Digital Recording Tools and Bottom-Up Cost Analysis of Tuberculosis Programs in Primary Care Settings of Low- and Middle-Income Countries: A Systematic Review and Meta-Analysis
DOI:
https://doi.org/10.55927/ijsmr.v4i6.83Keywords:
tuberculosis, digital recording, bottom-up costing, primary care, LMICAbstract
Tuberculosis (TB) remains the world's leading infectious disease killer, with 10.8 million new cases and 1.25 million deaths in 2023. Over 87% of cases occur in low- and middle-income countries (LMICs) where primary care facilities face critical gaps in data recording. This systematic review and meta-analysis examined the effectiveness and costs of digital recording tools for TB programs in LMIC primary care settings. Searches of PubMed/MEDLINE, Google Scholar, Scopus, and Cochrane Library (2014–2024) identified 15 eligible studies from 1,847 records, following PRISMA 2020. Digital tools achieved significantly higher data completeness (94.2%, 95% CI: 89.7–98.6%) versus paper-based systems (78.3%, 95% CI: 71.2–85.4%), an absolute improvement of 15.9 percentage points (p<0.001). Bottom-up unit costs ranged USD 8.50–43.20 per patient-year; spreadsheet-based tools were most cost-effective (mean USD 12.40/patient-year). Low-cost digital recording tools meaningfully improve TB data quality and represent a feasible investment toward End TB 2030 goals.
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