Mobile Technology for Empowering Health Workers in Underserved Communities: New Approaches to Facilitate the Elimination of Neglected Tropical Diseases

Stanton, Michelle C.; Molineux, Andrew; Mackenzie, Charles D.; Kelly-Hope, Louise A.

doi:10.2196/publichealth.5064

Cited by 32 publications

(22 citation statements)

References 15 publications

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“…In Africa, the clinical conditions are caused by Wuchereria bancrofti adult worms lodging in the lymphatic system and disrupting the immune system and lymph carriage. Currently, there are no standard rapid mapping guidelines to detect LF clinical cases; however, new approaches using local health workers and simple mHealth tools have started to be used in the field ( Stanton et al, 2016 ). For this study, the presence of lymphoedema and/or hydrocoele in individuals aged > 15 years was recorded and verified by a local medical officer.…”

Section: Methodsmentioning

confidence: 99%

Rapid integrated clinical survey to determine prevalence and co-distribution patterns of lymphatic filariasis and onchocerciasis in a Loa loa co-endemic area: The Angolan experience

Brito¹,

Paulo²,

Van-Dunem

et al. 2017

Parasite Epidemiology and Control

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The Republic of Angola is a priority country for onchocerciasis and lymphatic filariasis (LF) elimination, however, the co-distribution of the filarial parasite Loa loa (loiasis) is a significant impediment, due to the risk of severe adverse events (SAEs) associated with ivermectin used in mass drug administration (MDA) campaigns. Angola has a high risk loiasis zone identified in Bengo Province where alternative interventions may need to be implemented; however, the presence and geographical overlap of the three filarial infections/diseases are not well defined. Therefore, this study conducted a rapid integrated filarial mapping survey based on readily identifiable clinical conditions of each disease in this risk zone to help determine prevalence and co-distribution patterns in a timely manner with limited resources. In total, 2007 individuals from 29 communities in five provincial municipalities were surveyed. Community prevalence estimates were determined by the rapid assessment procedure for loiasis (RAPLOA) and rapid epidemiological mapping of onchocerciasis (REMO) together with two questions on LF clinical manifestations (presence of lymphoedema, hydrocoele). Overall low levels of endemicity, with different overlapping distributions were found. Loiasis was found in 18 communities with a prevalence of 2.0% (31/1571), which contrasted to previous results defining the area as a high risk zone. Onchocerciasis prevalence was 5.3% (49/922) in eight communities, and LF prevalence was 0.4% for lymphoedema (8/2007) and 2.6% for hydrocoeles (20/761 males) in seven and 12 communities respectively. The clinical mapping survey method helped to highlight that all three filarial infections are present in this zone of Bengo Province. However, the significant difference in loiasis prevalence found between the past and this current survey suggests that further studies including serological and parasitological confirmation are required. This will help determine levels of infection and risk, understand the associations between clinical, serological and parasitological prevalence patterns, and better determine the most appropriate treatment strategies to reach onchocerciasis and LF elimination targets in the loiasis co-endemic areas. Our results also suggest that the utility of the earlier RAPLOA derived maps, based on surveys undertaken over a decade ago, are likely to be invalid given the extent of population movement and environmental change, particularly deforestation, and that fine scale micro-mapping is required to more precisely delineate the interventions required defined by these complex co-endemicities.

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Section: Methodsmentioning

confidence: 99%

Rapid integrated clinical survey to determine prevalence and co-distribution patterns of lymphatic filariasis and onchocerciasis in a Loa loa co-endemic area: The Angolan experience

Brito¹,

Paulo²,

Van-Dunem

et al. 2017

Parasite Epidemiology and Control

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“…During this step, CHWs also have an essential role to play, such as in supporting the mapping of diseases of interest (especially intense case management diseases such as Buruli ulcer) and establishing a community-based surveillance system for early detection and reporting of suspected cases to primary health facilities (e.g. lymphatic filariasis detection [ 40 ]).…”

Section: (Main Text)mentioning

confidence: 99%

Neglected tropical diseases: exploring long term practical approaches to achieve sustainable disease elimination and beyond

Ortu

Williams

2017

Infect Dis Poverty

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BackgroundRemarkable progress has been made in the fight against neglected tropical diseases, but new challenges have emerged. Innovative diagnostics, better drugs and new insecticides are often identified as the priority; however, access to these new tools may not be sufficient to achieve and sustain disease elimination, if certain challenges and priorities are not considered.Main bodyThe authors summarise key operational challenges, and based on these, identify two major priorities: strengthening the capacity of the primary health care health system in correctly diagnosing and managing neglected tropical diseases; and establishing an effective disease surveillance process.Five steps are proposed as concrete actions to build an effective primary health care service for neglected tropical diseases, and a health management information system capable of accurately reporting these diseases. Community engagement and formalization of community health workers role are proposed as essential components of these steps.Shift of financial support from disease oriented programmes to disease integrated interventions, improved access to international guidelines for primary health care staff, and availability of donated drugs in health care structures are also suggested as key elements of the proposed process.ConclusionThe authors conclude that failure to address these priorities now may lead to further challenges on the long path towards neglected tropical disease elimination and beyond.Electronic supplementary materialThe online version of this article (doi: 10.1186/s40249-017-0361-8) contains supplementary material, which is available to authorized users.

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“…Specifically, the visual and linguistic design of mHealth apps, along with considerations for how mHealth apps are introduced to patients -may increase adoption and acceptability (12,13). Recent literature on mHealth interventions has primarily focused on mHealth adoption among health workers to facilitate their work and interactions with patients, primarily in low-and middle-income countries (14)(15)(16).…”

Section: Introductionmentioning

confidence: 99%

Use of mobile health apps in low-income populations: a prospective study of facilitators and barriers

Liu

Astudillo

Velez

et al. 2019

Preprint

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Background: Mobile applications (apps) are increasingly popular in healthcare. For low-income populations, barriers exist, yet limited data are available about the challenges and catalysts for adoption. Methods and Results: We partnered with a primary care center and a community organization and recruited patients to use a health app. A community health worker (CHW) consented participants, downloaded the app and instructed on its use, and provided ongoing technical support. Bi-weekly surveys for three months were sent via email/text to assess participant experiences and perceptions. The majority (81 of 108 [75.0%] English language-preferred and 50 of 52 [96.2%] Spanish language-preferred) of patients approached were enrolled. Common reasons for declining were: did not own a smartphone (13.8%), did not have email (20.7%), and not interested (58.6%). Enrollment challenges included: insufficient storage, unfamiliarity with downloading apps, forgotten passwords to email accounts, and slow/absent WiFi connection - which the CHW and the app company were able to address. Most participants, English and Spanish language-preferred respectively, were interested in monitoring their health through an app (74.4%; 70.4%), connecting devices such as FitBits© and blood pressure cuffs (78.9%; 50.0%), and being the owner of their health records (83.6%; 95.6%). There were concerns about sharing health information with research teams (66.7%; 51.9%), and data being sold (83.0%; 70.4%). However, many (58.6%; 87.2%) reported being likely to share health data with a trusted research team. Compared with before the study, most felt more comfortable using health apps (67.4%; 82.1%) and more likely to participate in research using apps (76.2%; 72.4%). Conclusions: The assistance of a CHW facilitated the enrollment of low-income individuals in a mobile health app by fostering trust and sustained engagement. Participants were interested in having several app features. Despite concerns about data privacy, they demonstrated greater interest in mobile health app use and research participation at study conclusion.

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Mobile Technology for Empowering Health Workers in Underserved Communities: New Approaches to Facilitate the Elimination of Neglected Tropical Diseases

Cited by 32 publications

References 15 publications

Rapid integrated clinical survey to determine prevalence and co-distribution patterns of lymphatic filariasis and onchocerciasis in a Loa loa co-endemic area: The Angolan experience

Rapid integrated clinical survey to determine prevalence and co-distribution patterns of lymphatic filariasis and onchocerciasis in a Loa loa co-endemic area: The Angolan experience

Neglected tropical diseases: exploring long term practical approaches to achieve sustainable disease elimination and beyond

Use of mobile health apps in low-income populations: a prospective study of facilitators and barriers

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