mHealth-supported tuberculosis contact investigation by community health workers in high-burden countries: a scoping review

Mobile health (mHealth) implementation strategies in tuberculosis (TB) contact investigations are intended to increase community health workers' (CHWs) engagement in TB contact investigations and case detection. This scoping review aimed to map and synthesize existing evidence on the design and development of acceptable and feasible mHealth implementation strategies for CHW-led TB contact investigations. We conducted a scoping review following the Arksey and O'Malley framework and PRISMA-ScR guidelines. We searched PubMed, Scopus, Cochrane Library, Web of Science, and Google Scholar for English-language studies published through October 2024 on mHealth interventions for TB contact investigation by CHWs. Eligible studies included empirical studies conducted in high-burden countries (HBCs) for TB, HIV-associated TB, and MDR/RR-TB. Studies were screened, and data were extracted using Rayyan AI-assisted software. We mapped implementation strategies, barriers, facilitators, acceptability, and feasibility of mHealth interventions. Quantitative findings were described, and qualitative data were synthesized thematically. Nine studies were included. Most interventions used hybrid mHealth technologies for communication, case registration, health records, and decision support. Implementation strategies specified actors, actions, targets, temporality, dose, and justifications. Barriers were related to CHWs, digital systems, service implementation, and TB-affected persons. Facilitators included stakeholder support, CHW training, mHealth design, community engagement, and patient-centered approaches. Overall, CHWs perceived mHealth interventions as acceptable and feasible. Successful implementation in HBCs requires strengthened CHW capacity, reliable technology, optimizing interaction between CHWs and digital tools, and continuous monitoring and evaluation throughout implementation.