The South African National Department of Health (NDoH) has set a new target of 90% treatment success rate of all clients initiated on treatment. However, in 2013, the treatment success rate among new patients with drug-sensitive TB in South Africa was 77%, well below the World Health Organization (WHO) target of 85%.
In the Eastern Cape Province, among new smear positive clients, treatment interruption and transfer-outs accounted for 8.5% and 4.8% respectively of negative outcomes. The program would have reached the WHO targets if these clients had been retained in care. Ensuring directly-observed treatment (DOT) and early antiretroviral therapy (ART) initiation in HIV-positive TB patients are some of the main strategies adopted by the WHO to ensure high treatment success rate.
The USAID TB CARE II South Africa project explored the use of mobile health (mHealth) technology, a mobile device-based software program, as an innovative approach to improve patient retention amongst drug resistant (DR) TB patients. The intervention was piloted in the Nelson Mandela Bay Metropolitan (NMBM) District in Eastern Cape Province in May 2015, using a software package designed specifically for the USAID TB CARE II South Africa project.
The rollout of the project was two-pronged: geo-mapping of DR-TB clients in the NMBM region diagnosed since 2012 and the introduction of the mHealth package for DOT supporters.