Bali — Digital recording systems for tuberculosis (TB) programs significantly improve data quality while reducing operational costs in primary healthcare facilities across developing countries. This finding comes from a recent systematic review by Gede Wirabuana Putra from Kartini Bali Health Polytechnic, published in 2026 in the International Journal of Scientific Multidisciplinary Research (IJSMR). The study is highly relevant as TB remains the world’s deadliest infectious disease, causing 10.8 million new cases and 1.25 million deaths in 2023.
One of the major challenges in TB control is not only treatment but also data management. In many low- and middle-income countries, primary healthcare centers still rely on paper-based systems, often leading to incomplete, delayed, and inaccurate records.
Putra highlights that data quality is the foundation of effective TB control. Without accurate and timely data, clinical decisions and public health policies become less efficient. This makes digital recording a critical step toward better surveillance and case management.
The study reviewed 1,847 published articles from PubMed, Google Scholar, Scopus, and Cochrane Library. After strict screening under PRISMA 2020 guidelines, 15 studies from nine countries were included in the final analysis, covering Indonesia, India, the Philippines, Bangladesh, Kenya, Uganda, Tanzania, Ethiopia, and Madagascar.
The findings showed that digital systems achieved 94.2 percent data completeness, compared to only 78.3 percent for paper-based systems. This 15.9 percent improvement demonstrates the strong impact of digital transformation on TB data quality.
Integrated platforms such as DHIS2 and Electronic Medical Records (EMR) delivered the highest data accuracy at 96.1 percent. However, simple spreadsheet-based systems like Google Sheets and Microsoft Excel turned out to be the most cost-effective.
The average implementation cost for spreadsheet-based tools was only USD 12.40 per patient per year, compared to USD 31.60 for DHIS2/EMR systems. Mobile apps averaged USD 22.80, while Video Observed Treatment (VDOT) systems exceeded USD 220 per patient annually.
The study suggests that digital transformation in healthcare does not always require expensive technology. For low-resource settings, spreadsheet-based systems can serve as practical entry points before transitioning into more advanced platforms.
For Indonesia, the findings are especially important. As the world’s second-largest TB burden country, Indonesia is currently expanding its national TB reporting system through SITB and DHIS2 integration. This study suggests that hybrid spreadsheet systems could support this transition effectively.
Putra also emphasized that technology alone is not enough. The study found that short training sessions of 1.5 to 3 hours for healthcare workers improved data quality by 23 percent.
Other factors such as stable electricity, internet access, technical support, and government policy alignment were also identified as key success factors.
The Bali study strengthens the argument that affordable digital tools can become powerful weapons in achieving the WHO’s End TB 2030 target, improving case detection, treatment efficiency, and public health outcomes worldwide.
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