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Use of eCompliance, an Innovative Biometric System for Monitoring of Tuberculosis Treatment in Rural Uganda
Sarah Jane Snidal
Sarah Jane Snidal
School of International and Public Affairs, Columbia University, New York; Millennium Villages Project, Mbarara, Uganda; Global Health Corps; The Earth Institute, Columbia University, New York
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Genevieve Barnard
Genevieve Barnard
School of International and Public Affairs, Columbia University, New York; Millennium Villages Project, Mbarara, Uganda; Global Health Corps; The Earth Institute, Columbia University, New York
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Emmanuel Atuhairwe
Emmanuel Atuhairwe
School of International and Public Affairs, Columbia University, New York; Millennium Villages Project, Mbarara, Uganda; Global Health Corps; The Earth Institute, Columbia University, New York
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Yanis Ben Amor
Yanis Ben Amor
School of International and Public Affairs, Columbia University, New York; Millennium Villages Project, Mbarara, Uganda; Global Health Corps; The Earth Institute, Columbia University, New York
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Directly observed therapy short-course (DOTS) requires direct observation of tuberculosis (TB) patients and manual recording of doses taken. Programmatically, manual tracking is both time-consuming and prone to human error. Our project in western Uganda assessed the impact on TB treatment outcomes of a comprehensive patient support program including eCompliance, a biometric medical record device, with the aim of increasing TB patient retention. Through an observational study of 142 patients, DOTS outcomes of patients in the intervention group were compared with two control groups. Descriptive statistical comparisons, case-cohort analysis, and difference in change over time were used to assess the impact. Intervention patients had a higher cure rate than all other patients (55.6% versus 28.3% [P < 0.01]) and the odds of having a “cured” outcome were 3.17 higher (P < 0.05). The intervention group had a statistically significantly lower odds of having a negative outcome (0% versus.17% [P < 0.01]) than patients from the control groups. Additionally, the intervention group had a lost to follow-up rate lower than all other groups (0% versus 7%) that was trending on significant. In resource-limited settings, implementing comprehensive DOTS including eCompliance may reduce the occurrence of negative DOTS outcomes for patients.
Author Notes
Financial support: This publication was supported by the National Center for Advancing Translational Sciences, National Institutes of Health (NIH), through Grant no. UL1 TR000040. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH.
Authors' addresses: Sarah Jane Snidal, LifeNet International, Global Health Corps, Bujumbura, Burundi, E-mail: sarahjane.snidal@gmail.com. Genevieve Barnard, The Schlesinger Fund for Global Healthcare Entrepreneurship, Babson College, Wellesley, E-mail: gvbarnard@gmail.com. Emmanuel Atuhairwe, Millennium Villages Project, Mbarara, Uganda, E-mail: atuhairwe.emmanuel@gmail.com. Yanis Ben Amor, The Earth Institute, Columbia University, NY, E-mail: yba2101@columbia.edu.
ProCite
RefWorks
Reference Manager
BibTeX
Zotero
EndNote
-
1.
WHO, 2012. Global Tuberculosis Report. Geneva, Switzerland: WHO. Available at: http://www.who.int/tb/publications/global_report/en/. Accessed June 25, 2014.
-
2.
Zumla A, Raviglione M, Hafner R, von Reyn CF, 2013. Tuberculosis. N Engl J Med 368: 745–755.
-
3.
Gray JM, Cohn DL, 2013. Tuberculosis and HIV coinfection. Semin Respir Crit Care Med 34: 32–43.
-
4.
Lonnroth K, Jaramillo E, Williams BG, Dye C, Raviglione M, 2009. Drivers of tuberculosis epidemics: the role of risk factors and social determinants. Soc Sci Med 68: 2240–2246.
-
5.
Zumla A, Nahid P, Cole ST, 2013. Advances in the development of new tuberculosis drugs and treatment regimens. Nat Rev Drug Discov 12: 388–404.
-
6.
Glaziou P, Falzon D, Floyd K, Raviglione M, 2013. Global epidemiology of tuberculosis. Semin Respir Crit Care Med 34: 3–16.
-
7.
Ben Amor Y, Day MS, Schluger NW, 2010. Preventing the next generation of extensively drug-resistant tuberculosis. Int J Tuberc Lung Dis 14: 525–527.
-
8.
Lienhardt C, Glaziou P, Uplekar M, Lonnroth K, Getahun H, Raviglione M, 2012. Global tuberculosis control: lessons learnt and future prospects. Nat Rev Microbiol 10: 407–416.
-
9.
Davies PD, 2003. The role of DOTS in tuberculosis treatment and control. Am J Respir Med 2: 203–209.
-
10.
Operation ASHA, 2013. Technology: The eCompliance Project. Available at: http://www.opasha.org/our-work/ecompliance-innovation-and-health/. Accessed October 11, 2013.
-
11.
Newell JN, Baral SC, Pande SB, Bam DS, Malla P, 2006. Family-member DOTS and community DOTS for tuberculosis control in Nepal: cluster-randomized controlled trial. Lancet 367: 903–909.
-
12.
Wright J, Walley J, Philip A, Pushpananthan S, Dlamini E, Newell J, Dlamini S, 2004. Direct observation of treatment for tuberculosis: a randomized controlled trial of community health workers versus family members. Trop Med Int Health 9: 559–565.
| Past two years | Past Year | Past 30 Days | |
|---|---|---|---|
| Abstract Views | 52 | 52 | 17 |
| Full Text Views | 373 | 100 | 2 |
| PDF Downloads | 141 | 39 | 4 |