Tuberculosis is one of the leading causes of mortality in India – killing at a rate of 2 people per minute. Doctor L. S. Chauhan, Director General at the Ministry of Health and Family Welfare, cites the incidence of approximately 1.8 million new cases every year. In fact, India has over 30% of the world’s TB patients, the majority of whom are poor.
Despite the curability of TB through the WHO DOTS programme (which does not, by the way, cure multi-drug resistant tuberculosis, or MDRTB), the problem still persists? Why? Well, the first reason is because of the ease with which the disease is contracted (literally by coughing on someone), and the difficulty with which it is detected, especially in poor regions. Second, even if the desease is detected (assuming it is detected in time), the patient must follow a strict course of medication over a set period of time. This proves to be especially difficult to enforce, as patients either miss doses or assume they are healthy once their condition starts to improve. Unfortunately, these decisions prove fatal.
In an attempt to address this problem, a team of MIT professors and researchers have developed the Ubox, an “intelligent pill delivery system intended to increase medication compliance for rural patients suffering with TB.”
A description of how it works follows after the jump.
UBox is a palm-sized plastic container with sixteen compartments. The user rotates the top handle clockwise to expose a new compartment, and pulls down a small lid at the base of the device to retrieve medication. A simple electronic timer records each time the lid is lowered to remove pills, creating a log of when the patient takes the medication. Further, healthcare workers who are assigned to ensure patients take their pills are given a USB-like modified audio plug and insert it into a port on top of the uBox when visiting a patient. The uBox records the time and date of this action, allowing for healthcare worker tracking as well.
According to NewScientistTech, the uBox will be given to 100 TB patients in Bihar, India, this year.
Even though the development of this simple technology presents an innovative solution to addressing the problem of adherence, the key to reducing TB, I believe, remains in maintaining an open channel of communication with the patient, both before, during, and after their bout with TB. Let’s be realistic – regardless of the technology, gadgets, or incentives available, if patients don’t understand the fundamental importance of taking the full, timely course of TB medication, infection/mortality rates will continue to rise. Constant follow-up through trained health workers, supplemented by community-wide awareness campaigns, are necessary to maximize the effectiveness of this device.
What are your thoughts? By the way, I’m sure you have already read it, but in case you haven’t, I’ll refer you to one of my favorite books on this issue – Mountains Beyond Mountains.
Source: Little Devices that Could