Supervision and support in surgical practice using mobile platform: a case of mass hydrocele surgeries in remote regions

Akoko, Larry; Mwanga, Ally; Chikawe, Maria; Lutainulwa, Evelyne; Ngoma, Deogratius; Nshalla, Andreas; Mwingira, Upendo

doi:10.21037/mhealth.2019.09.05

Cited by 8 publications

(7 citation statements)

References 7 publications

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“…Overall, the rate of post-surgery complications was low as found in several other countries where they ranged between 2.2-5.0% [7,21,24,27,42]. Most symptoms or complications had resolved at 3-months post-surgery, but a more defined follow-up plan and active involvement of the HSAs, district health workers and surgical teams in the immediate recovery period i.e.…”

Section: Discussionmentioning

confidence: 72%

“…Further, support for the cost and access to transport is needed as it is a significant barrier to surgical health care in rural areas of Malawi [41], and for men with hydrocoele as highlighted in this current study, and by Stanton et al [28] who found men living further from the district hospital were less likely to access surgery than those living close. Support for surgeons in these remote regions may also be an option for addressing the burden and the use of new mHealth technologies may help supervise and build capacity as recently shown in Tanzania [42]. These issues for hydocoele as well as groin hernias are important for the global surgery agenda [8,20] and also an integral component of the Sustainable Development Goals (SDGs) Goal 3-Good Health and Well-Being, which aims to end NTDs by 2030 and ensure coverage of interventions and access to essential health services [43].…”

Section: Discussionmentioning

confidence: 99%

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Significant improvement in quality of life following surgery for hydrocoele caused by lymphatic filariasis in Malawi: A prospective cohort study

et al. 2020

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Background Lymphatic filariasis (LF) is a mosquito-borne parasitic infection that causes significant disabling and disfiguring clinical manifestations. Hydrocoele (scrotal swelling) is the most common clinical condition, which affects an estimated 25 million men globally. The recommended strategy is surgical intervention, yet little is known about the impact of hydrocoele on men's lives, and how it may change if they have access to surgery. Methodology/Principal findings We prospectively recruited and followed-up men who underwent surgery for hydrocoele at six hospitals in an LF endemic area of Malawi in December 2015. Men were interviewed at hospitals pre-surgery and followed-up at 3-months and 6-months post-surgery. Data on demographic characteristics, clinical condition, barriers to surgery, post-surgery symptoms/ complications and quality of life indicators were collected and analysed pre-and post-surgery, by age group and stage of disease (mild/moderate vs. severe), using chi-square tests and student's t test (paired). 201 men were interviewed pre-surgery, 152 at 3-months and 137 at 6-months post-surgery. Most men had unilateral hydrocoeles (65.2%), mild/moderate stages (57.7%) with an average duration of 11.4 years. The most reported cause of hydrocoele was it being sexually transmitted (22.4%), and the main barrier to surgery was the cost (36.3%). Pre-surgery, a significant difference in the scrotum side affected was found by age group (X 2 = 5.978, p = 0.05), and men with severe stage hydrocoele reported more problems with their quality of life than those with mild/moderate stage (t = 2.793; p = 0.0006). Post-surgery, around half of the men reported some pain/discomfort (55.9%), swelling (8.6%), bleeding (3.3%) and infection (5.9%), most of which had resolved at 3-months when the most significant improvements in PLOS NEGLECTED TROPICAL DISEASES

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Section: Discussionmentioning

confidence: 72%

Section: Discussionmentioning

confidence: 99%

Significant improvement in quality of life following surgery for hydrocoele caused by lymphatic filariasis in Malawi: A prospective cohort study

et al. 2020

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“…Four out of 13 (31%) studies had different designs as follows: a mixed-methods approach to define challenges to be considered [ 38 ]; different implementation scenarios for a specific mHealth intervention [ 39 ]; the sustainability of an intervention [ 40 ]; and the process of developing a specific mHealth tool or assessing its usability [ 10 , 38 ]. One trial was a cross-sectional study analyzing the accuracy of a new diagnosis strategy [ 41 ], and another was a prospective cohort study testing the efficacy of an mHealth strategy in training health care workers [ 42 ]. There was only one controlled nonrandomized study to test the effectiveness of an intervention [ 43 ].…”

Section: Resultsmentioning

confidence: 99%

“…Five interventions were conducted through apps and cloud servers. One utilized the commercially available WhatsApp app [ 42 ], and the others used either very simple ad-hoc developed apps able to collect data and send to a server [ 32 ] or apps that included a wider range of elements and took a more comprehensive approach, for example, Guaral App [ 38 ], Nu-case [ 40 ], and SkinApp [ 10 ]. Only Guaral App and SkinApp are available from the app stores ( Table 3 ).…”

Section: Resultsmentioning

confidence: 99%

Mobile Health Strategies to Tackle Skin Neglected Tropical Diseases With Recommendations From Innovative Experiences: Systematic Review

Carrión¹,

Robles²,

Solà-Morales³

et al. 2020

JMIR Mhealth Uhealth

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Background Neglected tropical diseases (NTDs) represent a diverse group of 20 communicable diseases that occur in tropical and subtropical areas in 149 countries, affecting over 1 billion people and costing developing economies billions of dollars every year. Within these diseases, those that present lesions on the skin surface are classified as skin NTDs (sNTDs). Mobile health interventions are currently being used worldwide to manage skin diseases and can be a good strategy in the epidemiological and clinical management of sNTDs. Objective We aimed to analyze existing evidence about mobile health interventions to control and manage sNTDs in low- and middle-income countries (LMICs) and make recommendations for what should be considered in future interventions. Methods A systematic review was conducted of the MEDLINE, Embase, and Scopus databases over 10 years up to April 30, 2020. All types of clinical studies were considered. Data were synthesized into evidence tables. Apps were selected through a comprehensive systematic search in the Google Play Store and Apple App Store conducted between March 20 and April 15, 2020. Results From 133 potentially relevant publications, 13 studies met our criteria (9.8%). These analyzed eight different interventions (three SMS text messaging interventions and five app interventions). Six of the 13 (46%) studies were community-based cross-sectional studies intended to epidemiologically map a specific disease, mainly lymphatic filariasis, but also cutaneous leishmaniasis, leprosy, and NTDs, as well as sNTDs in general. Most of the studies were considered to have a high (5/13, 39%) or moderate (4/13, 31%) risk of bias. Fifteen apps were identified in the Google Play Store, of which three were also in the Apple App Store. Most of the apps (11/15, 73%) were targeted at health care professionals, with only four targeted at patients. The apps focused on scabies (3/15, 20%), lymphatic filariasis (3/15, 20%), cutaneous leishmaniasis (1/15, 7%), leprosy (1/15, 7%), yaws and Buruli ulcer (1/15, 7%), tropical diseases including more than one sNTDs (3/15, 20%), and NTDs including sNTDs (2/15, 13%). Only 1 (7%) app focused on the clinical management of sNTDs. Conclusions All mobile health interventions that were identified face technological, legal, final user, and organizational issues. There was a remarkable heterogeneity among studies, and the majority had methodological limitations that leave considerable room for improvement. Based on existing evidence, eight recommendations have been made for future interventions.

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“…Four out of 13 (31%) studies had different designs as follows: a mixed-methods approach to define challenges to be considered [38]; different implementation scenarios for a specific mHealth intervention [39]; the sustainability of an intervention [40]; and the process of developing a specific mHealth tool or assessing its usability [10,38]. One trial was a cross-sectional study analyzing the accuracy of a new diagnosis strategy [41], and another was a prospective cohort study testing the efficacy of an mHealth strategy in training health care workers [42]. There was only one controlled nonrandomized study to test the effectiveness of an intervention [43].…”

Section: Selection Of Studiesmentioning

confidence: 99%

Mobile Health Strategies to Tackle Skin Neglected Tropical Diseases With Recommendations From Innovative Experiences: Systematic Review (Preprint)

Carrión¹,

Robles²,

Solà-Morales³

et al. 2020

Preprint

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BACKGROUND Neglected tropical diseases (NTDs) is a diverse group of 20 communicable diseases that occur in tropical and subtropical conditions in 149 countries, affecting over one billion people and costing developing economies billions of dollars every year. Within these diseases, those that present lesions on the skin surface are classed as skin NTDs (sNTDs). Mobile health interventions are currently being used worldwide to manage skin diseases and can be a good strategy in the epidemiological and clinical management of sNTDs. OBJECTIVE To analyze existing evidence about mobile health interventions to control and manage sNTDs in low- and middle-income countries (LMIC) and make recommendations for what should be considered in future interventions. METHODS A systematic review was conducted of the Medline, Embase and Scopus databases over 10 years up to April 30, 2020. All types of clinical studies were considered. Data were synthesized into evidence tables. Apps were selected through a comprehensive systematic search in Google Play and Apple Store conducted between 20 March and 15 April 2020. RESULTS From 133 potentially relevant publications, 13 studies met the criteria. These analyze 8 different interventions (3 SMS text messaging and 5 app interventions). Six (46%) of the studies are community-based, cross-sectional studies intended to epidemiologically map a specific disease, mainly Lymphatic Filariasis (LF), but also Cutaneous Leishmaniasis (CL), Leprosy and NTDs and sNTDs in general. Most of the studies were considered to have a high (n=5) or moderate (n=4) risk of bias. Fifteen apps have been identified in Google Play, three of which are also in Apple Store. Most of the apps (73%) are targeted at healthcare professionals with only 4 targeted at patients. The apps focus on: Scabies (n=3); LF (n=3); CL (n=1); Leprosy (n=1); Yaws and Buruli Ulcer (n=1); a general overview of tropical diseases including more than one sNTDs (n=3); and NTDs including sNTDs (n=2). Only one app focuses on the clinical management of sNTDs. CONCLUSIONS There is a remarkable heterogeneity among studies and the majority have methodological limitations that leave considerable room for improvement. The few apps that are available are not supported by adequate methodological trials. Based on existing evidence, a number of recommendations are made for future interventions.

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Supervision and support in surgical practice using mobile platform: a case of mass hydrocele surgeries in remote regions

Cited by 8 publications

References 7 publications

Significant improvement in quality of life following surgery for hydrocoele caused by lymphatic filariasis in Malawi: A prospective cohort study

Significant improvement in quality of life following surgery for hydrocoele caused by lymphatic filariasis in Malawi: A prospective cohort study

Mobile Health Strategies to Tackle Skin Neglected Tropical Diseases With Recommendations From Innovative Experiences: Systematic Review

Mobile Health Strategies to Tackle Skin Neglected Tropical Diseases With Recommendations From Innovative Experiences: Systematic Review (Preprint)

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