ArticleBMC infectious diseases2023
Impact of the 99DOTS digital adherence technology on tuberculosis treatment outcomes in North India: a pre-post study.
Article in BMC infectious diseases, 2023. 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.
- The impact of digital adherence technologies on treatment outcomes, adherence, and patient-reported outcomes in tuberculosis: a systematic review and meta-analysis.BMC infectious diseases · 2025Pooled it
- Barriers to engagement in the care cascade for tuberculosis disease in India: A systematic review of quantitative studies.PLoS medicine · 2024Pooled it
- Multi-level determinants of tuberculosis treatment completion in rural Uganda: A cross-sectional study.PloS one · 2026Article
- An overview of mobile health applications (mHealth apps) supporting Tuberculosis elimination efforts.Frontiers in digital health · 2026Review
- Enhancing tuberculosis care in lower and middle-income countries through digital adherence technologies.Breathe (Sheffield, England) · 2026Article
- Time to first and recurrent missed video directly observed therapy sessions and associated factors among people with Tuberculosis in Kampala, Uganda.Frontiers in digital health · 2026Article
- Process Evaluation of Pragmatic Cluster-Randomized Trials of Digital Adherence Technologies for Tuberculosis Treatment Support: A Mixed-Method Study in Five Countries.Tropical medicine and infectious disease · 2025Article
- Lessons and updates from India's National Tuberculosis Elimination Program - bold decisions and innovative ways of fast-tracking progress toward ending tuberculosis.IJID regions · 2025Review
- Contextual factors influencing implementation of tuberculosis digital adherence technologies: a scoping review guided by the RE-AIM framework.BMJ global health · 2025Article
- Implementation outcomes of tuberculosis digital adherence technologies: a scoping review using the RE-AIM framework.BMJ global health · 2025Article
- Evaluation of the Drug-Resistant Tuberculosis (DR-TB) management component under the National Tuberculosis Elimination Program (NTEP) in Kerala, India, 2021-22.Lung India : official organ of Indian Chest Society · 2025Article
- Implementation, feasibility, and acceptability of 99DOTS-based supervision of treatment for drug-susceptible TB in Uganda.PLOS digital health · 2023Article
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Authors and funding
6 authors.
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Abstract
background99DOTS is a cellphone-based digital adherence technology. The state of Himachal Pradesh, India, made 99DOTS available to all adults being treated for drug-sensitive tuberculosis (TB) in the public sector in May 2018. While 99DOTS has engaged over 500,000 people across India, few studies have evaluated its effectiveness in improving TB treatment outcomes.
methodsWe compared treatment outcomes of adults with drug-sensitive TB before and after Himachal Pradesh's 99DOTS launch using data from India's national TB database. The pre-intervention group initiated treatment between February and October 2017 (N = 7722), and the post-intervention group between July 2018 and March 2019 (N = 8322). We analyzed engagement with 99DOTS and used multivariable logistic regression to estimate impact on favorable treatment outcomes (those marked as cured or treatment complete).
resultsIn the post-intervention group, 2746 (33.0%) people called 99DOTS at least once. Those who called did so with a wide variation in frequency (< 25% of treatment days: 24.6% of callers; 25-50% of days: 15.1% of callers, 50-75% of days: 15.7% of callers; 75-100% of days: 44.6% of callers). In the pre-intervention group, 7186 (93.1%) had favorable treatment outcomes, compared to 7734 (92.9%) in the post-intervention group. This difference was not statistically significant (OR = 0.981, 95% CI [0.869, 1.108], p = 0.758), including after controlling for individual characteristics (adjusted OR = 0.970, 95% CI [0.854, 1.102]).
conclusionsWe found no statistically significant difference in treatment outcomes before and after a large-scale implementation of 99DOTS. Additional work could help to elucidate factors mediating site-wise variations in uptake of the intervention.
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