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Tests, Texting and Tuberculosis: Nagging That Works

When it comes to treating tuberculosis, the primary difficulty many doctors encounter today is the unfortunate reality that giving patients antibiotics doesn't necessarily mean they'll actually take them.

This problem is especially pronounced in developing countries, where there is a growing need for an easy way to monitor patients who are often hours away from the nearest hospital. A team of students at Massachusetts Institute of Technology have come up with a plan that does just that, offering an easy-to-use texting system and incentives like free cell phone minutes to ensure that people with TB actually complete the six- to nine-month course of medications necessary for their complete recovery.

Following the new plan, patients who previously had to check in at medical centers each day need only a cell phone and special test strips to confirm that they are taking the prescribed daily doses of antibiotics.

The MIT group, created as a part of the Muhammad Yunus Challenge to Alleviate Poverty and aptly dubbed "X Out TB," used a recently developed technology known as paper microfluidics to create a new type of test strip that interacts with the urine of patients who have taken their medication. If metabolites from the antibiotics are present, chemicals on the strip reveal a number that can be submitted to a hospital database via a special cell phone texting system.

Patients who consistently submit these numbers as evidence they're continuing the treatment are rewarded with free cell phone minutes, an incentive chosen for its relative ease of distribution and wide appeal.

While potentially applicable all over the world, the "X Out TB" plan would be a particularly effective solution for tuberculosis treatment in third world countries, where many uneducated patients who don't have access to medical centers stop taking medication when they believe themselves cured. Rather than defeating the disease, they end up with TB resistant to the antibiotics, preventing those individuals from restarting the program and potentially helping spread a more pernicious version of the disease.

Having completed field-testing in Nicaragua, the MIT team plans to spend this summer in Pakistan and Indonesia, where their incentives-based system could help hundreds of patients fulfill treatment requirements and go on to lead disease-free lives.