Leprosy Diagnosed via Teledermatology in a U. S. Urban Academic Health Center Highlights Potential Benefits and a Pitfall of Existing Telemedicine Services

Watchmaker, Lauren E.; Watchmaker, Jacqueline; DeLeon, Dianne; Stavert, Robert

doi:10.1089/tmj.2018.0142

Cited by 4 publications

(3 citation statements)

References 5 publications

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“…Different remote assistance and monitoring strategies could contribute to having leprosy patients evaluated by dermatologists, in referral centers, when necessary, using a more agile and interactive approach, with a consequent reduction in morbidity and sequelae. 29 , 30 …”

Section: Discussionmentioning

confidence: 99%

Reviewing the therapeutic management of leprosy in primary care: demand case series referred to a University Hospital in the Midwest region of Brazil

Sousa¹,

Sousa²,

Turchi³

2021

Anais Brasileiros de Dermatologia

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Background Leprosy still represents a negleted public health problem in Brazil. Early and adequate treatment of leprosy, carried out in a primary health network is essential to reduce morbidity and sequelae. Objective To analyze the therapeutic management of leprosy patients referred from primary healthy services to a specialized service. Methods An analytical retrospective study using medical records and the Notifiable Diseases Information System. Patients diagnosed with leprosy, referred to a specialized outpatient clinic, between 2016 and 2017, in Goiás state, were included. The treatment carried out in the primary health services was compared to the Ministry of Health guidelines. Results Two-hundred twenty-five leprosy patients were included, of whom 33.3% were referred by leprosy reactions, 27.1% by sequelae, and 10.2% by suspected recurrence or reinfection. Reviewing the therapeutic management, 123 (54.7%) were considered inadequate, 92 (40.9%) adequate, and 10 (4.4%) inconclusive. Of the 200 multibacillary patients, 39.5% had adequate management. In contrast, 12 (85.1%) out of 14 paucibacillary patients had adequate management (χ 2 = 11.43 and p < 0.001). Regarding the leprosy reactions and sequelae management, 56.9% and 19.5% were considered inadequate, respectively. There was no difference between the percentage of adequate or inadequate management when considering the Goiás health macroregions (χ 2 = 7.23; 4 degrees of freedom; p = 0.12). Study limitations Use of recorded data, with incomplete medical records and lack of patient follow-up. Conclusions The study demonstrated the equivocal multibacillaryleprosy management conducted in healthy primary care, with an emphasis on leprosy reactions and sequelae. Training and monitoring the medical staff in the primary healthy services could reduce the morbidity and sequelae of leprosy.

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Section: Discussionmentioning

confidence: 99%

Reviewing the therapeutic management of leprosy in primary care: demand case series referred to a University Hospital in the Midwest region of Brazil

Sousa¹,

Sousa²,

Turchi³

2021

Anais Brasileiros de Dermatologia

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“…22 Con base en los resultados del estudio, las facilidades de acceso oportuno a citas con personal informado, capacitado y especializado, la telemedicina en zonas alejadas y personal de salud que previamente ha tratado a la familia, son mencionados como facilitadores dentro del plano de oferta de los servicios de salud; resultados similares fueron reportados en la bibliografía. 33,34 En conclusión, existen facilitadores y barreras que podrían influir en el comportamiento individual para el diagnóstico oportuno, la prevención de secuelas irreversibles y el contagio. Con respecto a las barreras, se identifica que a nivel personal y comunitario existe poca información sobre la lepra y, en algunos casos, esta es errónea, lo que favorece las demoras diagnósticas y la estigmatización.…”

Section: Discussionunclassified

Barreras y facilitadores relacionados con el diagnóstico de la lepra en Costa Rica

Chavarría¹,

Hernández²,

Aguirre³

2020

AMC

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Objetivo: analizar barreras y facilitadores relacionados con el diagnóstico de la lepra en Costa Rica, desde la perspectiva de la persona con la enfermedad y en el contexto de la vida cotidiana. Métodos: se llevó a cabo un estudio cualitativo de carácter exploratorio a partir de 25 entrevistas semiestructuradas, a personas con lepra o con antecedente de haberla padecido, de entre 23 y 88 años, atendidos en el sistema de salud público costarricense. A partir del análisis de los datos cualitativos, las barreras y facilitadores se agruparon en factores personales, culturales y la oferta de los servicios de salud. Resultados: en relación con los factores personales, la mayoría de los participantes reportó no poseer conocimiento ni conciencia previa a la enfermedad. El temor a ser estigmatizado, la sintomatología intermitente, sentirse bien, compromisos laborales y familiares, fueron percibidos como barreras. Entre los factores culturales, algunas creencias religiosas fueron percibidas como barreras, y la historia familiar de lepra como facilitador en términos de la búsqueda de atención y diagnóstico. Con respecto a los servicios de salud, el acceso oportuno a citas con personal de salud informado, la telemedicina y médicos de la familia, fueron citados como facilitadores. Conclusiones: las principales barreras y facilitadores descritos en los resultados del estudio deben ser tomados en cuenta a fin de contribuir a la detección y tratamiento oportuno de la lepra, para curar la enfermedad, evitar la discapacidad y eliminar la transmisión. Descriptores: lepra, barreras de acceso a los servicios de salud, diagnóstico precoz, análisis cualitativo, Costa Rica.

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“…In 2018, Hotez summarized how recent changes in climate, globalization, and urbanization have spurred the surge of NTDs in Texas [36]. Under these new circumstances, TD may acquire a truly global scope in the management of sNTDs; for example, in 2019 a woman who had recently immigrated to the United States from Brazil was diagnosed with leprosy using TD [37].…”

Section: Teledermatology: Advantages and Promisesmentioning

confidence: 99%

Teledermatology in the Control of Skin Neglected Tropical Diseases: A Systematic Review

Joshi

Ren

2021

Dermatol Pract Concept

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Introduction: Neglected tropical diseases (NTDs) include a group of about 20 illnesses that have garnered relatively little attention, despite their ability to inflict significant suffering and disability. Skin neglected tropical diseases (sNTDs) are a subset of NTDs that present with cutaneous manifestations and are well known for their ability to generate stigma and promote poverty. Teledermatology (TD) represents a potential method to control sNTDs. Objective: We sought to analyze the potential for TD to ease the burden of sNTDs. Methods: We performed a systematic literature search using the Texas Medical Center Library One Search, which scans 167 databases, including Embase, PubMed, and Scopus. We included all original investigations published after 2011 that assessed the impact of TD intervention in the control of one or more sNTDs. We excluded studies not written in English and studies that did not perform any outcome analyses. Results: 20 studies met our search criteria, and 18 expressed positive attitudes towards TD. Overall, we found that TD may be a sustainable, cost-effective strategy for expanding access to care for individuals afflicted with sNTDs. However, poor image quality, lack of access to further diagnostic tests, and ethical, legal, and cultural issues pose as barriers to TD utilization. Conclusion: TD may be helpful in achieving control of sNTDs but has its limitations. An integrated approach, which employs TD in conjunction with other strategies, represents a realistic path for alleviating sNTDs.

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Leprosy Diagnosed via Teledermatology in a U. S. Urban Academic Health Center Highlights Potential Benefits and a Pitfall of Existing Telemedicine Services

Abstract: This case emphasizes the importance of full access to patients' medical records for improving diagnostic accuracy. We believe that full-access systems will lower the risk of misdiagnosis and will help to maximize the potential of teledermatology.

Cited by 4 publications

References 5 publications

Reviewing the therapeutic management of leprosy in primary care: demand case series referred to a University Hospital in the Midwest region of Brazil

Reviewing the therapeutic management of leprosy in primary care: demand case series referred to a University Hospital in the Midwest region of Brazil

Barreras y facilitadores relacionados con el diagnóstico de la lepra en Costa Rica

Teledermatology in the Control of Skin Neglected Tropical Diseases: A Systematic Review

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