A new study by the Africa Centres for Disease Control and Prevention (Africa CDC) is exploring how mobile phone messaging can improve tuberculosis (TB) treatment adherence in Ethiopia and Liberia, two of the continent’s most affected countries.
The research is supported by a US$100,000 grant from the World Bank and is running from 17 November to 12 December 2025. It is being carried out in partnership with the Ministries of Health in Ethiopia and Liberia, the University of Liberia College of Health Sciences, Dire Dawa University, and the Dire Dawa Health Bureau, with technical coordination provided by Africa CDC’s Science and Innovation Directorate.
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Tuberculosis remains a major global health challenge. In 2023, an estimated 10.8 million people worldwide were infected, resulting in over 1.25 million deaths. Ethiopia and Liberia are among the highest TB-burden countries, with estimated incidence rates of 119 and 308 cases per 100,000 population, respectively. Despite progress in diagnosis and treatment, adherence to TB medication continues to be one of the weakest links in TB control – leading to treatment failure, relapse and drug-resistant TB.
To address this persistent challenge, the Africa CDC study is leveraging mobile technology as a practical solution. It aims to improve TB treatment adherence by testing SMS reminders, identifying barriers to digital technology adoption, and evaluating their impact on patient outcomes. It is titled ‘Improving TB Treatment Adherence through Mobile-Phone Messaging: Identifying Barriers, Facilitators, and Adoption Pathways in Ethiopia and Liberia’.
“This research is significant because it provides an opportunity to integrate digital innovation into TB care in Africa, advancing patient-centred solutions that address real-world barriers to treatment adherence,” said Dr Mosoka Fallah, Acting Director of Science and Innovation at Africa CDC. “By leveraging the widespread use of mobile phones, we can make TB treatment support more accessible, responsive and effective – particularly for vulnerable communities.”
The research will be conducted in two phases across Ethiopia and Liberia: a quantitative baseline assessment to measure current adherence levels among TB patients, followed by a pilot intervention using SMS-based reminders for patients identified with low adherence. A total of 844 TB patients (422 in each country) will be enrolled, with about 200 participants receiving SMS reminders. Both quantitative and qualitative approaches will be used to generate insights that inform national TB strategies and continental policy recommendations for digital health integration.
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“Africa CDC continues to prioritise implementation science that directly strengthens public health interventions in Member States,” Dr Fallah added. “This initiative will not only generate actionable evidence for TB programmes but also contribute to the broader digital health agenda in Africa.”
The study will provide evidence on the effectiveness of SMS-based TB adherence support in Africa, identify barriers and enablers to the use of digital adherence tools, and guide TB control policies and programmes in Ethiopia, Liberia and other Member States.
Dr Fallah explained that the research reflects Africa CDC’s commitment to driving evidence-based innovations that accelerate progress toward ending TB by 2035, in alignment with the WHO End-TB Strategy and the African Union’s health priorities.
