Feasibility and analysis considerations of continuous community-based cough monitoring in low- and middle-income settings


Continuous cough monitoring using a smartphone application is feasible in low- and middle-income country settings, as shown in this study with 568 participants with presumptive Tuberculosis that were monitored for cough frequency dynamics for at least 10 days.

This paper focuses on the practicality of using smartphone applications for continuous cough monitoring in patients with presumptive tuberculosis (TB) in various low- and middle-income countries.

Key findings and aspects of the study include:

  1. Study Design and Participants: The study was conducted over a period of 14 days, involving patients suspected of having TB. These patients were from health centers across five countries: Uganda, South Africa, Vietnam, the Philippines, and India. Participants were given smartphones equipped with the Hyfe Research application, a carrier sling, and training on how to use both the device and the app for cough monitoring.
  2. Participant Engagement: Out of 693 participants who consented to the study, 568 (approximately 82%) completed at least one recording session successfully. Among these, 421 participants (about 74%) recorded for at least 10 of the 14 days, typically for around 23.9 hours per day.
  3. Cough Detection and Patterns: The study observed a diurnal pattern in cough frequency, with a median of one cough per hour detected between 6 am and 2 pm local time, and significantly fewer coughs during other hours. The researchers also noted that the median coughs per hour were a robust metric for evaluating changes in cough frequency, being less susceptible to outlier values.

The research concluded that continuous cough monitoring using a smartphone application is a feasible approach in low- and middle-income countries. This study provides valuable insights into the feasibility of using digital tools for health monitoring in diverse settings and could have implications for the management and diagnosis of TB and other respiratory diseases.