TABLE 1

Details of digital support interventions for treatment of active tuberculosis (TB) and latent TB infection (LTBI)

Digital technologiesOperational detailsEstimate of effect
Active TB#LTBI
MM: Wisepill
  • Small device attached to standard pill dispenser

  • When opened, device communicates with web-based application by SMS

  • Device sends SMS to patient and HCW when daily dose is missed

  • One-way texting: no response is required of patient [26–28]

Assumed effect was equivalent to DOT/standard of careAssumed effect was equivalent to that of MM in trials of active TB
MM: 99DOTS
  • Taking pills from blister pack daily reveals random toll-free numbers

  • Any call from a registered patient number is marked as a dose taken

  • When patients call, they hear “thank you”

  • Automatic alerts to patients and HCW of missed doses

  • pen-source information technology system [29, 30]

Assumed effect was equivalent to DOT/standard of careAssumed effect was equivalent to that of MM in trials of active TB
VOT
  • Smartphone loaned to patients without one

  • Pre-arranged schedule for real-time (synchronous) daily VOT calls with HCW

  • Patient shows and names pills, then swallows them

  • Patient asked about adverse reactions

  • Missed appointments followed up first by phone calls, then by home visits [31]

Assumed effect was equivalent to DOT/standard of careAssumed effect was equivalent to that of MM in trials of active TB
Two-way SMS
  • Weekly SMS “check-ins” sent from central computer at clinic

  • Patients asked to respond within 24 h

  • First instance of non-response: follow-up SMS

  • Second instance of non-response: phone call [32]

Not estimatedAssumed effect was equivalent to that of two-way SMS in trials of HIV+

MM: medication monitor; VOT: video-observed therapy; SMS: short message service; HCW: healthcare worker; DOT: directly observed treatment. #: routine in-person DOT visits were replaced by digital technologies for active TB treatment supervision; : patients using digital interventions were 1.18 (95% CI 1.08–1.26) times more likely to complete treatment than those on self-administered treatment (derived from [33]); +: patients using digital intervention were 1.24 (95% CI 1.06–1.45) times more likely to complete treatment than those on self-administered treatment [34].