New smartphone app to boost efficacy of TB therapy

Scientists have developed a smartphone video-based app that could be a more effective substitute for a daily in-person visit by a health care worker required for tuberculosis (TB) treatment.

In the journal Open Forum Infectious Diseases, researchers from the Johns Hopkins University in the US described the app which provides video Directly Observed Therapy (video DOT).

"We believe video DOT offers an alternative that appears to be as effective as an in-person daily visits by health care workers to assure compliance with drug treatment, but also empowers patients to manage their TB without added stress," says Samuel Holzman, a research fellow at the Johns Hopkins University.

Tuberculosis requires measures to ensure that patients adhere to treatment. These recommendations include provisions for home or hospital based isolation or occasionally forced isolation for infectious individuals.

The reason for these mandates, said Holzman, is the disease's virulence.

Unlike the flu or the common cold, Mycobacterium tuberculosis, the bacteria that causes infectious tuberculosis, can hang in the air for extended periods when expelled by the coughs or saliva of patients, spreading to others across a room or through a building's ventilation.

Many people with active TB also have relatively few symptoms, allowing the bacteria to spread before a diagnosis is made.

To test the effectiveness of video DOT, the researchers conducted a pilot study utilizing the widely-available smartphone application developed by emocha Mobile Health in conjunction with Maunank Shah, and other clinician-scientists at the Johns Hopkins University School of Medicine.

As many as 28 adult TB patients being treated at three health departments in Maryland participated in the pilot study.

These patients had their therapy monitored using the emocha video DOT application in lieu of in-person visits by a health care worker.

The researchers found that patient adherence to treatment was about the same between the video DOT and in-person DOT, 94 per cent and 98 per cent respectively.

The researchers found that the overall proportion of prescribed doses that were verified through observation was six per cent higher with video DOT compared to in-person DOT.