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Mobile phone interventions for tuberculosis should ensure access to mobile phones to enhance equity - a prospective, observational cohort study in Peruvian shantytowns

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dc.contributor.author Saunders, Matthew J.
dc.contributor.author Wingfield, Tom
dc.contributor.author Tovar, Marco A.
dc.contributor.author Herlihy, Niamh
dc.contributor.author Rocha, Claudio
dc.contributor.author Zevallos, Karine
dc.contributor.author Montoya, Rosario
dc.contributor.author Ramos, Eric
dc.contributor.author Datta, Sumona
dc.contributor.author Evans, Carlton A.
dc.date.accessioned 2018-11-30T17:17:15Z
dc.date.available 2018-11-30T17:17:15Z
dc.date.issued 2018
dc.identifier.uri https://hdl.handle.net/20.500.12866/4119
dc.description.abstract OBJECTIVES: Mobile phone interventions have been advocated for tuberculosis care, but little is known about access of target populations to mobile phones. We studied mobile phone access among patients with tuberculosis, focusing on vulnerable patients and patients who later had adverse treatment outcomes. METHODS: In a prospective cohort study in Callao, Peru, we recruited and interviewed 2584 patients with tuberculosis between 2007 and 2013 and followed them until 2016 for adverse treatment outcomes using national treatment registers. Subsequently, we recruited a further 622 patients between 2016 and 2017. Data were analysed using logistic regression and by calculating relative risks (RR). RESULTS: Between 2007 and 2013, the proportion of the general population of Peru without mobile phone access averaged 7.8% but for patients with tuberculosis was 18% (P < 0.001). Patients without access were more likely to hold a lower socioeconomic position, suffer from food insecurity and be older than 50 years (all P < 0.01). Compared to patients with mobile phone access, patients without access at recruitment were more likely to subsequently have incomplete treatment (20% vs. 13%, RR = 1.5; P = 0.001) or an adverse treatment outcome (29% vs. 23% RR = 1.3; P = 0.006). Between 2016 and 2017, the proportion of patients without access dropped to 8.9% overall, but remained the same (18%) as in 2012 among the poorest third. CONCLUSION: Access to mobile phones among patients with tuberculosis is insufficient, and rarest in patients who are poorer and later have adverse treatment outcomes. Thus, mobile phone interventions to improve tuberculosis care may be least accessed by the priority populations for whom they are intended. Such interventions should ensure access to mobile phones to enhance equity. en_US
dc.language.iso eng
dc.publisher Wiley
dc.relation.ispartof urn:issn:1365-3156
dc.rights info:eu-repo/semantics/restrictedAccess
dc.rights.uri https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es
dc.subject tuberculosis en_US
dc.subject e-santé en_US
dc.subject ehealth en_US
dc.subject m-santé en_US
dc.subject Mhealth en_US
dc.subject Mobile Health en_US
dc.subject santé mobile en_US
dc.subject tuberculose en_US
dc.title Mobile phone interventions for tuberculosis should ensure access to mobile phones to enhance equity - a prospective, observational cohort study in Peruvian shantytowns en_US
dc.type info:eu-repo/semantics/article
dc.identifier.doi https://doi.org/10.1111/tmi.13087
dc.subject.ocde https://purl.org/pe-repo/ocde/ford#3.02.00 es_PE
dc.subject.ocde https://purl.org/pe-repo/ocde/ford#3.03.06


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