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		Feasibility and Effectiveness of Mobile App for Active Case Finding for Tuberculosis in India
							| Telehealth and Medicine Today
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<meta name="DC.Creator.PersonalName" content="Weijia Zhang"/>
<meta name="DC.Creator.PersonalName" content="Mariam E. Dogar"/>
<meta name="DC.Creator.PersonalName" content="Monika Jain"/>
<meta name="DC.Creator.PersonalName" content="Edwin Rodriges"/>
<meta name="DC.Creator.PersonalName" content="Sangeeta Pathak"/>
<meta name="DC.Creator.PersonalName" content="Salil Bhargava"/>
<meta name="DC.Creator.PersonalName" content="Amar Gupta"/>
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<meta name="DC.Description" xml:lang="en" content="Background: Tuberculosis (TB) is an infectious disease with 2.8 million cases and 480,000 deaths each year in India. The city of Indore alone with a population of 3.5 million had 7,839 identified TB cases in 2017. However, about two to three thousand additional cases remain unidentified per district officials. The unidentified cases lead to an endemic TB and hamper the efforts of organizations such as The Collaborative to Eliminate TB from India (CETI) to reduce the incidence of TB with the method of Active Case Finding (ACF).1&amp;nbsp;Previously, 1,332 mobile apps attempted to use technology to overcome the challenge of unreported TB patients in Indian slum areas due to the inaccurate, lost, or unhelpful data collected in ACF; yet the existing apps for TB prevention and treatment possessed minimal functionality. Over a period of 3 months, the CETI developed a mobile data collection app to generate a TB diagnostic survey and to collect data from patient registration form.
Methods: To study the feasibility and effectiveness of the app, a pilot survey was conducted of 163,496 homes covering a population of 828,020 in the slum areas of Indore and Bhopal.
Findings: Between the years of 2018 and 2019, 14,349 pulmonary suspected cases and 4,357 extra pulmonary suspected cases of TB were identified. Among the total of 18,706 cases identified, 7,756 patients (48.1%) had low-grade fever for over 2 weeks, 6,331 patients (39.2%) had persistent cough for more than 2 weeks, 7,693 patients (47.7%) had weight loss, and 251 patients (1.6%) had cough with blood.
Interpretation: This pilot experience shows that an app is a useful tool for TB case recording and follow-up in the field. Further training of the health workers, and more widespread availability and ease of use of mobile phones will be necessary."/>
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<meta name="DC.Title" content="Feasibility and Effectiveness of Mobile App for Active Case Finding for Tuberculosis in India"/>
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<meta name="citation_title" content="Feasibility and Effectiveness of Mobile App for Active Case Finding for Tuberculosis in India"/>
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<meta name="citation_reference" content="Ministry of Health &amp;amp; Family Welfare – Government of India. TB India report 2018 [Internet]. [cited 2020 Jun 26]. Available from: https://tbcindia.gov.in/showfile.php?lid=3314"/>
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<meta name="citation_reference" content="Active case finding: Systematic screening for active tuberculosis [Internet]. World Health Organization; 2015 [cited 2020 Jun 26]. Available from: https://www.who.int/tb/areas-of-work/laboratory/active-case-finding/en/"/>
<meta name="citation_reference" content="Iribarren SJ, Schnall R, Stone PW, Carballo-Diéguez A. Smartphone applications to support tuberculosis prevention and treatment: Review and evaluation [Internet]. JMIR mHealth and uHealth. JMIR Publications; 2016 [cited 2020 Jun 26]. Available from: https://www.ncbi.nlm.nih.gov/pubmed/27177591"/>
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		  	 <article class="obj_article_details">

		
	<h1 class="page_title">
		Feasibility and Effectiveness of Mobile App for Active Case Finding for Tuberculosis in India
	</h1>

	
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					<h2 class="pkp_screen_reader">Authors</h2>
					<ul class="authors">
											<li>
							<span class="name">
								Weijia Zhang
							</span>
															<span class="affiliation">
									Wellesley College, Wellesley, MA, USA
																	</span>
																				</li>
											<li>
							<span class="name">
								Mariam E. Dogar
							</span>
															<span class="affiliation">
									Massachusetts Institute of Technology (MIT), Cambridge, MA, USA
																	</span>
																				</li>
											<li>
							<span class="name">
								Monika Jain
							</span>
															<span class="affiliation">
									TSU Quillen College of Medicine, Mountain Home, TN, USA; Collaborative to Eliminate Tuberculosis in India (CETI), Indore, India
																	</span>
																				</li>
											<li>
							<span class="name">
								Edwin Rodriges
							</span>
															<span class="affiliation">
									EC Digital Services, India
																	</span>
																				</li>
											<li>
							<span class="name">
								Sangeeta Pathak
							</span>
															<span class="affiliation">
									Collaborative to Eliminate Tuberculosis in India (CETI), Indore, India
																	</span>
																				</li>
											<li>
							<span class="name">
								Salil Bhargava
							</span>
															<span class="affiliation">
									Collaborative to Eliminate Tuberculosis in India (CETI), Indore, India; MGM Medical College, Indore, India
																	</span>
																				</li>
											<li>
							<span class="name">
								Amar Gupta
							</span>
															<span class="affiliation">
									Computer Science and Artificial Intelligence Labs (CSAIL), Institute of Medical Engineering and Science (IMES); Department of Electrical Engineering and Computer Science, MIT, Cambridge, MA, USA
																	</span>
																				</li>
											<li>
							<span class="name">
								Manoj Jain
							</span>
															<span class="affiliation">
									Collaborative to Eliminate Tuberculosis in India (CETI), Indore, India; Rollins School of Public Health, Emory University, Atlanta, GA, USA
																	</span>
																				</li>
										</ul>
				</section>
			
																																					<section class="item doi">
						<h2 class="label">
														DOI:
						</h2>
						<span class="value">
							<a href="https://doi.org/10.30953/tmt.v5.177">
								https://doi.org/10.30953/tmt.v5.177
							</a>
						</span>
					</section>
							
									<section class="item keywords">
				<h2 class="label">
										Keywords:
				</h2>
				<span class="value">
											Actice Cases Finding, 											Telemedicine, 											Tuberculosis									</span>
			</section>
			
										<section class="item abstract">
					<h2 class="label">Abstract</h2>
					<p><strong>Background</strong>: Tuberculosis (TB) is an infectious disease with 2.8 million cases and 480,000 deaths each year in India. The city of Indore alone with a population of 3.5 million had 7,839 identified TB cases in 2017. However, about two to three thousand additional cases remain unidentified per district officials. The unidentified cases lead to an endemic TB and hamper the efforts of organizations such as The Collaborative to Eliminate TB from India (CETI) to reduce the incidence of TB with the method of Active Case Finding (ACF).<sup>1</sup> Previously, 1,332 mobile apps attempted to use technology to overcome the challenge of unreported TB patients in Indian slum areas due to the inaccurate, lost, or unhelpful data collected in ACF; yet the existing apps for TB prevention and treatment possessed minimal functionality. Over a period of 3 months, the CETI developed a mobile data collection app to generate a TB diagnostic survey and to collect data from patient registration form.</p>
<p><strong>Methods</strong>: To study the feasibility and effectiveness of the app, a pilot survey was conducted of 163,496 homes covering a population of 828,020 in the slum areas of Indore and Bhopal.</p>
<p><strong>Findings</strong>: Between the years of 2018 and 2019, 14,349 pulmonary suspected cases and 4,357 extra pulmonary suspected cases of TB were identified. Among the total of 18,706 cases identified, 7,756 patients (48.1%) had low-grade fever for over 2 weeks, 6,331 patients (39.2%) had persistent cough for more than 2 weeks, 7,693 patients (47.7%) had weight loss, and 251 patients (1.6%) had cough with blood.</p>
<p><strong>Interpretation</strong>: This pilot experience shows that an app is a useful tool for TB case recording and follow-up in the field. Further training of the health workers, and more widespread availability and ease of use of mobile phones will be necessary.</p>
				</section>
			
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										<section class="item references">
					<h2 class="label">
						References
					</h2>
					<div class="value">
																					<p>Collaboration for Elimination of TB (CETI). Collaboration to eliminate tuberculosis in India: TB free India [homepage on the Internet]. CETI; 2020 [cited 2020 Jun 26]. Available from: <a href="https://www.tbfree.org/">https://www.tbfree.org/</a> </p>
															<p>Ministry of Health &amp; Family Welfare – Government of India. TB India report 2018 [Internet]. [cited 2020 Jun 26]. Available from: <a href="https://tbcindia.gov.in/showfile.php?lid=3314">https://tbcindia.gov.in/showfile.php?lid=3314</a> </p>
															<p>CETI experience. </p>
															<p>Active case finding: Systematic screening for active tuberculosis [Internet]. World Health Organization; 2015 [cited 2020 Jun 26]. Available from: <a href="https://www.who.int/tb/areas-of-work/laboratory/active-case-finding/en/">https://www.who.int/tb/areas-of-work/laboratory/active-case-finding/en/</a> </p>
															<p>Iribarren SJ, Schnall R, Stone PW, Carballo-Diéguez A. Smartphone applications to support tuberculosis prevention and treatment: Review and evaluation [Internet]. JMIR mHealth and uHealth. JMIR Publications; 2016 [cited 2020 Jun 26]. Available from: <a href="https://www.ncbi.nlm.nih.gov/pubmed/27177591">https://www.ncbi.nlm.nih.gov/pubmed/27177591</a> </p>
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						<h3>Most read articles by the same author(s)</h3>

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							Amar Gupta,
													Mariam E. Dogar,
													Emily Sijin Zhai,
													Pooja Singla,
													Tooba Shahid,
													Hilal Nuriye Yildirim,
													Sabrina Romero,
													Shaurya Singh,
												<a href="https://bhty.journals.publicknowledgeproject.org/index.php/journal/article/view/160">
							Innovative Telemedicine Approaches in Different Countries: Opportunity for Adoption, Leveraging, and Scaling-Up
						</a>,
						<a href="https://bhty.journals.publicknowledgeproject.org/index.php/journal/issue/view/15">
							Telehealth and Medicine Today: Volume 5, Issue I, 2020
						</a>
					</li>
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							Lyle Berkowitz, MD, FACP, FHIMSS,
													Shayan Vyas, MD, MBA, FAAP,
													Igor O. Korolev, DO, PhD,
													Paul De Raeve, RN, MSc, MStat, PhD,
													Prabhakaran Dorairaj, MD, DM (Cardiology), MSc, FRCP, FNASC,
													Prof. Sergio  Pillon,
													Matthew Sakumoto, MD,
													Ingrid Vasiliu-Feltes, MD,
													Liz  Ashall-Payne,
													Mitch B. Parker, MBA, CISSP,
													Brendan  Smith,
													Allison Viola, MBA,
													Rafael J. Grossmann, MD, FACS,
													Srikanth  Velamakanni,
													Chris  Roberts,
													Amar Gupta, PhD,
													John D. Halamka, MD,
												<a href="https://bhty.journals.publicknowledgeproject.org/index.php/journal/article/view/248">
							Predictions for Telehealth in 2021: We Can’t Wait for It!
						</a>,
						<a href="https://bhty.journals.publicknowledgeproject.org/index.php/journal/issue/view/19">
							Telehealth and Medicine Today: Volume 6, Issue 1, 2021
						</a>
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							Agni Kumar,
													Nancy Hung,
													Yuhan Wu,
													Robyn Baek,
													Amar Gupta,
												<a href="https://bhty.journals.publicknowledgeproject.org/index.php/journal/article/view/186">
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						<a href="https://bhty.journals.publicknowledgeproject.org/index.php/journal/issue/view/16">
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							Amar Gupta,
													Mike Baird,
													Shayan Vyas,
													Joel Reich,
													Stephanie Zawada,
													Sumit Nagpal,
													Oren J. Mechanic,
												<a href="https://bhty.journals.publicknowledgeproject.org/index.php/journal/article/view/165">
							Predictions for Telehealth in 2020: Will This be the Takeoff Year?
						</a>,
						<a href="https://bhty.journals.publicknowledgeproject.org/index.php/journal/issue/view/15">
							Telehealth and Medicine Today: Volume 5, Issue I, 2020
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							Amar Gupta, Editor-in-Chief,
												<a href="https://bhty.journals.publicknowledgeproject.org/index.php/journal/article/view/268">
							Sixteenth International Conference of Telemedicine Society of India: Experiences and Lessons Learnt for Evolving Transformation at a Global Level
						</a>,
						<a href="https://bhty.journals.publicknowledgeproject.org/index.php/journal/issue/view/20">
							Telehealth and Medicine Today: Volume 6, Issue 2, 2021
						</a>
					</li>
							</ul>
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