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Background: Suboptimal adherence to anti-tuberculosis medication in patients is associated with adverse treatment outcomes including treatment failure, relapse, and emergence of drug resistance. Objectives: We conducted the present study with the objectives of evaluating the effectiveness of a mHealth package on the medication adherence of patients with tuberculosis (TB) on antitubercular (directly observed treatment short-course [DOTS]) treatment. Methods: We conducted Quasi-experimental study at six DOTS centers of Delhi among 220 newly diagnosed TB patients. We included adult TB patients (18 years and above) who were on DOTS therapy ≥30 days, had access to a mobile phone and were able to read messages and receive calls. We excluded patients with impaired hearing, blindness and those on non-DOTS therapy or having multidrug-resistant/extensively drug-resistant TB. Participants in the intervention group received amHealth package for 90 days. The medication adherence of the study participants was measured using Morisky, Green, and Levine Adherence Scale. Results: A total of 130 men and 90 women were recruited for the study. Occupational interference and forgetfulness were the most common reasons for medication nonadherence in the patients. In the intervention group, the medication adherence to antitubercular medication (daily DOTS regimen) was 85.5% at baseline which increased to 96.4% at endline (postintervention) (P = 0.004). No significant change was observed in the control group (P = 0.328). The increase in adherence was observed across the following subgroups: age, gender, education, and Socioeconomic status. Conclusions: The mHealth intervention in TB patients was effective in improving the adherence to DOTS therapy.

Complete postexposure prophylaxis with 4 doses of anti-rabies vaccine (ARV) in a previously vaccinated (nonnaïve) individual results in administration of two extra ARV doses resulting in wastages of precious resources comprising vaccine logistics, human resources, physician, and patient time. This cross-sectional study conducted in a secondary care hospital in Delhi among 175 incident animal bite cases observed 39 (22.3%) had an animal-bite history within the previous 5 years. A total of 19 (10.8%) cases reported a history of complete ARV vaccination during a previous animal-bite exposure. However, in the absence of supportive patient medical documentation, all the animal bite cases without exception were prescribed a full course of ARV irrespective of their previous exposure status. Rabies immunoglobulins (anti rabies serum) were also re-administered in 13 (81.2%) cases. National guidelines for rabies prophylaxis should, therefore, consider the inclusion of an explicit decision-making algorithmic mechanism when the health-care provider is confronted with this situation carrying the potential for hidden vaccine wastage.

BACKGROUND: There is growing recognition of the role of mobile learning (M-learning) for undergraduate (UG) academic education and teaching purposes, but teacher attitudes toward it can be variable. OBJECTIVE: To determine the attitudes toward the incorporation of M-learning methods for UG medical education among resident doctors at a government medical college in Delhi, India. METHODS: A cross-sectional study was conducted for 3-months duration (2019) among 60 final year junior and senior resident doctors. The participants were selected from all the preclinical and paraclinical department, and one clinical department selected randomly based on the probability proportion to size method. The data was collected using self-administered instruments including the modified 20-item M-learning Perception Scale (MLPS). RESULTS: Social media (36.7%) and instant messaging platforms (85%) were routinely used by the participants for exchanging academic (medical) and health-related information. The mean score for all the MLPS item responses was >3, indicating positive attitudes toward M-Learning. The participants expressed maximum agreement with the views stating M-Learning can “supplement traditional teaching,” was “reliable for personal use,” and “improves the quality of lessons.” The responses of those participants having preexisting familiarity with health information and education portals, and those aware of massive open online courses correlated significantly with higher MLPS scores. CONCLUSION: M-learning is visualized as an increasingly relevant teaching and learning medium by early-career resident doctors involved in UG medical education in India.