Feasibility and Effectiveness of Mobile App for Active Case Finding for Tuberculosis in India

Abstract

Background: Tuberculosis (TB) is an infectious disease with 2.8 million cases and 480,000 deaths each year in India. The city of Indore alone with a population of 3.5 million had 7,839 identified TB cases in 2017. However, about two to three thousand additional cases remain unidentified per district officials. The unidentified cases lead to an endemic TB and hamper the efforts of organizations such as The Collaborative to Eliminate TB from India (CETI) to reduce the incidence of TB with the method of Active Case Finding (ACF).¹ Previously, 1,332 mobile apps attempted to use technology to overcome the challenge of unreported TB patients in Indian slum areas due to the inaccurate, lost, or unhelpful data collected in ACF; yet the existing apps for TB prevention and treatment possessed minimal functionality. Over a period of 3 months, the CETI developed a mobile data collection app to generate a TB diagnostic survey and to collect data from patient registration form.

Methods: To study the feasibility and effectiveness of the app, a pilot survey was conducted of 163,496 homes covering a population of 828,020 in the slum areas of Indore and Bhopal.

Findings: Between the years of 2018 and 2019, 14,349 pulmonary suspected cases and 4,357 extra pulmonary suspected cases of TB were identified. Among the total of 18,706 cases identified, 7,756 patients (48.1%) had low-grade fever for over 2 weeks, 6,331 patients (39.2%) had persistent cough for more than 2 weeks, 7,693 patients (47.7%) had weight loss, and 251 patients (1.6%) had cough with blood.

Interpretation: This pilot experience shows that an app is a useful tool for TB case recording and follow-up in the field. Further training of the health workers, and more widespread availability and ease of use of mobile phones will be necessary.