Tuberculosis (TB) is globally the deadliest infectious disease in recent years, with an estimated number of 1.5 million deaths annually. According to the WHO, multidrug resistant tuberculosis (MDR-TB) is an international crisis. This is an escalating problem in sub-Saharan Africa as well and a serious threat to TB-control in these countries. Despite all efforts, treatment success for drug susceptible TB is less than 85% (which is the aim of the WHO) worldwide and between 50-60% for MDR-TB. Currently, most TB research is designed to find out whether new approaches, both in diagnostics and treatment, are safe and effective. This research already has led to many advances in recent years, and researchers continue to search for more effective methods for dealing with tuberculosis. One important topic of the latter is how to improve adherence to treatment by TB patients. The current DOT strategy (directly observed therapy) is not effective enough as can be seen by the treatment success numbers.

Mpilo Mobile is in the start-up phase of TB research in Zimbabwe. In the Netherlands, the research is supported by TB center Beatrixoord of the UMCG (University Medical Center Groningen).

Mpilo Mobile is in the process of seeking cooperation with TB institutes in Zimbabwe.
A local study team will be established, and a project plan will be developed in conjunction with the TB Expertise Center of the UMCG.

Digital health interventions have the potential to address shortfalls in the current standard of care. (1,2). It can help in a more patient-centered care approach for TB treatment. Although access to the internet, smartphones, and other forms of technology is still limited in areas with a high TB burden, mobile “feature” phones (i.e. phones that lack the advanced functionality of smartphones but can be used to make calls, send text messages, and access some simple internet features through a text-based interface) are ubiquitous.(3) We therefore consider developing a digital health platform that will be compatible with feature phones to provide support, including information about TB, for patients. Also new approaches using mHealth to improve treatment adherence will be supported.

Platform content will be developed in conjunction with local study team members to ensure that it will be comprehended by and will be appropriate for the study population.

To determine whether this platform will result in a better frequency of treatment success when it is combined with the standard of care, we intend to collaborate with clinics in Zimbabwe.

The period of July to September 2020 will be used to lay the foundation for Mpilo Mobile’s TB research in Zimbabwe.

Onno Akkerman, MD PhD.
Albert Nijland, MD PhD.

World Health Organization. The end TB strategy, 2015 (source).

Communications Authority of Kenya. Second quarter sector statistics report for the financial year 2018/2019 (October–December 2018). 2018 (source).

Metcalfe JZ, O’Donnell MR, Bangsberg DR. Moving beyond directly observed therapy for tuberculosis. PLoS Med 2015; 12(9):e1001877.