB treatment management database. The app uses this information to send text messages (SMS) to patients, reminding them to take their medication and to show up for scheduled health checks and follow-up tests.
Commune health worker uses the mobile phone application to enter and upload TB patient information to the system. Photo: PATH/Dao Dinh Sang.
The application aims to support TB patient treatment adherence, which is especially important in a country where MDR-TB in both new and relapse TB cases is on the rise.
Two women sit in a TB hospital waiting room in Vietnam. Photo: PATH/Nguyen Ba Quang.
Piloted in 17 communes of Vung Tau City in Vietnam, preliminary findings show that the app increased the percentage of on-time visits for scheduled health checks (from 72.3 to 82 percent for the third visit), as well as overall treatment success rates (from 91 to 98 percent) in TB patients. PATH’s app allows TB patients to better manage their treatment, empowering them to take control over the disease. One of the most exciting aspects of this app is that Vung Tau City has expanded its use within the province post-pilot, which shows great promise for the cost-effectiveness and sustainability of this tool.
Incorporating mHealth solutions is new territory for tuberculosis efforts in Vietnam, but based on the positive results so far, the team is looking to expand the reach of this app and other potential mHealth solutions. An evaluation of the pilot, planned for mid-2015, will contribute to a set of recommendations for the National TB Program.
The team’s success with the pilot mHealth app was accepted for oral presentation at the 45th Annual TB Union Conference in Barcelona, Spain.
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