Maia’s story: mobile app transforms drug-resistant TB treatment
In July 2021, Maia was diagnosed with drug-resistant tuberculosis (DR-TB). She is not sure how she got the disease, but she understood shortly after her diagnosis that the treatment could radically impact her and her family’s life.
- 24 March 2022
- 4 min read
- by The Global Fund
Maia Chikovani is a busy mother of two boys. She spends her days looking after Luka, 14, and Saba, 12; managing the household; and tending to the animals on their small farm in the village of Bashi in western Georgia. She also works outside the home as a caretaker.
Along with her two sons, Maia lives with her parents and brother. The family depends on her job and on her parents’ pension to get by financially.
In July 2021, Maia was diagnosed with drug-resistant tuberculosis (DR-TB). She is not sure how she got the disease, but she understood shortly after her diagnosis that the treatment could radically impact her and her family’s life.
Treating DR-TB is grueling. Patients like Maia take daily medications that can have severe side effects for up to two years. Many are hospitalized for months at a time and are required to make daily trips to a health clinic to ensure their treatment is supported and monitored closely.
For Maia, and for many other patients with DR-TB, frequent trips to a clinic not only take a lot of time but are also expensive. These trips would make it impossible for Maia to be able to work to support herself and her family.
The Global Fund is working with governments and other partners to improve treatment for patients like Maia by decentralizing DR-TB treatment from major health facilities into communities and homes and introducing all-oral treatment regimens that result in fewer side effects.
In Georgia, this work includes the roll-out of the AdhereTB mobile application – a video-supported treatment (VST) application developed by the National Center for Disease Control and Public Health of Georgia, with support from the Global Fund – which Maia now uses.
“This application helps because I can do the work I have at home – I can feed the animals and care for the kids. Without it, I would not even have the job I have now because I would not have the time for it,” she says.
Patients like Maia take their medication at home, record the process and upload videos that a nurse later reviews. Patients can also ask the nurse questions and report side effects in real-time. The application saves patients time and transportation costs, and throughout the COVID-19 pandemic, it has helped reduce the number of people at health clinics while ensuring patients remain on treatment.
“When they first told me there was an application, I could use I felt a bit uncomfortable,” Maia says. “But the next day, when they showed me how it worked, I understood it, and it was quite easy for me to navigate and upload videos.”
Maia usually takes her daily TB medicine at noon, after she returns from work. “I have to indicate the number of pills I will take,” she says. “Today is Monday, and I note 14. I then push the start button and the video recording begins. I show the medicine in my hand, then swallow the pills and push the finish button and the video is uploaded.”
Patients using AdhereTB can record and upload videos when it is most convenient for them, see a list of medications they have been prescribed, the descriptions of each drug and possible side effects. Patients are also given smartphones and internet access if needed. Maia found it most convenient to use her personal mobile phone. The application also saves health care workers valuable time, allowing one nurse to supervise multiple patients on a schedule that works best for the entire health care team.
Nurse Maia Kintsurashvili is the adherence nurse who has worked closely with Maia C. Every evening, she observes and carefully checks videos uploaded by her nine patients, including Maia, through AdhereTB.
She also feels that the application has made life easier for patients with DR-TB in Georgia.
“It gives them more time: They do not have to come to the clinic every day and can take the medication at any convenient time of day,” says Nurse Kintsurashvili. “It also helps in the reality of the COVID-19 pandemic. Being in a risk group for COVID-19, they do not have to visit [frequently] and meet people who might be infected.”
Global Fund investments now support VST applications such as AdhereTB in several countries across the region, including in Armenia, Azerbaijan, Belarus, Kazakhstan, Moldova and Ukraine.
FOOTNOTES
Written and edited by Melanie Sharpe and Anush Babajanyan. Photography by Anush Babajanyan. With many thanks to the National Center for Disease Control and Public Health of Georgia for their support.
Bashi, Kveda Bashi, Georgia
Website
This article is originally published by The Global Fund on 4 February 2022.
