Mobile Health Technologies could enhance Public Private Mix for Tuberculosis care in Rural Southwestern Uganda: Qualitative Findings

Background Despite some global progress in the implementation of the public-private mix for Tuberculosis care, the engagement of private healthcare providers remains wanting especially in high incidence countries such as Uganda. Although mobile health technologies are low-cost approaches that can enhance Tuberculosis care, there is a dearth of research about their application in fostering public-private mix. Objective To explore the potentials of mobile health technologies in fostering public-private mix for Tuberculosis care in Uganda. Methods This was a qualitative study design that involved in-depth interviews with 13 key informants (private healthcare workers) purposively selected between June and July 2020 due to their active involvement in Tuberculosis care from four private hospitals in Mbarara City. The interviews were transcribed and coded to identify key themes for analysis using content analysis. Results Mobile Health technologies (such as mobile apps, text messages) have the potential to map and link patients from private hospitals to the referral units, support patient medication adherence, notify and report Tuberculosis cases to the Ugandan Ministry of Health, and enhance patient care and monitoring. Conclusion Mobile Health technologies have the potential to revolutionize Tuberculosis care by establishing a centralized pathway for linking the referred patients from private hospitals to public hospitals. Future research should focus on assessing the utilization of mobile health technologies in enhancing access to referral units by presumptive Tuberculosis patients referred from private hospitals in low-resource settings.

Shifting to the ambulatory patient-centered tuberculosis care model in Romania – preliminary results of the pilot project conducted in Marius Nasta Institute of Pneumology dispensaries, January–December 2020

Reversing the concept of the Romanian medical system in terms of approaching patients with tuberculosis (TB) and removing them from a hospital-centred system into a more friendly outpatient system, closer to their needs, is one of its challenges. Preliminary data of this project show that through minimal and consistent investments the diagnosis, treatment and monitorisation can be made exclusively in the outpatient department for these patients.

Delivering tertiary tuberculosis care virtually

ObjectiveTo assess the impact of a virtual multidisciplinary team (MDT) review panel in reducing travel for children with a rare disease (tuberculosis (TB)) without compromising clinical outcomes.DesignRetrospective review of patients discussed in a virtual MDT panel. Independent pre-intervention and post-intervention data from Public Health England.SettingPaediatric departments across North West England.PatientsChildren aged <16 years with suspected TB infection/disease.InterventionWeekly, virtual MDT discussion between district paediatricians and a tertiary TB team.Main outcome measureCare closer to home, time from presentation to treatment.Results45% (37 of 82) children received care closer to home. Median time from presentation to treatment reduced by 28% (from 18 to 13 days). 21% more children were diagnosed before developing symptoms (76% of children presented with symptoms pre-intervention, 55% post-intervention). 5 children incorrectly labelled with latent TB infection were treated for TB disease.ConclusionsA clinical network supported by virtual MDT reviews can improve treatment for children with rare diseases while providing care close to home.