Bi-directional drones to strengthen healthcare provision: experiences and lessons from Madagascar, Malawi and Senegal

Knoblauch, Astrid M.; Rosa, Sara De La; Sherman, Judith; Blauvelt, Carla; Matemba, Charles; Maxim, Luciana; Defawe, Olivier; Gueye, Abdoulaye; Robertson, Joanie; McKinney, Jesse; Brew, Joe; Paz, Enrique Conejero; Small, Peter M.; Tanner, Marcel; Rakotosamimanana, Niaina; Lapierre, Simon

doi:10.1136/bmjgh-2019-001541

Cited by 60 publications

(62 citation statements)

References 15 publications

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“…The benefits of strengthening referral systems on delays and diagnosis rates have been demonstrated in other low-income countries [35]. In Madagascar, innovative technologies such as drones were recently tested to accelerate access to diagnosis and render TB care more patient-centric by overcoming pertinent logistic barriers on the last mile [36]. In addition, the country was upscaling its GeneXpert MTB/RIF platform capacity from 7 to 15 in 2019 and this expansion is expected to help towards narrowing this gap in the cascade of care.…”

Section: Discussionmentioning

confidence: 99%

Multidrug-resistant tuberculosis surveillance and cascade of care in Madagascar: a five-year (2012–2017) retrospective study

Knoblauch

Lapierre

Randriamanana

et al. 2020

BMC Med

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Background: In Madagascar, the multidrug-resistant tuberculosis (MDR-TB) surveillance programme was launched in late 2012 wherein previously treated TB cases and symptomatic MDR-TB contacts (hereafter called presumptive MDR-TB cases) undergo drug susceptibility testing. This retrospective review had per aim to provide an update on the national MDR-TB epidemiology, assess and enhance programmatic performance and assess Madagascar's MDR-TB cascade of care. Methods: For 2012-2017, national TB control programme notification, clinical management data and reference laboratory data were gathered. The development and coverage of the surveillance programme, the MDR-TB epidemiology and programmatic performance indicators were assessed using descriptive, logistic and spatial statistical analyses. Data for 2017 was further used to map Madagascar's TB and MDR-TB cascade of care. Results: The geographical coverage and diagnostic and referral capacities of the MDR-TB surveillance programme were gradually expanded whereas regional variations persist with regard to coverage, referral rates and sample referral delays. Overall, the rate of MDR-TB among presumptive MDR-TB cases remained relatively stable, ranging between 3.9% in 2013 and 4.4% in 2017. Most MDR-TB patients were lost in the second gap of the cascade pertaining to MDR-TB cases reaching diagnostic centres but failing to be accurately diagnosed (59.0%). This poor success in diagnosis of MDR-TB is due to both the current use of low-sensitivity smear microscopy as a first-line diagnostic assay for TB and the limited access to any form of drug susceptibility testing. Presumptive MDR-TB patients' sample referral took a mean delay of 28 days before testing. Seventy-five percent of diagnosed MDR-TB patients were appropriately initiated on treatment, and 33% reached long-term recurrence-free survival.

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Section: Discussionmentioning

confidence: 99%

Multidrug-resistant tuberculosis surveillance and cascade of care in Madagascar: a five-year (2012–2017) retrospective study

Knoblauch

Lapierre

Randriamanana

et al. 2020

BMC Med

Self Cite

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“…Drones have even been suggested for indoor use to deliver medications right to patients' bedsides (Tucker 2017). Now, public health institutions in developed countries are looking to the possibility of using drones to provide more rapid and cost-effective healthcare in light of dwindling healthcare resources and personnel (Knoblauch et al 2019). Enshrined in the healthcare tradition are codes of conduct and values of wellbeing that must structure the introduction of any new drug, practice, or technology.…”

Section: Introductionmentioning

confidence: 99%

An Ethical Framework for the Design, Development, Implementation, and Assessment of Drones Used in Public Healthcare

Cawthorne

Wynsberghe

2020

Sci Eng Ethics

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The use of drones in public healthcare is suggested as a means to improve efficiency under constrained resources and personnel. This paper begins by framing drones in healthcare as a social experiment where ethical guidelines are needed to protect those impacted while fully realizing the benefits the technology offers. Then we propose an ethical framework to facilitate the design, development, implementation, and assessment of drones used in public healthcare. Given the healthcare context, we structure the framework according to the four bioethics principles: beneficence, non-maleficence, autonomy, and justice, plus a fifth principle from artificial intelligence ethics: explicability. These principles are abstract which makes operationalization a challenge; therefore, we suggest an approach of translation according to a values hierarchy whereby the top-level ethical principles are translated into relevant human values within the domain. The resulting framework is an applied ethics tool that facilitates awareness of relevant ethical issues during the design, development, implementation, and assessment of drones in public healthcare.

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“…[488,489] DDPPPT: treatment of disease (stroke), therapy [487,490] Medical Imaging [487,488] 7. [492,496] TMR: telemedicine [492] MERT: health research [496] 8. DDPPPT: gene therapy, diagnosis, cancer treatments [503][504][505][506] Surgery [505] PDDD: drug delivery, drug coating and encapsulation [503] 10.…”

Section: Convergence Of Disruptive Technologies In Healthcarementioning

confidence: 99%

The Hype and Disruptive Technologies of Industry 4.0 in Major Industrial Sectors: A State of the Art

Bongomin¹,

Yemane²,

Kembabazi³

et al. 2020

Preprint

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Very well into the dawn of the fourth industrial revolution (industry 4.0), we hardly distinguish between what is artificial and what is natural (e.g. man-made virus and natural virus). Thus, the level of discombobulation among people, companies or countries is indeed unprecedented. The fact that industry 4.0 is explosively disrupting or retrofitting each and every industrial sector, makes industry 4.0 the famous buzzword amongst researchers today. However, the insight of industry 4.0 disruption in the industrial sectors remains ill-defined in both academic and non-academic literature. The present study aimed at identifying industry 4.0 neologisms, understanding the industry 4.0 disruption and illustrating the disruptive technologies convergence in the major industrial sectors. A total of 99 neologisms of industry 4.0 were identified. Industry 4.0 disruption in Education industry (Education 4.0), Energy industry (Energy 4.0), Agriculture industry (Agriculture 4.0), Healthcare industry (Healthcare 4.0), and Logistics industry (Logistics 4.0) are described. The convergence of 12 disruptive technologies including 3D printing, Artificial intelligence, Augmented reality, Big Data, Blockchain, Cloud computing, Drones, Internet of things, Nanotechnology, Robotics, Simulation and Synthetic biology in agriculture, healthcare and logistics industries are illustrated.

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Bi-directional drones to strengthen healthcare provision: experiences and lessons from Madagascar, Malawi and Senegal

Cited by 60 publications

References 15 publications

Multidrug-resistant tuberculosis surveillance and cascade of care in Madagascar: a five-year (2012–2017) retrospective study

Multidrug-resistant tuberculosis surveillance and cascade of care in Madagascar: a five-year (2012–2017) retrospective study

An Ethical Framework for the Design, Development, Implementation, and Assessment of Drones Used in Public Healthcare

The Hype and Disruptive Technologies of Industry 4.0 in Major Industrial Sectors: A State of the Art

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