For people with tuberculosis, treatment is a grind. They must take antibiotics daily for six months or longer to kill the bacteria — even though they’ll likely feel cured after a few weeks.
Some patients abandon treatment early, raising concerns among health officials that the disease will re-emerge more drug-resistant than before. That’s why TB patients today typically must take their medicine while being observed — in person — by a public health worker.
Now researchers at University of California San Diego have developed a smartphone app that allows TB patients to make videos of themselves taking required pills. The app uploads the videos to the Internet cloud for county health workers to view remotely.
UCSD on Thursday said it has teamed with the Verizon Foundation to demonstrate the technology in three cities — San Diego, San Francisco and New York.
The pilot program has already kicked off locally and is expected to launch in other cities soon.
“Health departments — whenever they are able — are tasked with watching the patients take their pills every day just to make sure they are not missing doses,” said Dr. Richard Garfein, a professor at the UCSD School of Medicine. “We’ve come up with a way that is less time-consuming and less expensive.”
There’s a medical reason for making it easier for TB patients stick with their treatment plans. It helps prevent TB bacteria from mutating and becoming tougher to kill. Globally, drug-resistant strains of TB are on the rise.
“Then it becomes a much bigger problem for public health departments to deal with because the cheap, effective drugs don’t work anymore, and they have to go to more expensive, more toxic and less effective drugs,” Garfein said.
Tuberculosis infects about 10,000 people each year in the United States. Infection rates are higher elsewhere, including India, Asia and parts of Latin America.
States with large immigrant populations — California, New York, Texas and Florida — account for more than half of TB cases in the United States. About 200 to 300 new cases are reported annually in San Diego County, said Kathleen Moser, director of the TB and refugee health branch of the county Health and Human Services Agency.
Researchers at UCSD’s School of Medicine and Qualcomm Institute/Calit2 research center developed the video-monitoring app and back-office technology. About a year ago, they launched a 50-patient trial in San Diego and Tijuana funded by the National Institutes of Health. More than 93 percent of prescribed doses were observed via video.
The new trial funded by the Verizon Foundation aims to see how the system performs on a larger scale. Verizon is providing a $300,000 grant, as well as free 4G Android smartphones and a cloud storage system that’s compliant with federal security and privacy laws. Its total contribution is $2.5 million, said spokesman Ken Muche.
Researchers want 50 patients to participate in each of the three cities. Since most patients do a good job posting the videos, it frees up county health workers to concentrate on patients who are not good about taking their medicines, Garfein said.
“What I’m hoping is once the health departments start using it, they are not going to want to stop,” he said.