Bringing real-time geospatial precision to HIV incidence measurements via mobile phones (Preprint)

Abstract

Background: Precise measurements of HIV incidences at community levels can help mount a more effective public health response, but the most reliable methods currently require labor-intensive population surveys. Novel mobile phone technologies are being tested for adherence to medical appointments and antiretroviral therapy, but using them to track HIV test results with automatically generated geospatial coordinates has not been widely tested. Objective: We customized a portable reader for interpreting the results of HIV lateral flow tests, and developed a mobile phone app to track HIV test results in urban and rural locations in Rwanda. Methods: 20 healthcare workers used the technology to track the test results of 2290 patients across three hospital sites (two urban sites in Kigali, and a rural site in the Western Province of Rwanda). Smartphones for less than $70 USD each were used. The mobile phone app to record HIV test results could take place without internet connectivity, with uploading of results to the cloud taking place later with internet. Results: 92% of HIV test results could be tracked in real time on an online dashboard with geographical resolution down to street resolution. Out of the 20 healthcare workers, 68% would recommend the lateral flow reader, and 100% would recommend the mobile phone app. Conclusions: Mobile phones have the potential to bring geographical precision to measurements of HIV incidences in real time.