Mobile Health Strategies to Tackle Skin Neglected Tropical Diseases With Recommendations From Innovative Experiences: Systematic Review

Abstract

Background Neglected tropical diseases (NTDs) represent a diverse group of 20 communicable diseases that occur in tropical and subtropical areas in 149 countries, affecting over 1 billion people and costing developing economies billions of dollars every year. Within these diseases, those that present lesions on the skin surface are classified as skin NTDs (sNTDs). Mobile health interventions are currently being used worldwide to manage skin diseases and can be a good strategy in the epidemiological and clinical management of sNTDs. Objective We aimed to analyze existing evidence about mobile health interventions to control and manage sNTDs in low- and middle-income countries (LMICs) and make recommendations for what should be considered in future interventions. Methods A systematic review was conducted of the MEDLINE, Embase, and Scopus databases over 10 years up to April 30, 2020. All types of clinical studies were considered. Data were synthesized into evidence tables. Apps were selected through a comprehensive systematic search in the Google Play Store and Apple App Store conducted between March 20 and April 15, 2020. Results From 133 potentially relevant publications, 13 studies met our criteria (9.8%). These analyzed eight different interventions (three SMS text messaging interventions and five app interventions). Six of the 13 (46%) studies were community-based cross-sectional studies intended to epidemiologically map a specific disease, mainly lymphatic filariasis, but also cutaneous leishmaniasis, leprosy, and NTDs, as well as sNTDs in general. Most of the studies were considered to have a high (5/13, 39%) or moderate (4/13, 31%) risk of bias. Fifteen apps were identified in the Google Play Store, of which three were also in the Apple App Store. Most of the apps (11/15, 73%) were targeted at health care professionals, with only four targeted at patients. The apps focused on scabies (3/15, 20%), lymphatic filariasis (3/15, 20%), cutaneous leishmaniasis (1/15, 7%), leprosy (1/15, 7%), yaws and Buruli ulcer (1/15, 7%), tropical diseases including more than one sNTDs (3/15, 20%), and NTDs including sNTDs (2/15, 13%). Only 1 (7%) app focused on the clinical management of sNTDs. Conclusions All mobile health interventions that were identified face technological, legal, final user, and organizational issues. There was a remarkable heterogeneity among studies, and the majority had methodological limitations that leave considerable room for improvement. Based on existing evidence, eight recommendations have been made for future interventions.

Community perceptions and acceptability of mass drug administration for the control of neglected tropical diseases in Asia-Pacific countries: A systematic scoping review of qualitative research

“…Second, only three published papers examined NTDs (on lymphatic filariasis and scabies) in the Pacific, creating a dearth of qualitative evidence from which to guide implementation of effective NTD control programs in the Pacific region more specifically. Our analysis contributes to the growing body of NTD-related systematic, rapid and scoping reviews with a focus on, for example, social stigma [60]; treatment adherence [61,62]; community understandings of mass drug administration for specific NTDs [63]; the role of nurses, community health workers and community drug distributors in responses to NTDs [64] [65,66]; and innovation in responses to tackling NTDs [67][68][69][70][71][72].…”

Hansenapp: Development of a mobile application to assist primary healthcare providers to control leprosy

“…The adoption of digital innovations by health teams as a facilitating instrument for the management and monitoring of patients' health is a relevant strategy for improving leprosy control actions [27]. The Hansenapp proved to be a promising technological tool to assist healthcare providers in caring for leprosy patients and monitoring contacts.…”

Teledermatology in the Control of Skin Neglected Tropical Diseases: A Systematic Review

“…Although none of the studies we reviewed employed mobile applications and AI in conjunction with TD, we acknowledge the potential synergy of combining these technologies. Recently, Carrion et al reviewed the utility of mobile applications in mitigating the burden of sNTDs and although they concluded that numerous barriers to widespread mobile health implementation remain, their review demonstrates that creative mobile technologies, some with a modicum of success, do exist and can help curb the morbidity associated with sNTDs [32]. Adding AI can further potentiate the power of TD.…”