Connected diagnostics: linking digital rapid diagnostic tests and mobile health wallets to diagnose and treat brucellosis in Samburu, Kenya

Autor: T. Rinke de Wit, D. Nzorubara, M. Otieno, Ramona Koech, David Onchonga, Sherzel Smith, M. Thuranira, Liang Ze Wong, G. Bhat, E. van den Bogaart
Přispěvatelé: APH - Global Health, APH - Quality of Care, APH - Personalized Medicine, Global Health
Jazyk: angličtina
Rok vydání: 2019
Předmět:
Male
020205 medical informatics
02 engineering and technology
Health informatics
0302 clinical medicine
Health care
0202 electrical engineering
electronic engineering
information engineering
Mobile payment
Medicine
030212 general & internal medicine
Mobile health
Medical diagnosis
Geography
Medical
Child
mHealth
Diagnostics
Aged
80 and over
Transients and Migrants
education.field_of_study
Rapid diagnostic test
Health Policy
Middle Aged
Telemedicine
Computer Science Applications
Technical Advance
Point-of-Care Testing
Child
Preschool
lcsh:R858-859.7
Female
Medical emergency
Adult
Adolescent
Population
Health Informatics
lcsh:Computer applications to medicine. Medical informatics
Brucellosis
03 medical and health sciences
Young Adult
Humans
education
Aged
business.industry
Diagnostic Tests
Routine
Infant
medicine.disease
Kenya
Malaria
Feasibility Studies
business
Mobile health wallet
Cell Phone
Zdroj: BMC Medical Informatics and Decision Making
BMC Medical Informatics and Decision Making, Vol 19, Iss 1, Pp 1-12 (2019)
BMC medical informatics and decision making, 19(1):139. BioMed Central
ISSN: 1472-6947
Popis: Background Despite WHO guidelines for testing all suspected cases of malaria before initiating treatment, presumptive malaria treatment remains common practice among some clinicians and in certain low-resource settings the capacity for microscopic testing is limited. This can lead to misdiagnosis, resulting in increased morbidity due to lack of treatment for undetected conditions, increased healthcare costs, and potential for drug resistance. This is particularly an issue as multiple conditions share the similar etiologies to malaria, including brucellosis, a rare, under-detected zoonosis. Linking rapid diagnostic tests (RDTs) and digital test readers for the detection of febrile illnesses can mitigate this risk and improve case management of febrile illness. Methods This technical advance study examines Connected Diagnostics, an approach that combines the use of point-of-care RDTs for malaria and brucellosis, digitally interpreted by a rapid diagnostic test reader (Deki Reader) and connected to mobile payment mechanisms to facilitate the diagnosis and treatment of febrile illness in nomadic populations in Samburu County, Kenya. Consenting febrile patients were tested with RDTs and patient diagnosis and risk information were uploaded to a cloud database via the Deki Reader. Patients with positive diagnoses were provided digital vouchers for transportation to the clinic and treatment via their health wallet on their mobile phones. Results In total, 288 patients were tested during outreach visits, with 9% testing positive for brucellosis and 0.6% testing positive for malaria. All patients, regardless of diagnosis were provided with a mobile health wallet on their cellular phones to facilitate their transport to the clinic, and for patients testing positive for brucellosis or malaria, the wallet funded their treatment. The use of the Deki Reader in addition to quality diagnostics at point of care also facilitated geographic mapping of patient diagnoses in relation to key risk areas for brucellosis transmission. Conclusions This study demonstrates that the Connected Dx approach can be effective even when addressing a remote, nomadic population and a rare disease, indicating that this approach to diagnosing, treatment, and payment for healthcare costs is feasible and can be scaled to address more prevalent diseases and conditions in more populous contexts.
Databáze: OpenAIRE
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