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Open Access Study protocol

SMS reminders to improve the tuberculosis cure rate in developing countries (TB-SMS Cameroon): a protocol of a randomised control study

Georges Bediang12*, Beat Stoll3, Nadia Elia3, Jean-Louis Abena4, Désiré Nolna4, Philippe Chastonay3 and Antoine Geissbuhler2

Author Affiliations

1 Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, PO Box 1364 Yaoundé, Cameroon

2 Department of Radiology and Medical Informatics, University of Geneva, Geneva, Switzerland

3 Institute of Global Health, Faculty of Medicine, University of Geneva, Geneva, Switzerland

4 National Tuberculosis Control Programme, Ministry of Public Health, Dschang, Cameroon

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Trials 2014, 15:35  doi:10.1186/1745-6215-15-35

Published: 24 January 2014

Abstract

Background

Tuberculosis is a public health problem in Cameroon, just like in many other countries in the world. The National Tuberculosis Control Programme (PNLT) put in place by the state, aims to fight tuberculosis through the implementation of international directives (Directly Observed Treatment Short, DOTS). Despite the deployment of this strategy across the world, its implementation is difficult in the context of low-resource countries. Some expected results are not achieved. In Cameroon, the cure rate for patients with sputum positive pulmonary tuberculosis (TPM+) after 6 months is only about 65%, 20% below the target. This is mainly due to poor patient adherence to treatment. By relying on the potential of mobile Health, the objective of this study is to evaluate the effect of SMS reminders on the cure rate of TPM + patients, measured using 6-month bacilloscopy.

Methods/design

This is a blinded, randomised controlled multicentre study carried out in Cameroon. The research hypothesis is that sending daily SMS messages to remind patients to take their prescribed tuberculosis medication, together with the standard DOTS strategy, will increase the cure rate from 65% (control group: DOTS, no SMS intervention) to 85% (intervention group: DOTS, with SMS intervention) in a group of new TPM + patients. In accordance with each treatment centre, the participants will be randomly allocated into the two groups using a computer program: the intervention group and the control group. A member of the research team will send daily SMS messages. Study data will be collected by health professionals involved in the care of patients. Data analysis will be done by the intention-to-treat method.

Discussion

The achieving of expected outcomes by the PNLT through implementation of DOTS requires several challenges. Although it has been demonstrated that the DOTS strategy is effective in the fight against tuberculosis, its application remains difficult in developing countries. This study explores the potential of mHealth to support DOTS strategy. It will gather new evidence on the effectiveness of mHealth-based interventions and SMS reminders in the improvement of treatment adherence and the cure rate of tuberculosis patients, especially in a low-resource country such as Cameroon.

Trial registration

The trial is registered on the Pan-African Clinical Trials Registry (http://www.pactr.org webcite) under unique identification number: PACTR201307000583416.

Keywords:
SMS reminder; Text messaging; mHealth; Tuberculosis; Developing country; Low-resource country; Africa