Evaluation of miLINC to shorten time to treatment for rifampicin-resistant Mycobacterium tuberculosis

Post Date: 
2019-09-01
Publication: 
The International Journal of Tuberculosis and Lung Disease
Summary: 

BACKGROUND:
Achieving the 90–90–90 targets for tuberculosis (TB) will require interventions that enhance diagnosis, linkage, treatment and adherence to care. As a first step in the process, our team designed a suite of smartphone applications known as miLINC to improve time from diagnosis to treatment initiation in drug-resistant TB patients.

SETTING:
Three clinical locations in a large, peri-urban district in KwaZulu-Natal, South Africa.

OBJECTIVE:
To assess the acceptability, feasibility and impact of the miLINC mobile health applications as a solution to reducing the time from presentation to treatment initiation of rifampicin-resistant (RR) TB patients.

METHODS:
We used a prospective, observational quality improvement evaluation of miLINC's impact among newly diagnosed patients with RR-TB.

RESULTS:
A convenience sample comprising details of 6341 patients with presumptive TB were entered into miLINC. Of the 631 TB-positive sputum specimens, 41 (6.5%) were found to be RR-TB. The mean time from clinical presentation to RR-TB treatment initiation was 3 days, 21 h, 17 min.

CONCLUSION:
This is the first study to suggest that the time from presentation to diagnosis and to treatment initiation for patients with RR-TB can be significantly improved using an integrated approach combining technology with appropriate human resources.

Citation: 
Farley, J. E; McKenzie-White, J; Bollinger, R; Hong, H; Lowensen, K; Chang, L. W; Stamper, P; Berrie, L; Olsen, F; Isherwood, L; Ndjeka, N; Stevens, W. Evaluation of miLINC to shorten time to treatment for rifampicin-resistant Mycobacterium tuberculosis. International Union Against Tuberculosis and Lung Disease. 2019 Sep;23(9):980-988(9).