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

Autor:	Yotsu RR; Department of Tropical Medicine, Tulane School of Public Health and Tropical Medicine, New Orleans, LA, United States.; School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan.; Department of Dermatology, National Center for Global Health and Medicine, Shinjuku, Japan., Almamy D; Department of Dermatology, Université Alassane Ouattara, Bouaké, Côte d'Ivoire., Vagamon B; Department of Dermatology, Université Alassane Ouattara, Bouaké, Côte d'Ivoire.; Raoul Follereau Institute Côte d'Ivoire, Adzopé, Côte d'Ivoire., Ugai K; School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan., Itoh S; Department of Genome Informatics, Graduate School of Medicine, Osaka University, Suita, Japan.; Department of Home Health and Palliative Care Nursing, Graduate School of Health Care Sciences, Tokyo Medical and Dental University, Tokyo, Japan., Koffi YD; Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire.; National Buruli Ulcer Control Program, Ministry of Health of Côte d'Ivoire, Abidjan, Côte d'Ivoire., Kaloga M; National Buruli Ulcer Control Program, Ministry of Health of Côte d'Ivoire, Abidjan, Côte d'Ivoire., Dizoé LAS; National Control Program for Elimination of Leprosy, Ministry of Health of Côte d'Ivoire, Abidjan, Côte d'Ivoire., Kouadio K; Pasteur Institute, Abidjan, Côte d'Ivoire., Aka N; Pasteur Institute, Abidjan, Côte d'Ivoire., Yeboue LKG; Hope Commission International, Abidjan, Côte d'Ivoire., Yao KA; Hope Commission International, Abidjan, Côte d'Ivoire., Blanton RE; Department of Tropical Medicine, Tulane School of Public Health and Tropical Medicine, New Orleans, LA, United States.
Jazyk:	angličtina
Zdroj:	JMIR dermatology [JMIR Dermatol] 2023 Jun 14; Vol. 6, pp. e46295. Date of Electronic Publication: 2023 Jun 14.
DOI:	10.2196/46295
Abstrakt:	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. (©Rie R Yotsu, Diabate Almamy, Bamba Vagamon, Kazuko Ugai, Sakiko Itoh, Yao Didier Koffi, Mamadou Kaloga, Ligué Agui Sylvestre Dizoé, Kouamé Kouadio, N’guetta Aka, Luc Kowaci Gontran Yeboue, Koffi Aubin Yao, Ronald E Blanton. Originally published in JMIR Dermatology (http://derma.jmir.org), 14.06.2023.)
Databáze:	MEDLINE
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