ArticlePloS one2022
A cost analysis of implementing mobile health facilitated tuberculosis contact investigation in a low-income setting.
Article in PloS one, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 2 of them syntheses that pooled it.
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Who cites it
12 citing papers in PubMed, 2 syntheses or guidelines pooled it, 20 citations in OpenAlex.
- Using mHealth Technologies for Case Finding in Tuberculosis and Other Infectious Diseases in Africa: Systematic Review.JMIR mHealth and uHealth · 2024Pooled it
- Availability of published evidence on coverage, cost components, and funding support for digitalisation of infectious disease surveillance in Africa, 2003-2022: a systematic review.BMC public health · 2024Pooled it
- mHealth-supported tuberculosis contact investigation by community health workers in high-burden countries: a scoping review.Global health action · 2026Article
- Article
- Economic Evaluations of mHealth Interventions for the Management of Type 2 Diabetes: A Scoping Review.Journal of diabetes science and technology · 2025Article
- Costs and cost-effectiveness of community health worker programs focussed on HIV, TB and malaria infectious diseases in low- and middle-income countries (2015-2024): A scoping literature review.PLOS global public health · 2025Article
- A user-centred implementation strategy for tuberculosis contact investigation in Uganda: protocol for a stepped-wedge, cluster-randomised trial.BMC public health · 2023Article
- A user-centred implementation strategy for tuberculosis contact investigation in Uganda: Protocol for a stepped-wedge, cluster-randomised trial.Research square · 2023Article
- mHealth to improve implementation of TB contact investigation: a case study from Uganda.Implementation science communications · 2023Article
- Exploring the tuberculosis medication program in Indonesia as perceived by patients and their families: A qualitative study.Belitung nursing journal · 2023Article
- A Scoping Review on Accentuating the Pragmatism in the Implication of Mobile Health (mHealth) Technology for Tuberculosis Management in India.Journal of personalized medicine · 2022Article
- Precision geospatial targeting for cost-effective tuberculosis case finding in Eastern Uganda: a quasi-experimental study.Therapeutic advances in infectious diseaseArticle
Corrections and comments
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Authors and funding
12 authors at 3 institutions in 3 countries.
Funding
Abstract
introductionMobile health (mHealth) applications may improve timely access to health services and improve patient-provider communication, but the upfront costs of implementation may be prohibitive, especially in resource-limited settings.
methodsWe measured the costs of developing and implementing an mHealth-facilitated, home-based strategy for tuberculosis (TB) contact investigation in Kampala, Uganda, between February 2014 and July 2017. We compared routine implementation involving community health workers (CHWs) screening and referring household contacts to clinics for TB evaluation to home-based HIV testing and sputum collection and transport with test results delivered by automated short messaging services (SMS). We carried out key informant interviews with CHWs and asked them to complete time-and-motion surveys. We estimated program costs from the perspective of the Ugandan health system, using top-down and bottom-up (components-based) approaches. We estimated total costs per contact investigated and per TB-positive contact identified in 2018 US dollars, one and five years after program implementation.
resultsThe total top-down cost was $472,327, including $358,504 (76%) for program development and $108,584 (24%) for program implementation. This corresponded to $320-$348 per household contact investigated and $8,873-$9,652 per contact diagnosed with active TB over a 5-year period. CHW time was spent primarily evaluating household contacts who returned to the clinic for evaluation (median 30 minutes per contact investigated, interquartile range [IQR]: 30-70), collecting sputum samples (median 29 minutes, IQR: 25-30) and offering HIV testing services (median 28 minutes, IQR: 17-43). Cost estimates were sensitive to infrastructural capacity needs, program reach, and the epidemiological yield of contact investigation.
conclusionOver 75% of all costs of the mHealth-facilitated TB contact investigation strategy were dedicated to establishing mHealth infrastructure and capacity. Implementing the mHealth strategy at scale and maintaining it over a longer time horizon could help decrease development costs as a proportion of total costs.
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