The electronic system uses mobile phones and computers in hospitals, helping to track client samples from sputum collection points to the laboratory and back to patients.

Under the system, community volunteers collect sputum samples from presumed patients using an android application; scan them with the phone camera and upload the data to a central database.

When results are out, an SMS is automatically sent to the client notifying him or her to visit the hospital to collect the information.

This system has shortened the period between collection of samples, release of results, and starting treatment, thus improving the treatment rate.

"I went to the hospital for a TB test in the morning. Around 3 pm the same day, l received an SMS on my phone notifying me to visit the hospital and get the results, " says Gracian Stephano.

The 35-year-old man from Lilongwe recovered from tuberculosis six months after starting treatment.

Stephano says he received his TB test results a few hours after being tested. This means that he was put on treatment in good time.

Further, he was receiving notifications through his phone about appointments with the doctor.

"I am happy l received results for my TB test the same day l was diagnosed with TB. l started treatment the same day and I was being reminded about the next appointment with the doctor to collect medication. My condition improved quickly and l recovered from TB. l am fine now and able to work," he says.

The TB e-Health System, popularly known as iMoSyS, the name of the service provider, was introduced in Malawi to enable faster and effective tracking of TB samples from the community level to the point of treatment initiation.

Once a sputum sample for a client is tested and results are out, an SMS is automatically sent to that person's mobile phone number, notifying them to visit the hospital to get the results.

All patients who are on TB treatment are also reminded of their next appointment with the doctor to collect medication through an SMS.

TB Officer for Bwaila Hospital in Lilongwe Solo Fotera says over 2000 TB patients in the district have benefited from the new system.

Fotera says clients are no longer waiting for days to get TB test results as details are sent to the laboratory almost in real time.

“In the past, patients waited for days to get TB [test] results but with the new system, patients are able to get results a few hours after submitting sputum samples. Patients start treatment the same day and this has reduced the chances of transmitting TB to others,” observes Fotera.

The TB eHealth System is being implemented in 15 districts in Malawi covering four health facilities in each district.

To ease the process, the application which it uses was installed in mobile phones that were distributed to community volunteers which are linked to computers in the hospitals that are involved in the programme.

Martha Limitedi is a TB survivor from Balaka District. She narrates how the system helped her to recover from the disease.

Says Martha, "I was showing TB signs, and a community volunteer came to collect my sputum sample. The samples were sent to the facility and within 24 hours, l got a notification on my phone to visit the facility to get the results...l was diagnosed TB positive and started treatment immediately. During the six months of treatment, l was reminded of the dates to visit the hospital until I completed my TB treatment...my life was saved...l am happy this system helped me a lot."

Martha's sentiments are echoed by Loveness Eva who says she survived TB because she started treatment before her condition worsened.

"After submitting my sputum samples, l got the results quickly. l received an SMS on my phone the same day notifying me to visit the facility to get results. This helped me to start treatment in good time. l recovered from TB because l started treatment in good time before my condition worsened," she recalls.

IT Specialist for the TB electronic treatment system is Francis Mutwalo.

Mutwalo says the automatic messages that are sent to patients do not indicate whether the patient is positive or negative for privacy reasons, but only inform them to go to the hospital to get the results.

He says the system, apart from patients, also involves health workers by reminding them of the dates the patients should go to collect medication and to follow up on those who abscond treatment.

Maseto Kalembekera, TB focal person for Phalula Heath Centre in Balaka, explains how the system links them with patients.

"In the past, it was hard to follow up TB patients. They were taking days before receiving results of their TB tests but the new system is helping patients to get the results in good time. Patients are reminded of the dates of their next hospital visit; even us health workers, are reminded to follow up on TB patients who shun treatment. This has helped to reduce the death rate," says Kalembera

District TB Officer for Balaka Thomas Bizeck describes the electronic system as a game changer, saying it has brought improvement in the management of TB patients.

District Medical Officer for Dedza Moris Lingalirani says the TB eHealth System has also helped to improve treatment success rate currently at 95 percent and reduced the death rate to below 5 percent in the district.

In the past, patients were waiting for several days to get TB test results. They depended on volunteers to travel to health facilities to collect the results and take them back to the patients, a process that was prone to errors.

With the current TB eHealth System, when community volunteers collect sputum samples in villages, they scan them using smart phones and send them to health facilities for testing. When results are out, both the patient and community volunteers receive a notification on their mobile phones.

Up to 25 ,000 people suffer from TB in Malawi every year, and the death rate stood at 7 percent as of December 2023.

The coming in of the electronic treatment management system brings hope for reduced burden. Already it has helped Malawi to be on the right track in the fight against TB with the treatment success rate now at 90 percent and THE death rate at 7 percent. If it is fully rolled out, more lives would be saved.