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Meta-Analysis
. 2020 Jan 14;20(1):42.
doi: 10.1186/s12879-020-4765-x.

Does phone messaging improves tuberculosis treatment success? A systematic review and meta-analysis

Kassahun Dessie Gashu  1 , Kassahun Alemu Gelaye  2 , Zeleke Abebaw Mekonnen  3 , Richard Lester  4 , Binyam Tilahun  3   4
Affiliations
Meta-Analysis

Does phone messaging improves tuberculosis treatment success? A systematic review and meta-analysis

Kassahun Dessie Gashu et al. BMC Infect Dis. .

Abstract

Background: Compliance to anti-TB treatment is crucial in achieving cure and avoiding the emergence of drug resistance. Electronic health (eHealth) interventions are included in the strategy to end the global Tuberculosis (TB) epidemic by 2035. Evidences showed that mobile messaging systems could improve patient adherence to clinic appointment for diagnosis and treatment. This review aimed to assess the effect of mobile-phone messaging on anti-TB treatment success.

Methods: All randomized controlled trial (RCT) and quasi-experimental studies done prior to August 26, 2019 were included in the review. Studies were retrieved from PubMed, EMBASE, Cochrane and ScienceDirect databases including, grey and non-indexed literatures from Google and Google scholar. Quality of studies were independently assessed using Cochrane Risk of Bias Assessment Tool. A qualitative synthesis and quantitative pooled estimation were used to measure the effect of phone messaging on TB treatment success rate. PRISMA flow diagrams were used to summarize article selection process.

Results: A total of 1237 articles were identified, with 14 meeting the eligibility criteria for qualitative synthesis. Eight studies with a total of 5680 TB patients (2733 in intervention and 2947 in control groups) were included in meta-analysis. The pooled effect of mobile-phone messaging revealed a small increase in treatment success compared to standard of care (RR 1.04, 95% CI 1.02 to 1.06), with low heterogeneity (I2 = 7%, p < 0.0002). In the review, performance, detection and attrition biases were reported as major risk of biases.

Conclusions: Mobile-phone messaging showed a modest effect in improving anti-TB treatment success; however, the quality of evidence was low. Further controlled studies are needed to increase the evidence-base on the role of mHealth interventions to improve TB care.

Protocol registration number: CRD420170744339. http://www.crd.york.ac.uk/PROSPERO/display_record.php?ID=CRD42017074439.

Keywords: Mobile phone; Text messaging; Treatment success; Tuberculosis.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
PRISMA flow diagram for inclusion of articles
Fig. 2
Fig. 2
Risk of bias summary and graph: authors’ judgments for each included study
Fig. 3
Fig. 3
Forest Plot of the effect of mobile-phone messaging on Anti-TB treatment success
Fig. 4
Fig. 4
Sensitivity analysis excluding Mohammed et al. and Liu X. et al. studies to see its influence on effect size estimation
Fig. 5
Fig. 5
A sub-group analysis of effect of mobile-phone messaging on TB TSR by national TB burden
Fig. 6
Fig. 6
Effect of mobile-phone messaging on TB TSR sub-grouped by model of phone messaging
Fig. 7
Fig. 7
Funnel Plot of studies comparing phone messaging and standard of care on TSR of TB
See this image and copyright information in PMC

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