Impact of a Mobile Application for Public-Private Tuberculosis Screening on Case Detection and Notification in Nigeria

Abstract

Abstract Background Tuberculosis remains a major public health concern in Nigeria, with significant diagnostic and treatment gaps, particularly within the public-private mix healthcare sector. To address these challenges, the Mobile Application for Tuberculosis Screening was introduced as a digital tool to strengthen TB screening, presumptive case identification, and notification across diverse healthcare settings. Methods A mixed-method study design was employed, integrating retrospective quantitative data analysis using a comparative analysis approach with qualitative thematic analysis. Quantitative data were drawn from the MATS database, routine facility records, and national TB surveillance systems, comparing pre- and post-MATS implementation periods. Key Informant Interviews and Focus Group Discussions were conducted with TB patients, health workers, and program managers across five geopolitical zones to explore user experiences, operational realities, and systemic barriers. Results Between 2021 and 2023, a total of 1,048,575 individuals were screened using MATS across 24 states, identifying 283,807 presumptive TB cases and a diagnostic yield of 16.9% (4,725). The most notable TB case gains were in the North-West and North-Central regions. Private-for-profit facilities and patent medicine vendors contributed over 60% of presumptive identifications, underscoring the importance of engaging non-state actors in TB control. Qualitative findings highlighted positive user experiences and improved data management but also revealed barriers to diagnostic follow-through, including logistical constraints, economic challenges, and health system inefficiencies. Conclusion MATS significantly improved the efficiency and quality of Nigeria’s private sector TB case detection and strengthened TB surveillance. While operational barriers remain, the tool demonstrates strong potential for further scale-up and integration into broader disease management frameworks. Future success will depend on sustained investment in digital infrastructure, strengthening referral and linkages, and patient support to optimise impact and advance national TB control goals.