Child case of Buruli ulcer successfully treated through a school‐based skin survey project in Côte d’Ivoire

Yotsu, Rie Roselyne; Murase, Chiaki; Koffi, N.; Yao, Aubin; Kouadio, Kouamé; N’Golo, David Coulibaly; Nguetta, Aka; Akiyama, Masashi; Constance, Kadio M.; Vagamon, Bamba

doi:10.1111/1346-8138.15148

Cited by 3 publications

(2 citation statements)

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“…However, there is a lack of skills and expertise in dermatology to pursue this, which is a universal situation in most LMICs [ 23 ]. Our field is no exception, and it has been challenging to follow up with our patients without making repeated field visits, which are often a long distance from city centers [ 24 ]. In addition, this lack of capability to follow up with patients is partly due to a lack of a system to document patient records.…”

Section: Introductionmentioning

confidence: 99%

An mHealth App (eSkinHealth) for Detecting and Managing Skin Diseases in Resource-Limited Settings: Mixed Methods Pilot Study

Yotsu,

Almamy,

Vagamon

et al. 2023

JMIR Dermatol

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Background In sub-Saharan Africa, the disease burden from skin diseases, including skin-related neglected tropical diseases (skin NTDs), is extremely high. These diseases often are overlooked due to limited access to health care stemming from, for example, remote geographical locations and a lack of experts. To address these gaps, we developed a mobile health app, eSkinHealth, which is a field-adapted platform to serve as a portable electronic patient chart and for teledermatology. Objective The purpose of the study is to evaluate the usability and effectiveness of the app in rural Côte d’Ivoire for diagnosing and managing skin NTDs and other skin diseases. Methods A 2-arm trial with local health care providers and patients with skin diseases was implemented over a 3-month period. The providers were assigned to an intervention receiving the eSkinHealth app or control with usual care. Four nurses and 8 community health care workers participated in each arm. The training was provided on the use of the app to the intervention arm only, while both arms were trained on skin diseases. For the usability study, we evaluated our approach with the System Usability Scale (SUS) and in-depth interviews. For the effectiveness study, our primary outcome was to evaluate the detection and management of 5 skin NTDs as our targeted diseases, namely, Buruli ulcer, leprosy, lymphatic filariasis, scabies, and yaws, using the eSkinHealth app. Procedures of our methods were reviewed and approved by the institutional review board of the Ministry of Health and by Tulane University. Results The mean age of our participants (providers) was 40.5 and 42.5 years for the intervention and control arms, respectively, and all were male (n=24). The average SUS scores taken from the intervention arm at baseline, the midpoint (6 weeks), and the end of study (12 weeks) were 72.3 (SD 11.5), 72.3 (SD 12.4), and 86.3 (SD 10.8), respectively. All participants interviewed, including 4 dermatologists and program managers, were satisfied with the app. Especially community health care workers felt empowered by being equipped with the tool. A total of 79 cases of skin NTDs were reported in the intervention arm as compared to 17 cases in the control arm (P=.002). Besides the skin NTDs, more skin diseases and conditions were reported from the control than from the intervention arm (P<.001). However, 100 cases (66%) were not given any particular diagnosis in the control arm and were documented only as a “dermatosis.” In the intervention arm, 151 cases (72.9%) were diagnosed within the eSkinHealth platform, and the remaining were diagnosed on-site by dermatologists. Conclusions The study provided evidence for the usability and effectiveness of the eSkinHealth app embedded into our surveillance approach to improve the detection and management of skin NTDs and other skin diseases in Côte d’Ivoire and, furthermore, is expected to contribute to knowledge on mobile health approaches in the control of skin diseases in resource-limited settings. Trial Registration ClinicalTrials.gov NCT05300399; https://clinicaltrials.gov/ct2/show/NCT05300399

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Section: Introductionmentioning

confidence: 99%

An mHealth App (eSkinHealth) for Detecting and Managing Skin Diseases in Resource-Limited Settings: Mixed Methods Pilot Study

Yotsu,

Almamy,

Vagamon

et al. 2023

JMIR Dermatol

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show abstract

“…However, there is a lack of skills and expertise in dermatology to pursue this, which is a universal situation in most LMICs [ 17 ]. Our field is no exception, and it has been challenging to follow-up with our patients without making repeated field visits, which are often a long distance from city centers [ 18 ]. In addition, this lack of capability to follow up with patients is partly due to the lack of a system to document patient records.…”

Section: Introductionmentioning

confidence: 99%

The Early Detection and Case Management of Skin Diseases With an mHealth App (eSkinHealth): Protocol for a Mixed Methods Pilot Study in Côte d’Ivoire

Yotsu¹,

Itoh²,

Yao³

et al. 2022

JMIR Res Protoc

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Background There is a high prevalence of skin diseases sub-Saharan Africa, including skin neglected tropical diseases (NTDs) that could lead to lifelong disabilities and deformities if not diagnosed and treated early. To achieve early detection and early treatment of these skin diseases, we developed a mobile health app, eSkinHealth. Objective This paper outlines a protocol for evaluating the effect of our eSkinHealth app in the early detection and effective management of skin diseases in Côte d’Ivoire. Methods A mixed methods pilot trial will be conducted in Côte d’Ivoire and will consist of 3 phases: (1) the development and improvement of the eSkinHealth app, (2) a pilot trial to evaluate the usability of the eSkinHealth app for local medical staff in Côte d’Ivoire, and (3) a pilot trial to evaluate the effectiveness of early detection and case management of targeted skin NTDs (Buruli ulcer, leprosy, yaws, and lymphatic filariasis) with the eSkinHealth app in Côte d’Ivoire. The pilot study will be implemented as a 2-arm trial with local health care providers and patients with skin NTDs over a 3-month follow-up period. The local health care providers will be assigned to an intervention group receiving the eSkinHealth app to be used in their daily practices or a control group. Training will be provided on the use and implementation of the app and the diagnostic pipeline to the intervention group only, while both groups will receive training on skin diseases. Our primary outcome is to evaluate the early detection and effective management of skin diseases using the eSkinHealth app in Côte d’Ivoire by the number of cases diagnosed and managed. Additionally, we will evaluate the eSkinHealth app with validated questionnaires and in-depth interviews. Procedures of our methods have been reviewed and approved by the Institutional Review Board of the Ministry of Health, Côte d’Ivoire and by Tulane University in 2021. Results This study was funded in 2021. We started the enrollment of patients in February 2022, and data collection is currently underway. We expect the first results to be submitted for publication in 2023. Conclusions Our eSkinHealth app is a field-adapted platform that could provide both direct diagnostic and management assistance to health workers in remote settings. The study will provide evidence for the usability and the effectiveness of the eSkinHealth app to improve the early detection and case management of skin NTDs in Côte d’Ivoire and, furthermore, is expected to contribute to knowledge on mobile health approaches in the control of skin NTDs. Trial Registration ClinicalTrials.gov NCT05300399; https://clinicaltrials.gov/ct2/show/study/NCT05300399 International Registered Report Identifier (IRRID) DERR1-10.2196/39867

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An mHealth App (eSkinHealth) for Detecting and Managing Skin Diseases in Resource-Limited Settings: Mixed Methods Pilot Study (Preprint)

Yotsu¹,

Almamy²,

Vagamon³

et al. 2023

Preprint

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BACKGROUND The prevalence of skin diseases is extremely high in sub-Saharan Africa. Among these are skin neglected tropical diseases (skin NTDs) that could lead to lifelong disabilities and deformities if not diagnosed and treated early. To achieve early detection and early treatment of these skin diseases, we developed a mobile health (mHealth) app, eSkinHealth. OBJECTIVE We evaluated the usability and effectiveness of our eSkinHealth app in the detection and effective management of skin diseases in rural Côte d’Ivoire. METHODS A 2-arm trial with local healthcare providers and patients with skin NTDs was implemented over a 3-month follow-up period. The healthcare providers were assigned to an intervention group receiving the eSkinHealth app to be used in their daily practices or a control group with usual care. A total of 4 nurses and 8 community healthcare workers (CHWs) were selected to participate in the study for each arm. Training was provided on the use and implementation of the app and the diagnostic pipeline to the intervention group only, while both groups received training on skin diseases. For usability study, we evaluated the eSkinHealth app with validated questionnaires and in-depth interviews. For effectiveness study, our primary outcome was to evaluate the early detection and effective management of our targeted skin NTDs (Buruli ulcer, leprosy, lymphatic filariasis, scabies, and yaws) and other skin diseases using the eSkinHealth app by the number of cases reported and managed. Procedures of our methods were reviewed and approved by the IRB of the Ministry of Health, Côte d’Ivoire and by Tulane University. RESULTS The mean age of our participants (providers) was 40.5 and 42.5 for intervention and control arms, respectively, and all were male (n=24). The System Usability Score (SUS) was applied to 12 users of the eSkinHealth app in the intervention arm. The average scores at baseline, the midpoint (6 weeks), and the end of the study (12 weeks) were 72.3 (SD 11.5), 72.3 (SD 12.4), and 86.3 (SD 10.8), respectively. All participants interviewed, including four dermatologists and program managers in addition to our participants, were satisfied with the app. Especially, CHWs felt empowered by equipped with the tool. Seventy-nine cases of skin NTDs were reported in the intervention arm as compared to 17 cases in the control arm (p value=0.0019). CONCLUSIONS Our eSkinHealth is a field-adapted platform that could both provide direct diagnostic and management assistance to health workers in remote settings. The study provided evidence for the usability and the effectiveness of the eSkinHealth app to improve the early detection and case management of skin NTDs and other skin diseases in Côte d’Ivoire and, furthermore, are expected to contribute to knowledge on mobile health approaches in the control of skin NTDs. CLINICALTRIAL ClinicalTrials.gov NCT05300399; https://clinicaltrials.gov/ct2/show/NCT05300399.

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Child case of Buruli ulcer successfully treated through a school‐based skin survey project in Côte d’Ivoire

Cited by 3 publications

References 6 publications

An mHealth App (eSkinHealth) for Detecting and Managing Skin Diseases in Resource-Limited Settings: Mixed Methods Pilot Study

An mHealth App (eSkinHealth) for Detecting and Managing Skin Diseases in Resource-Limited Settings: Mixed Methods Pilot Study

The Early Detection and Case Management of Skin Diseases With an mHealth App (eSkinHealth): Protocol for a Mixed Methods Pilot Study in Côte d’Ivoire

An mHealth App (eSkinHealth) for Detecting and Managing Skin Diseases in Resource-Limited Settings: Mixed Methods Pilot Study (Preprint)

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