Mobile app boosts tuberculosis detection across Nigeria

Tuberculosis remains a major health problem in Nigeria, with many people still missing diagnosis and treatment. These gaps are particularly large in the mixed public and private health care settings where patients often first seek help. To tackle this, researchers led by corresponding author Bethrand Odume evaluated a new digital tool called the Mobile Application for Tuberculosis Screening (MATS). The app was designed to standardize screening, help identify people who might have TB, and make it easier to notify public health systems when a possible case is found. The evaluation set out to understand whether MATS could improve the detection of TB cases and strengthen the flow of information across different kinds of health facilities. The project reached health workers, program managers and patients to learn how the tool worked in real clinics and shops, and to measure its effects on numbers of people screened and cases identified. By looking at both numbers and personal experiences, the study aimed to show whether a mobile screening app could help close longstanding diagnostic and reporting gaps.

The team used a mixed-method study design that combined numbers and words to evaluate MATS. For the quantitative part they carried out a retrospective comparative analysis using data from the MATS database, routine facility records, and national TB surveillance systems, comparing periods before and after MATS was introduced. For the qualitative part they conducted Key Informant Interviews and Focus Group Discussions with TB patients, health workers, and program managers across five geopolitical zones to understand user experiences and operational realities. Between 2021 and 2023, MATS was used to screen 1,048,575 individuals across 24 states. From that group, 283,807 people were identified as presumptive TB cases and the diagnostic yield was 16.9%, corresponding to 4,725 confirmed cases. The largest increases in case detection came from the North-West and North-Central regions. Private-for-profit facilities and patent medicine vendors together contributed more than 60% of presumptive identifications. The qualitative work reported positive user experiences and better data management, but also found barriers to completing diagnosis such as logistical constraints, economic challenges, and health system inefficiencies.

The findings suggest that MATS improved the efficiency and quality of TB screening and helped strengthen surveillance in Nigeria’s private sector. By making it easier for a wide range of providers to record and report presumptive cases, the app brought more people into the diagnostic pathway and made information flow more reliable. At the same time, the study shows that technology alone is not enough: many people did not complete diagnostic follow-through because of transport difficulties, costs, and gaps in referral systems and clinic capacity. The authors conclude that while MATS has strong potential for wider rollout, success will depend on continued investment in digital infrastructure, better referral and linkage systems, and practical patient support to overcome economic and logistical barriers. Integrating MATS into broader disease management frameworks and sustaining funding and training will be key to turning better screening into lasting reductions in missed TB cases.