RESUMO
BACKGROUND: Detection and management of neglected tropical diseases such as cutaneous leishmaniasis present unmet challenges stemming from their prevalence in remote, rural, resource constrained areas having limited access to health services. These challenges are frequently compounded by armed conflict or illicit extractive industries. The use of mobile health technologies has shown promise in such settings, yet data on outcomes in the field remain scarce. METHODS: We adapted a validated prediction rule for the presumptive diagnosis of CL to create a mobile application for use by community health volunteers. We used human-centered design practices and agile development for app iteration. We tested the application in three rural areas where cutaneous leishmaniasis is endemic and an urban setting where patients seek medical attention in the municipality of Tumaco, Colombia. The application was assessed for usability, sensitivity and inter-rater reliability (kappa) when used by community health volunteers (CHV), health workers and a general practitioner, study physician. RESULTS: The application was readily used and understood. Among 122 screened cases with cutaneous ulcers, sensitivity to detect parasitologically proven CL was >95%. The proportion of participants with parasitologically confirmed CL was high (88%), precluding evaluation of specificity, and driving a high level of crude agreement between the app and parasitological diagnosis. The chance-adjusted agreement (kappa) varied across the components of the risk score. Time to diagnosis was reduced significantly, from 8 to 4 weeks on average when CHV conducted active case detection using the application, compared to passive case detection by health facility-based personnel. CONCLUSIONS: Translating a validated prediction rule to a mHealth technology has shown the potential to improve the capacity of community health workers and healthcare personnel to provide opportune care, and access to health services for underserved populations. These findings support the use of mHealth tools for NTD research and healthcare.
Assuntos
Diagnóstico Precoce , Leishmaniose Cutânea/diagnóstico , Aplicativos Móveis , Medicina Tropical/métodos , Adaptação Fisiológica , Adolescente , Adulto , Colômbia/epidemiologia , Agentes Comunitários de Saúde , Feminino , Humanos , Leishmaniose Cutânea/epidemiologia , Masculino , Programas de Rastreamento/métodos , Área Carente de Assistência Médica , Reprodutibilidade dos Testes , Medicina Tropical/instrumentação , Adulto JovemRESUMO
Mobile applications (apps) can bring health research and its potential downstream benefits closer to underserved populations. Drawing on experience developing an app for detecting and referring cases of cutaneous leishmaniasis in Colombia, called Guaral/app, we review key steps in creating such mobile health (mHealth) tools. These require consideration of the sociotechnical context using methods such as systems analysis and human-centered design (HCD), predicated on engagement and iteration with all stakeholders. We emphasize usability and technical concerns and describe the interdependency of technical and human considerations for mHealth systems in rural communities.
Assuntos
Pesquisa Biomédica/métodos , Telefone Celular/estatística & dados numéricos , Doenças Negligenciadas/diagnóstico , Medicina Tropical/métodos , Pesquisa Biomédica/instrumentação , Humanos , Aplicativos Móveis , Doenças Negligenciadas/epidemiologia , Software , Medicina Tropical/instrumentaçãoRESUMO
In communities where there are only limited
Assuntos
Criança , Lactente , Humanos , Recém-Nascido , Doenças do Recém-Nascido , Medicina Tropical/métodos , Medicina Tropical/instrumentação , Medicina Tropical/história , Transtornos da Nutrição do Lactente/complicações , Anormalidades Congênitas/embriologiaRESUMO
DISENTERIA-Compreende-se por disenteria um quadro mórbido cujo sintoma predominante é a diarréia misturada com sangue e muco.Há três variedades distintas:1., a disenteria provocada por Protozoários;2., a disenteria bacilar, e3., a disenteria provocada por Helmintos....
Assuntos
Humanos , Criança , Cólera/diagnóstico , Cólera/epidemiologia , Cólera/fisiopatologia , Disenteria/diagnóstico , Disenteria/epidemiologia , Disenteria/fisiopatologia , Disenteria/terapia , Doenças Transmissíveis/diagnóstico , Doenças Transmissíveis/epidemiologia , Doenças Transmissíveis/etiologia , Doenças Transmissíveis/fisiopatologia , Medicina Tropical/história , Medicina Tropical/instrumentaçãoRESUMO
Indicaciones generales acerca de alimentos y bebidas, prevención de diarrea, medicación, y documentación de viajeros
Assuntos
Medicina Tropical/instrumentação , Medicina Tropical/métodos , Medicina Tropical/normas , Malária/prevenção & controleRESUMO
Indicaciones generales acerca de alimentos y bebidas, prevención de diarrea, medicación, y documentación de viajeros