{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T00:44:10Z","timestamp":1773881050094,"version":"3.50.1"},"reference-count":24,"publisher":"International Union Against Tuberculosis and Lung Disease","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJTLD Open"],"accepted":{"date-parts":[[2025,9,14]]},"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>SUMMARY<\/jats:title>\n                  <jats:sec>\n                    <jats:title>BACKGROUND<\/jats:title>\n                    <jats:p>The Russian invasion of Ukraine in February 2022 has disrupted TB care. We examine the effects of the war on people with drug-susceptible TB (PWTB) and health care worker (HCW) engagement with a digital adherence technology (DAT).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>We conducted a cluster-randomised trial of a DAT intervention in Ukraine. In the intervention arm, PWTB received a pillbox with a daily treatment reminder. Pillbox openings were captured real-time onto a platform, accessed by HCWs who could add manual doses where relevant. We compared DAT engagement in pre-, early-, and later-war periods.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>From June 2021 to 2022, 816 PWTB (32% women, median age 44 years) were enrolled. DAT engagement varied across regions and time period, with a decline in engagement post-February 2022. PWTB DAT engagement was 78%\u201384% of treatment-days. There was a three- to four-fold increase in unknown dose or delays in manual reporting of adherence (&gt;7 days) post-February 2022 versus pre-war in Mykolaivska and Donetska oblasts and a two-fold increase in Odeska, Lvivska, and Zakarpatska oblasts.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSION<\/jats:title>\n                    <jats:p>The war significantly disrupted DAT engagement, particularly in regions heavily affected by the conflict. Reduced engagement was likely due to migration and communication challenges. There is a critical need for resilient TB care in conflict settings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.5588\/ijtldopen.25.0503","type":"journal-article","created":{"date-parts":[[2026,1,15]],"date-time":"2026-01-15T10:26:56Z","timestamp":1768472816000},"page":"24-30","source":"Crossref","is-referenced-by-count":0,"title":["The effects of war on digital adherence technology engagement for TB treatment in Ukraine"],"prefix":"10.5588","volume":"3","author":[{"given":"N.","family":"Deyanova","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6199-0931","authenticated-orcid":true,"given":"C.F.","family":"McQuaid","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"V.","family":"Kochanov","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A.","family":"Bogdanov","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"N.","family":"Madden","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7143-1009","authenticated-orcid":true,"given":"S.","family":"Charalambous","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"K.","family":"van Kalmthout","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7853-4211","authenticated-orcid":true,"given":"D.","family":"Jerene","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6524-3754","authenticated-orcid":true,"given":"K.L.","family":"Fielding","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"K.","family":"Gamazina","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"3554","published-online":{"date-parts":[[2026,1,1]]},"reference":[{"key":"2026031812065784000_3.1.24.1","doi-asserted-by":"publisher","DOI":"10.3201\/eid0101.950102"},{"issue":"19","key":"2026031812065784000_3.1.24.2","doi-asserted-by":"crossref","first-page":"10783","DOI":"10.3390\/su131910783","article-title":"The influence of war and conflict on infectious disease: a rapid review of historical lessons we have yet to learn","volume":"13","author":"Goniewicz","year":"2021","journal-title":"Sustainability"},{"issue":"9449","key":"2026031812065784000_3.1.24.3","doi-asserted-by":"crossref","first-page":"1974","DOI":"10.1016\/S0140-6736(04)17481-3","article-title":"Communicable diseases in complex emergencies: impact and challenges","volume":"364","author":"Connolly","year":"2004","journal-title":"Lancet Lond Engl"},{"key":"2026031812065784000_3.1.24.4","doi-asserted-by":"crossref","unstructured":"Price-Smith AT . 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