The Development of a Mobile Application to Support Peripheral Health Workers to Diagnose and Treat People with Skin Diseases in Resource-Poor Settings

Mieras, Liesbeth; Taal, Anneke T.; Post, Erik; A, Ndeve; Hees, C.L.M. van

doi:10.3390/tropicalmed3030102

Cited by 31 publications

(31 citation statements)

References 18 publications

(26 reference statements)

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“…Some may be useful for training. In 2017, there were more than 500 mobile applications in dermatology with a significant growth in telemedicine applications (9). One example is the SkinApp application developed to improve the management of dermatological diseases in front-line health centers.…”

Section: Technological Limitsmentioning

confidence: 99%

Teledermatology Use in Remote Areas of French Guiana: Experience From a Long-Running System

Messagier

Blaizot

Couppié

et al. 2019

Front. Public Health

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is an overseas region of France on the north coast of South America and is mostly covered by tropical rainforest. Most human settlements are located along the coast while some settlements are scattered across the hinterland. In 2001, the French public health service launched a telemedicine pilot project between the main hospital in Cayenne and remote health centers in French Guiana to tackle healthcare access inequalities. The aim of the present study was to review dermatology cases of the French Guiana telemedicine network to assess the use of telemedicine in dermatology, in order to evaluate its usefulness and propose ways to improve the system. Methods: A retrospective study was conducted on all dermatology cases referred between July 2015 and December 2016 through the French Guiana platform. The Model for Assessment of Telemedicine (MAST) methodology was used as recommended by the European Union. Results: A total of 254 cases were reviewed by dermatologists at Cayenne hospital over the 18-month study period, with a mean of 14 cases per month. All the 16 peripheral health centers used the telemedicine service during the study. In most cases (202/254, 80%), specialists provided a single diagnosis to the referrers. Infectious diseases represented the main reasons for requests (92/202, 46%) including 32% (29/92) of neglected tropical diseases like leprosy and cutaneous leishmaniasis. A total of 39% (100/258) peripheral centers answered the end-users' survey, and more than 85% found the answer delay was fast, the service useful and with an educational benefit. Overall, the accuracy of the diagnosis increased with the quality of the pictures provided, though the latter was good in only 60% (75/125) of the cases. Most patients for whom a teleconsultations has been required (234/254, 92%) have been managed in the peripheral health centers, while referring the patient to Cayenne was necessary for only 20/254 (8%). Conclusion: The telemedicine system in French Guiana appears to be an interesting solution to the lack of specialists and allowed a better access to specialized dermatology care for people living in the remote areas of this region.

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Section: Technological Limitsmentioning

confidence: 99%

Teledermatology Use in Remote Areas of French Guiana: Experience From a Long-Running System

Messagier

Blaizot

Couppié

et al. 2019

Front. Public Health

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“…Six (46%) studies [ 32 - 37 ] were reported to be community-based cross-sectional studies with the main objective of epidemiologically mapping a specific disease based on its clinical symptoms. 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 ].…”

Section: Resultsmentioning

confidence: 99%

“…Various innovative methods have been used to enhance the clinical management and epidemiological surveillance of, among others, skin and infectious diseases worldwide. These include, but are not limited to, technological methods such as telemedicine, artificial intelligence, and mobile health (mHealth) [ 10 ]. mHealth has been proven to be a promising tool to improve the diagnosis and treatment of several diseases such as skin cancer [ 11 ].…”

Section: Introductionmentioning

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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“…Digital interventions such as eLearning, digital diagnostics, and geolocation of leprosy patients are priorities. A number of applications are under development, including digital registries; a leprosy referral and surveillance network among healthcare providers; tele-dermatology to support health workers with access to medical specialists [ 22 ]; and, smartphone apps to facilitate diagnosis and treatment for peripheral health workers [ 23 ]. Policy to support the practical implementation of these developments will also be needed.…”

Section: Panel: the Research Priorities To Achieve Zero Leprosymentioning

confidence: 99%

A comprehensive research agenda for zero leprosy

et al. 2020

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Background Leprosy control achieved dramatic success in the 1980s–1990s with the implementation of short course multidrug therapy, which reduced the global prevalence of leprosy to less than 1 in 10 000 population. However, a period of relative stagnation in leprosy control followed this achievement, and only limited further declines in the global number of new cases reported have been achieved over the past decade. Main text In 2016, major stakeholders called for the development of an innovative and comprehensive leprosy strategy aimed at reducing the incidence of leprosy, lowering the burden of disability and discrimination, and interrupting transmission. This led to the establishment of the Global Partnership for Zero Leprosy (GPZL) in 2018, with partners aligned around a shared Action Framework committed to achieving the WHO targets by 2030 through national leprosy program capacity-building, resource mobilisation and an enabling research agenda. GPZL convened over 140 experts from more than 20 countries to develop a research agenda to achieve zero leprosy. The result is a detailed research agenda focusing on diagnostics, mapping, digital technology and innovation, disability, epidemiological modelling and investment case, implementation research, stigma, post exposure prophylaxis and transmission, and vaccines. This research agenda is aligned with the research priorities identified by other stakeholders. Conclusions Developing and achieving consensus on the research agenda for zero leprosy is a significant step forward for the leprosy community. In a next step, research programmes must be developed, with individual components of the research agenda requiring distinct expertise, varying in resource needs, and operating over different timescales. Moving toward zero leprosy now requires partner alignment and new investments at all stages of the research process, from discovery to implementation.

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The Development of a Mobile Application to Support Peripheral Health Workers to Diagnose and Treat People with Skin Diseases in Resource-Poor Settings

Cited by 31 publications

References 18 publications

Teledermatology Use in Remote Areas of French Guiana: Experience From a Long-Running System

Teledermatology Use in Remote Areas of French Guiana: Experience From a Long-Running System

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

A comprehensive research agenda for zero leprosy

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