In the fight against tuberculosis in Africa a group from Massachusetts Institute of Technology has invented a smart electromechanical pill box designed to help patients comply with their treatment.
This device, called the uBox, makes sure that the patient takes his/her full regimen of treatment which is crucial to the success of TB therapy. If a patient misses taking part of the course of treatment then resistant strains of the bacterium can develop and produce more severe forms of the disease in the future.
The uBox was developed by Manish Bhardwaj, who is a doctoral student in the Department of Electrical Engineering and Computer Science (Microsystems Technology Laboratories). He was becoming increasingly concerned about ways to help cure tuberculosis sufferers in Asia and Africa.
"The problem is, how do you get people to take this complex regimen" he asked.
The disease claims two million lives in Africa every year and although modern medicine has the means to cure it using a combination of strong antibiotics the problem arises from the strict regimen of treatment.
In effect the patients cannot be trusted to take the full course of treatment every day over a six month period. The mode of treatment has to be very strict to achieve success.
Manish Bhardwaj added "How do you know if pills are getting to the patients or if patients are taking them? Today, there's no good way of doing this... people fail to take all their pills... it is possible to do harm by treatment that doesn't have good adherence. Even missing a few pills can lead to the development of resistant strains, which can then be spread by that noncompliant patient. The people they infect have no chance."
In order to do this the MIT team developed the uBox which has 14 cells in it to accept the daily dose of treatment (solid dosage forms) for a 14 day period. The box is designed to dispense from one chamber per day and the patient is warned with a flashing light and a buzzer as to when they need to take the cocktail of pills.
The uBox does not allow double dosing, as only one compartment will open per day. The patient then uses the box for two weeks and then a health worker refills the box and can also check on patient compliance at the same time by recording digital data as to the time of usage by inserting a 'key like' device into the uBox.
The health workers will also carry a mobile phone/PDA device, the uPhone, to record patient temperature, weight, and also medical history and symptom-related questions. All of this information is then transferred to the patient's confidential records.
A clinical trial using the new system started in India in January 2008. A team from MIT travelled to Bihar province and trained 22 health workers to use the uBox and uPhone. In March 2008 the trial will start properly using 100 uBoxes and 10 uPhones. If this is successful 1,000 uBoxes will be produced for a second trial.
The project has also garnered the interest of the Bill and Melinda Gates Foundation, who may provide support. The potential for the uBox is unlimited, not just confined to TB - it has equal value for anyone that needs to take daily medication.