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Adaptation and performance of a mobile application for early detection of cutaneous leishmaniasis.
Rubiano, Luisa; Alexander, Neal D E; Castillo, Ruth Mabel; Martínez, Álvaro José; García Luna, Jonny Alejandro; Arango, Juan David; Vargas, Leonardo; Madriñán, Patricia; Hurtado, Lina-Rocío; Orobio, Yenifer; Rojas, Carlos A; Del Corral, Helena; Navarro, Andrés; Gore Saravia, Nancy; Aronoff-Spencer, Eliah.
Afiliação
  • Rubiano L; Centro Internacional de Entrenamiento e Investigaciones Médicas, CIDEIM, Cali, Colombia.
  • Alexander NDE; Universidad Icesi, Cali, Colombia.
  • Castillo RM; Centro Internacional de Entrenamiento e Investigaciones Médicas, CIDEIM, Cali, Colombia.
  • Martínez ÁJ; Universidad Icesi, Cali, Colombia.
  • García Luna JA; Centro Internacional de Entrenamiento e Investigaciones Médicas, CIDEIM, Cali, Colombia.
  • Arango JD; Universidad Icesi, Cali, Colombia.
  • Vargas L; Centro Internacional de Entrenamiento e Investigaciones Médicas, CIDEIM, Cali, Colombia.
  • Madriñán P; Centro Internacional de Entrenamiento e Investigaciones Médicas, CIDEIM, Cali, Colombia.
  • Hurtado LR; Grupo i2t, Universidad Icesi, Cali, Colombia.
  • Orobio Y; Grupo i2t, Universidad Icesi, Cali, Colombia.
  • Rojas CA; Grupo i2t, Universidad Icesi, Cali, Colombia.
  • Del Corral H; Centro Internacional de Entrenamiento e Investigaciones Médicas, CIDEIM, Cali, Colombia.
  • Navarro A; Centro Internacional de Entrenamiento e Investigaciones Médicas, CIDEIM, Cali, Colombia.
  • Gore Saravia N; Universidad Icesi, Cali, Colombia.
  • Aronoff-Spencer E; Facultad Nacional de Salud Pública, Universidad de Antioquia, Medellín, Colombia.
PLoS Negl Trop Dis ; 15(2): e0008989, 2021 02.
Article em En | MEDLINE | ID: mdl-33571192
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

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Medicina Tropical / Leishmaniose Cutânea / Diagnóstico Precoce / Aplicativos Móveis Tipo de estudo: Diagnostic_studies / Prognostic_studies / Risk_factors_studies / Screening_studies Limite: Adolescent / Adult / Female / Humans / Male País/Região como assunto: America do sul / Colombia Idioma: En Revista: PLoS Negl Trop Dis Assunto da revista: MEDICINA TROPICAL Ano de publicação: 2021 Tipo de documento: Article País de afiliação: Colômbia País de publicação: Estados Unidos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Medicina Tropical / Leishmaniose Cutânea / Diagnóstico Precoce / Aplicativos Móveis Tipo de estudo: Diagnostic_studies / Prognostic_studies / Risk_factors_studies / Screening_studies Limite: Adolescent / Adult / Female / Humans / Male País/Região como assunto: America do sul / Colombia Idioma: En Revista: PLoS Negl Trop Dis Assunto da revista: MEDICINA TROPICAL Ano de publicação: 2021 Tipo de documento: Article País de afiliação: Colômbia País de publicação: Estados Unidos