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Table 3 Characteristics studies included in the review

From: Does phone messaging improves tuberculosis treatment success? A systematic review and meta-analysis

Study ID Belknap, et al, 2017 [49]
Setting USA, Spain, Hong Kong and South Africa
Methods A randomized clinical trial
Participants Adults (aged ≥18 years) LTBI cases
Sample size Overall, 1002 LTBI case were participated
Interventions A one-way weekly text-based treatment reminder
Outcomes Treatment completion was 87% in DOTS, 74% in self-administration and 76 in self-administration plus SMS reminders groups.
Limitations All participants were not randomly assigned to receive SMS reminders
Study ID Barclay, 2009 [46]
Setting South Africa
Methods A single arm interventional study from July, 2006 to April, 2007
Participants Tuberculosis patients at three clinics in the Cape Town
Sample size 155 patients
Interventions Text messaging using SIMpill for 10 months
Outcomes Drug adherence stabilized between 86 and 92% with a treatment success rate of 94% after patients used the SIMpill for 10 months.
Limitations No comparator groups
Study ID bridges.org, 2005 [50]
Setting South Africa
Methods A single arm trial with historical control
Participants All adults with pulmonary and extra pulmonary TB were included in the study
Sample size About 221 TB patients were followed in single arm design
Interventions A one-way text-based daily phone reminder for anti-TB medication for six and eight months
Outcomes Treatment success rate was 73% in trial and 69% in the latest statistics available for the City of Cape Town’s TB Control Program
Limitations No inferential statistics in treatment success rates, due to limited sample size
Study ID Fang X.H. et al, 2017 [51]
Setting China
Methods A Randomized controlled trial was conducted from December 1, 2014 to 31, 2015
Participants All pulmonary TB patients from six districts
Sample size Overall 350 (160 in intervention and 190 in control groups)
Interventions A one-way text-based daily phone reminder for anti-TB medication for six months
Outcomes The treatment completion rate in SMS group (96.25%) was significantly higher than that in the control group (86.84%), p-0.002
Limitations Study included few predictor variables and generalizability restricted to one province
Study ID Farooqi et’al, 2015 [44]
Setting Pakistan
Methods Randomized controlled trial was conducted from June 2014 to June 2015
Participants Patients enrolled for anti-TB drugs were distributed in intervention and control groups
Sample size 148 TB patients
Interventions A one-way text and graphic reminders sent daily to intervention group for two months
Outcomes Primary outcome was default, defined as not taking medicine for two consecutive months. TB treatment success rate was 96.9% in intervention group and 94.26% in controls, p-0.983
Limitations Didn’t assess background knowledge of participants
Study ID Johnston, et al, 2018 [52]
Setting Canada
Methods A parallel, randomized controlled trial
Participants Adults initiating LTBI therapy between June 2012 and September 2015
Sample size Overall, the study enrolled 358 participants (170 in intervention and 188 in control arms)
Interventions An interactive (two-way) text and phone call message service for LTBI adherence.
Outcomes Treatment completion was 79% in intervention and 82% in control groups with RR 0.97; p = 0.550
Limitations Outcome influenced by intensive monitoring schedule of the standard care
Study ID Georges B. et al, 2018 [53]
Setting Cameroon
Methods A randomized controlled trial conducted between February 2013 and April 2014
Participants Adults (>  18 years) and newly diagnosed PTB patients
Sample size Two hundred seventy-nine participants; 137 in intervention 142 in control groups
Interventions A one-way daily text-based reminder and motivational messages for six months
Outcomes At five months, treatment success was 81% in intervention and 75% in control groups with OR = 1.45; p = 0.203.
Limitations High attrition of participants
Study ID Hermans SM. et al, 2017 [54]
Setting Uganda
Methods Quasi-experimental study design held between November 2010 and October 2011
Participants Adult, literate, HIV/TB patients access with mobile phone
Sample size Overall 485 (183 in intervention and 302 in control groups) followed up.
Interventions An interactive (two way) text-based medication and appointment reminder, and educational messages using a total of 8 SMSs per 2 weeks for two months
Outcomes After 8 weeks intervention, successful completion of treatment was 93% in intervention and 89% in control groups, p-0.43.
Limitations Use of pre-intervention control group prone to temporal changes could influence outcomes
Study ID Kumboyono, 2017 [48]
Setting Indonesia
Methods A post-test-only controlled-group design
Participants Adult TB patients enrolled on treatment
Sample size 45 TB patients enrolled on treatment
Interventions A text-based phone messaging to motivate patients
Outcomes There was no difference in treatment compliance between the SMS and control groups with a p-0.059 of Fisher’s Exact test.
Limitations Limited sample size
Study ID Kunawararak et’al, 2011 [41]
Setting Thailand
Methods A two arm RCT between April 2008 and December 2009
Participants New sputum smear positive pulmonary TB patients (both non-MDR-TB and MDR-TB) Patients aged > 15 years
Sample size 98 (60 Non-MDR and 38 MDR) TB patients
Interventions An interactive daily phone call reminder for six and eighteen months
Outcomes Treatment success Rate (TSR) was significantly higher in intervention group (100%) than control (96.7%) in non-MDR-TB, (p-0.047).
Limitations Limited sample size
Study ID Liu et’al, 2012 [45]
Setting China
Methods A pragmatic cluster-randomized trial in 36 districts. From 1 June 2011 to 7 March 2012, 4292 TB patients were enrolled across the clusters.
Participants New pulmonary TB patients, starting on standard 6-month short-course chemotherapy
Sample size 4292 TB patients
Interventions An interactive daily text messages to reminder medications for six months
Outcomes TB treatment success was 96.1% in SMS groups, 91.4% in control groups, with p-0.084
Limitations Over-estimation of poor adherence
Study ID Mohammed et’al, 2013 [43]
Setting Pakistan
Methods A two-arm, randomized controlled trial in Karachi, Pakistan. Individual participants were randomized to either SMS or the control group.
Participants Newly-diagnosed patients with smear or bacteriologically positive pulmonary tuberculosis who were on treatment for less than two weeks; ≥15 years; reported having access to a mobile phone; and intended to live in Karachi throughout treatment were eligible. The study enrolled 2207 participants, with 1110 randomized to SMS and 1097 to the control group.
Sample size 2207 TB patients
Interventions An interactive daily text pill reminder for six months and participants respond with SMS or missed calls after taking medication. Up to 3 SMSs sent for non-respondents a day.
Outcomes There was no significant difference between the SMS or control groups for treatment success (719 or 83% vs. 903 or 83%, respectively, p = 0.782).
Limitations Lack of an objective tool to measure adherence
Study ID Narasimhan et’al, 2013 [47]
Setting India
Methods Single arm interventional study
Participants TB patients seeking care from the DOTS centers
Sample size 104 patients recruited, 100 patients were followed until end of treatment
Interventions Text and/or voice call reminder enabled treatment adherence support system
Outcomes A voice call reminder system could improve patients adherence to TB drugs
Limitations The effect size of the intervention was not determined
Study ID Sarah I. et al, 2013 [42]
Setting Argentina
Methods A randomized 1:1 allocation
Participants Patients newly diagnosed with TB who were ≥ 18 years, and had mobile-phone access
Sample size 38 TB patients (18 in intervention and 19 in control)
Interventions An interactive bi-weekly text-based educational messages to patients to adhere to medication for the first 2 months of treatment
Outcomes Treatment success was 17/18 in intervention arm and 17/19 in control arm.
Limitations Baseline knowledge not addressed; use self-reporting that may bias the outcome