More than 11 million people in the United States, and almost 2.2 billion people worldwide—one third of the world's population—are infected with tuberculosis. Most infected people have latent TB, meaning they have the tuberculosis bacteria in their bodies, but their immune systems protect them from becoming sick. However, over 9.2 million people worldwide have active TB disease.
Patients who develop latent TB do not have symptoms and they are not contagious, but they have a 5-10 percent of developing active TB. Treatment of latent TB with an antibiotic reduces the risk it will progress to active disease. But there are many reasons people with latent TB who start treatment do not complete it. They show no symptoms of illness, and may not understand that they are at risk of developing active TB. In addition, they may experience side effects from the medication, or get tired of having to take the drugs for months.
Eyal Oren, Ph.D., is using a Social Behavioral Research Grant from the American Lung Association to study whether texting patients being treated for latent TB with a daily reminder to take their medicine will increase their completion rate. He will also study whether patients receiving the texts miss fewer medical appointments and doses, and have a shorter course of treatment compared with latent TB patients receiving their usual care, but no texts.
"Between 40 and 60% of individuals being treated for latent TB complete their care," says Dr. Oren, Assistant Professor of Epidemiology at the University of Arizona in Tucson. "You would never see such a low rate for cancer treatment. But people don’t understand that if they don’t have symptoms that they still need to get treatment." He explains that people who do not complete their treatment for latent TB and go on to develop active disease can spread TB to friends and family through frequent exposure.
Dr. Oren became interested in the issue of TB treatment compliance while working at the Public Health – Seattle & King County TB Control Program. He notes that texting is being investigated as a public health tool for everything from HIV medication compliance in Africa to reminding U.S. teens about sun safety. "Text messaging is quick and direct, and inexpensive," he says. Read more about Dr. Oren's research about texting and TB here.
The grant is not Dr. Oren’s first experience with the American Lung Association. As a graduate student living in Seattle, he volunteered for the American Lung Association of Washington’s Master Home Environmentalist program, conducting home assessments of environmental pollutants such as mold, and providing advice on how to reduce exposure. "I really enjoyed it," he says. "It was a great introduction to the American Lung Association and its programs."
Page last updated: February 25, 2020