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

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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.
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Keywords: South Africa; linkage to care; mhealth; treatment initiation; tuberculosis

Document Type: Research Article

Affiliations: 1: REACH Initiative, Johns Hopkins University School of Nursing, Baltimore, MD, Department of Community Public Health, Johns Hopkins University School of Nursing, Baltimore, MD 2: Johns Hopkins Center for Clinical Global Health Education, Baltimore, MD, Johns Hopkins University School of Medicine, Baltimore, MD, USA 3: National Health Laboratory Service, National Priority Programs Unit, Johannesburg 4: South African National Department of Health, Pretoria 5: National Health Laboratory Service, National Priority Programs Unit, Johannesburg, University of the Witwatersrand, School of Clinical Medicine, Johannesburg, South Africa

Publication date: September 1, 2019

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  • The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on tuberculosis and lung health world-wide.

    Certain IJTLD articles are selected for translation into French, Spanish, Chinese or Russian. They are available on the Union website

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