Systematic Review and Meta-Analysis of the Diagnostic Accuracy of Mobile-Linked Point-of-Care Diagnostics in Sub-Saharan Africa

Abstract

Mobile health devices are emerging applications that could help deliver point-of-care (POC) diagnosis, particularly in settings with limited laboratory infrastructure, such as Sub-Saharan Africa (SSA). The advent of Severe acute respiratory syndrome coronavirus 2 has resulted in an increased deployment and use of mHealth-linked POC diagnostics in SSA. We performed a systematic review and meta-analysis to evaluate the accuracy of mobile-linked point-of-care diagnostics in SSA. Our systematic review and meta-analysis were guided by the Preferred Reporting Items requirements for Systematic Reviews and Meta-Analysis. We exhaustively searched PubMed, Science Direct, Google Scholar, MEDLINE, and CINAHL with full text via EBSCOhost databases, from mHealth inception to March 2021. The statistical analyses were conducted using OpenMeta-Analyst software. All 11 included studies were considered for the meta-analysis. The included studies focused on malaria infections, Schistosoma haematobium, Schistosoma mansoni, soil-transmitted helminths, and Trichuris trichiura. The pooled summary of sensitivity and specificity estimates were moderate compared to those of the reference representing the gold standard. The overall pooled estimates of sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, and diagnostic odds ratio of mobile-linked POC diagnostic devices were as follows: 0.499 (95% CI: 0.458–0.541), 0.535 (95% CI: 0.401–0.663), 0.952 (95% CI: 0.60–1.324), 1.381 (95% CI: 0.391–4.879), and 0.944 (95% CI: 0.579–1.538), respectively. Evidence shows that the diagnostic accuracy of mobile-linked POC diagnostics in detecting infections in SSA is presently moderate. Future research is recommended to evaluate mHealth devices’ diagnostic potential using devices with excellent sensitivities and specificities for diagnosing diseases in this setting.

Improving cascade outcomes for active TB: A global systematic review and meta-analysis of TB interventions

“…However, digital interventions have significantly improved healthcare services delivery and uptake for other infectious diseases like HIV [ 130 ]. New digital tools like smartphone-based diagnostics are cost-effective for rapid diagnostics in point-of-care testing and could enable real-time remote patient monitoring [ 131 , 132 ]. Thus, the roles of digital interventions in decentralizing and expanding healthcare could be tailored for efficient use in TB care and should be further researched.…”

mHealth in Sub-Saharan Africa and Europe: Context of current health, healthcare status, and demographic structure

“…Numerous studies found gaps in or sparse or fragmented research on mHealth approaches in SSA for a number of aspects of healthcare such as maternal health, pneumonia, antenatal care, malaria, neurology, hypertension, and obesity. 83 , 38 , 41 , 47 , 48 , 45 , 43 In Europe, findings also reported gaps or limited and fragmented research on several mHealth approaches such as COPDs, obesity, maternal and child health, vaccination programs, and genetics. 58 , 45 , 62 , 63 , 64 Research should be carried out to address these and other existing gaps.…”

Fine-scale-mapping of Schistosoma haematobium infections at the school and community levels and intermediate host snail abundance in the north of Pemba Island: baseline cross-sectional survey findings before the onset of a 3-year intervention study

“…Hence, offering praziquantel in health facilities, including mother and child health care units, by medical personnel [31] and using a test-and-treat strategy instead of preventive chemotherapy without prior diagnosis might increase compliance among adults. However, to date, no sensitive and specific test for S. haematobium detection at the point-of-care exists, presenting a considerable challenge for low-prevalence settings where most people are only slightly infected [32][33][34][35][36]. The development of a highly sensitive and specific test that is affordable and simple and can also be used in health facilities in low-prevalence areas is an urgent need when moving towards interruption of transmission and post-elimination surveillance [37][38][39][40].…”