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The KNCV-led TB REACH project, which is funded by the Stop TB Partnership, supported adult drug-sensitive (DS) TB patients to adhere to, and complete their treatment through a digital adherence technology (DAT) called 99DOTS (medication sleeves). The TB REACH project is the predecessor of the ASCENT project, funded and supported by Unitaid. As part of the intervention, KNCV assessed the practicalities and scalability of implementing 99DOTS, and its impact on improving treatment outcome among the patients.

Angelito* was one of the patients that participated in the TB Reach project in the Philippines.

“My name is Angelito and I am a TB survivor from Mandaluyong City, Philippines.”

Angelito in his dance costume.

“Being an active person I never imagined I would fall ill of tuberculosis (TB). I was employed full time overseeing 15 stores of 7-Eleven. On the side, I choreographed dances for a fee. I was busy, especially during the Christmas season. Company employees who seriously aspired to win the top prize for the Christmas party dancing competition vied for my services. So did students. I loved dancing and choreography gave expression to the creative part of me. On top of that I was being paid to do it. What more could I want? I could do this forever!”

“In August 2019, what I thought was the good life began to unravel. I started to lose weight and feel inordinately tired. Occasionally I would feel a tight pain in my chest. I felt a bit feverish in the late afternoon. And I was coughing badly. My ate (older sister) advised me to get a check-up. But it was a friend who convinced me to see a doctor.”

“When I told my sister that I had tested positive for TB, she wasn’t surprised. She suspected it, she said. Our grandmother and a younger sister had TB some years ago, so she knew the symptoms. Our relatives were similarly familiar with TB, and seemed unfazed by the fact that I had contracted the disease. They didn’t keep their distance as I had expected. Instead they encouraged me to keep going with my treatment. I knew then that I wasn’t alone.”

Nurse Anton shows Angelito how to use the 99DOTS medication sleeve.

“At the private clinic I consulted with, nurse Anton told me that we were going to use 99DOTS to track my medication intake. “This will enable me to see whether you’re religiously taking your medicine even if you don’t come to the clinic every day,” he pointed out. He patiently explained how this so-called digital adherence technology worked. He reminded me that the code revealed after taking the pill from the medication sleeve had to be texted to the toll-free number he gave me. In this way, my drug intake for each day would be recorded. If I forgot to take my daily dose, I would receive a reminder.”

A successfully logged-in 3-digit code registers green in the 99DOTS platform.

“I felt relieved when nurse Anton mentioned that I didn’t have to visit the clinic every day for him to see if I took my medicine. A visit every two weeks for drug refill was all that he asked of me. This meant I saved on transportation money. Unable to continue earning a living because of my illness, I had to budget the little amount I had saved.”

Six months after he started TB treatment, and faithfully taking his medication with the help of 99DOTS, Angelito was declared cured.

“On 6 December 2019, I started my TB treatment. Thanks to nurse Anton’s warm support, and my family’s constant cheering and encouragement, I didn’t give up. I completed my treatment on 21 May 2020. And thanks, too, for 99DOTS. I won’t hesitate to recommend it to TB patients who wish to get cured.”

* The name of the patient interviewed is known by KNCV and changed here because of privacy.

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