A Scoping Review of Community Health Worker-Led Digital Adherence Technologies for Multi-Drug Resistant Tuberculosis in Lagos, Nigeria (2021–2026)

This scoping review addresses the critical challenge of low treatment adherence in multi-drug resistant tuberculosis (MDR-TB) management within Lagos, Nigeria, a high-burden urban setting. It systematically maps and synthesises the emerging evidence from 2021 to 2026 on the implementation and impact of community health worker (CHW)-led digital adherence technologies (DATs), such as video-supported therapy and medication monitors. The methodology adhered to the Joanna Briggs Institute framework, involving systematic searches of electronic databases and grey literature to identify relevant primary studies and programme reports. Key findings reveal a nascent but growing evidence base suggesting that CHW-facilitated DATs can improve treatment observation, generate real-time adherence data, and strengthen patient-provider communication. Nevertheless, significant implementation barriers were consistently reported, including gaps in technological literacy, unreliable electricity and internet connectivity, and the absence of sustainable CHW remuneration models. The review concludes that while this integrated human-digital model holds potential to bolster Nigeria's MDR-TB response, its effective scale-up requires context-specific implementation strategies. It underscores the urgent need for equity-focused operational research and substantial public-sector investment in digital infrastructure to translate this potential into practice across similar African urban centres.