The objective of this study was to test whether an airtime reward increased tuberculosis (TB) Check screening uptake. This served as a feasibility study for the planned Phase 2, which aimed to test behavioural messaging to boost take-up of TB testing among users who were advised to get tested by TB Check.

The study was a randomised controlled trial with a parallel design.

This study assessed mHealth support to boost TB testing in high-burden Cape Town clinics.

Patients aged 18 or above with a valid mobile phone number that had been added within the last 5 years were invited by the Western Cape Department of Health and Wellness through unsolicited text messages to screen for TB using TB Check.

Patients in the intervention group (n=1250) were additionally offered R15 airtime for completing the screening and participating in the research study. Patients were allocated to the intervention or control group through parallel randomisation with equal group size.

The primary outcome was the number of TB Check screenings completed within 1 week of the SMS invitation being sent.

Messages were successfully delivered to 616 patients in the control group and 633 patients in the intervention group. Uptake of the invitation by the intended recipients was very low. Eight users in the control group and 20 users in the intervention group initiated a self-screening (1.3% vs 3.2% of delivered messages; 95% CI of difference (0.2 to 3.5)), but only three users in the control group and seven users in the intervention group successfully completed a self-screening (0.49% vs 1.11% of delivered messages; 95% CI of difference (–0.4 to 1.6)). Low delivery of text message invitations (50.0%) and low completion of users who started the screening (35.7%) posed additional challenges. No adverse events were recorded.

The addition of a small airtime participation reward to unsolicited text message invitations did not appear to be an effective tool to reach targeted individuals in this context. The results of Phase 1 reported here suggested that Phase 2 would not be feasible, so we did not proceed with the planned Phase 2. However, uptake of incentivised self-screening was unexpectedly high among users who were not originally invited (presumably known contacts of the original invitees). Within 5 days of the invitations being sent, 1962 unique self-screenings had taken place using the incentive code; only 7 of these users were originally invited. The lessons learnt from this study can help to inform future efforts to promote TB self-screening, mHealth initiatives and attempts to engage with patients via text message. 

The study was pre-registered with the South African National Clinical Trials Registry (Phase 1 trial no DOH-27-112023-9045, Phase 2 trial no DOH-27-112023-4944) and the Pan African Clinical Trials Registry (Phase 1 trial no PACTR202311529334858).

To describe the outcomes and associations of pericardial disease, with a particular focus on the outcomes of patients admitted with primary or secondary pericardial disease.

Retrospective observational study.

All public and private hospitals in New South Wales, Australia.

Hospitalised patients with pericardial disease admitted from 2004 to 2021 that was (a) a primary diagnosis or (b) a secondary diagnosis.

Mortality both in-hospital and during several years of available follow-up.

Out of 45 446 patients diagnosed with pericardial disease, under half (46.8%) had pericardial disease as the primary reason for hospitalisation. Patients in whom pericardial disease was the primary compared with the secondary diagnosis were more commonly male (68.2% vs 59.1%), younger (median 51.2 years vs 66.0 years) and less comorbid (age-adjusted median Charlson Comorbidity Index 1 vs 4). In patients with pericardial disease, adjusted in-hospital mortality was fivefold lower if this was the primary diagnosis (OR 0.21, p

Patients with pericardial disease have a low in-hospital mortality of about 1% if this was the primary diagnosis. However, patients in whom it was a secondary diagnosis, especially in the presence of comorbidities such as malignancy, had a much worse prognosis.