A Systematic Review on the Impact of Digital Health Technologies in Latent Tuberculosis Infection Management

Objectives
To date, there is no study that has attempted to focus and summarize the role of digital health technologies in improving latent tuberculosis infection (LTBI) care. This review aims to address this gap and determine the impact of digital health technologies on LTBI screening and treatment outcomes.
Methods
A systematic literature search was performed on six electronic databases from database inception until November 1, 2020. Studies that assessed the clinical use of digital health technologies in LTBI screening and treatment outcomes were eligible to be reviewed. Two investigators independently evaluated and extracted relevant studies. The Cochrane risk of bias tools were used to evaluate the methodological quality of the included studies. Descriptive data were summarized narratively. The effect of digital health technologies on LTBI treatment completion was estimated using random-effects meta-analysis.
Results
A total of 4,723 studies were screened, of which eleven eligible articles describing ten unique studies were included in this review. The use of digital health technologies to improve LTBI care includes voice and/or textual reminders, synchronous video call, tele-education and mobile applications to review tuberculin skin test induration. Improvement in LTBI treatment completion was observed with the use of textual reminders in regions with intermediate and high tuberculosis burden in comparison to regions with low tuberculosis burden [risk ratio (RR): 1.20; 95%CI: 0.99 – 1.46 versus RR: 0.97; 95%CI: 0.90 – 1.04, p = 0.04].
Conclusions
Our findings showed limited improvement in LTBI treatment completion with the use of digital health technologies. Nevertheless, digital interactive tools such as synchronous video call could help establish rapport between health care providers and individuals receiving LTBI treatment. As such, barriers to LTBI management could be addressed efficiently, which could in turn improve the quality of LTBI care among those affected.