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

Carme Carrion, Noemí Robles, Oriol Sola-Morales, Marta Aymerich, Jose Antonio Ruiz Postigo, Carme Carrion, Noemí Robles, Oriol Sola-Morales, Marta Aymerich, Jose Antonio Ruiz Postigo

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.

Keywords: SMS text messaging; apps; low- and middle-income countries; mHealth; mobile health; neglected tropical diseases; skin neglected tropical diseases.

Conflict of interest statement

Conflicts of Interest: None declared.

©Carme Carrion, Noemí Robles, Oriol Sola-Morales, Marta Aymerich, Jose Antonio Ruiz Postigo. Originally published in JMIR mHealth and uHealth (http://mhealth.jmir.org), 31.12.2020.

Figures

Figure 1
Figure 1
PRISMA flow diagram of the selection of papers for inclusion in the review. NTD: neglected tropical disease.

References

    1. Control of Neglected Tropical Diseases. World Health Organization. [2020-12-14]. .
    1. Working to overcome the global impact of neglected tropical diseases: First WHO report on Neglected Tropical Diseases. World Health Organization. [2020-12-14].
    1. Verrest L, Dorlo TPC. Lack of Clinical Pharmacokinetic Studies to Optimize the Treatment of Neglected Tropical Diseases: A Systematic Review. Clin Pharmacokinet. 2017 Jun 15;56(6):583–606. doi: 10.1007/s40262-016-0467-3.
    1. Gómez LJ, van Wijk R, van Selm L, Rivera A, Barbosa M, Parisi S, van Brakel WH, Arevalo J, Quintero W, Waltz M, Puchner K. Stigma, participation restriction and mental distress in patients affected by leprosy, cutaneous leishmaniasis and Chagas disease: a pilot study in two co-endemic regions of eastern Colombia. Trans R Soc Trop Med Hyg. 2020 Jul 01;114(7):476–482. doi: 10.1093/trstmh/trz132.
    1. Pires M, Wright B, Kaye PM, da Conceição V, Churchill RC. The impact of leishmaniasis on mental health and psychosocial well-being: A systematic review. PLoS One. 2019 Oct 17;14(10):e0223313. doi: 10.1371/journal.pone.0223313.
    1. van 't Noordende AT, Aycheh MW, Schippers A. The impact of leprosy, podoconiosis and lymphatic filariasis on family quality of life: A qualitative study in Northwest Ethiopia. PLoS Negl Trop Dis. 2020 Mar;14(3):e0008173. doi: 10.1371/journal.pntd.0008173.
    1. Engelman D, Fuller LC, Solomon AW, McCarthy JS, Hay RJ, Lammie PJ, Steer AC. Opportunities for Integrated Control of Neglected Tropical Diseases That Affect the Skin. Trends Parasitol. 2016 Nov;32(11):843–854. doi: 10.1016/j.pt.2016.08.005.
    1. Mitjà O, Marks M, Bertran L, Kollie K, Argaw D, Fahal AH, Fitzpatrick C, Fuller LC, Garcia Izquierdo B, Hay R, Ishii N, Johnson C, Lazarus JV, Meka A, Murdoch M, Ohene S, Small P, Steer A, Tabah EN, Tiendrebeogo A, Waller L, Yotsu R, Walker SL, Asiedu K. Integrated Control and Management of Neglected Tropical Skin Diseases. PLoS Negl Trop Dis. 2017 Jan;11(1):e0005136. doi: 10.1371/journal.pntd.0005136.
    1. Yotsu RR, Kouadio K, Vagamon B, N'guessan K, Akpa AJ, Yao A, Aké J, Abbet Abbet R, Tchamba Agbor Agbor B, Bedimo R, Ishii N, Fuller LC, Hay R, Mitjà O, Drechsler H, Asiedu K. Skin disease prevalence study in schoolchildren in rural Côte d'Ivoire: Implications for integration of neglected skin diseases (skin NTDs) PLoS Negl Trop Dis. 2018 May 17;12(5):e0006489. doi: 10.1371/journal.pntd.0006489.
    1. Mieras L, Taal A, Post E, Ndeve A, van Hees C. The Development of a Mobile Application to Support Peripheral Health Workers to Diagnose and Treat People with Skin Diseases in Resource-Poor Settings. Trop Med Infect Dis. 2018 Sep 15;3(3):102. doi: 10.3390/tropicalmed3030102.
    1. Rat C, Hild S, Rault Sérandour J, Gaultier A, Quereux G, Dreno B, Nguyen J. Use of Smartphones for Early Detection of Melanoma: Systematic Review. J Med Internet Res. 2018 Apr 13;20(4):e135. doi: 10.2196/jmir.9392.
    1. Patterson V. Telemedicine for epilepsy support in resource-poor settings. Front Public Health. 2014 Aug 21;2:120. doi: 10.3389/fpubh.2014.00120. doi: 10.3389/fpubh.2014.00120.
    1. Wootton R, Geissbuhler A, Jethwani K, Kovarik C, Person D, Vladzymyrskyy A, Zanaboni P, Zolfo M. Long-running telemedicine networks delivering humanitarian services: experience, performance and scientific output. Bull World Health Org. 2012 May 01;90(5):341–347. doi: 10.2471/blt.11.099143.
    1. Delaigue S, Morand J, Olson D, Wootton R, Bonnardot L. Teledermatology in Low-Resource Settings: The MSF Experience with a Multilingual Tele-Expertise Platform. Front Public Health. 2014;2:233. doi: 10.3389/fpubh.2014.00233. doi: 10.3389/fpubh.2014.00233.
    1. Surovi N, Kiber A, Kashem A, Babi KN. Study and development of algorithm of different skin diseases analysis using image processing method. Asian J Biomed Pharmaceut Sci. 2017;7(60)
    1. Yadav N, Kumar V, Shrivastava U. Skin Diseases Detection Models using Image Processing: A Survey. IJCA. 2016 Mar 17;137(12):34–39. doi: 10.5120/ijca2016909001.
    1. Garcia-Vidal C, Sanjuan G, Puerta-Alcalde P, Moreno-García E, Soriano A. Artificial intelligence to support clinical decision-making processes. EBioMedicine. 2019 Aug;46:27–29. doi: 10.1016/j.ebiom.2019.07.019.
    1. Peiffer-Smadja N, Dellière S, Rodriguez C, Birgand G, Lescure F, Fourati S, Ruppé E. Machine learning in the clinical microbiology laboratory: has the time come for routine practice? Clin Microbiol Infect. 2020 Oct 12;26(10):1300–1309. doi: 10.1016/j.cmi.2020.02.006.
    1. Ryu S. Book Review: mHealth: New Horizons for Health through Mobile Technologies: Based on the Findings of the Second Global Survey on eHealth (Global Observatory for eHealth Series, Volume 3) Healthc Inform Res. 2012;18(3):231. doi: 10.4258/hir.2012.18.3.231.
    1. Puigdomenech Puig E, Robles N, Saigí-Rubió F, Zamora A, Moharra M, Paluzie G, Balfegó M, Cuatrecasas Cambra G, Garcia-Lorda P, Carrion C. Assessment of the Efficacy, Safety, and Effectiveness of Weight Control and Obesity Management Mobile Health Interventions: Systematic Review. JMIR Mhealth Uhealth. 2019 Oct 25;7(10):e12612. doi: 10.2196/12612.
    1. Wood CS, Thomas MR, Budd J, Mashamba-Thompson TP, Herbst K, Pillay D, Peeling RW, Johnson AM, McKendry RA, Stevens MM. Taking connected mobile-health diagnostics of infectious diseases to the field. Nature. 2019 Feb;566(7745):467–474. doi: 10.1038/s41586-019-0956-2.
    1. 39+ smartphone statistics you should know in 2020. Review 42. 2020. [2020-12-14].
    1. Rizvi SMH, Schopf T, Sangha A, Ulvin K, Gjersvik P. Teledermatology in Norway using a mobile phone app. PLoS One. 2020 Apr 27;15(4):e0232131. doi: 10.1371/journal.pone.0232131.
    1. Chan S, Reddy V, Myers B, Thibodeaux Q, Brownstone N, Liao W. Machine Learning in Dermatology: Current Applications, Opportunities, and Limitations. Dermatol Ther (Heidelb) 2020 Jun;10(3):365–386. doi: 10.1007/s13555-020-00372-0.
    1. Kho J, Gillespie N, Horsham C, Snoswell C, Vagenas D, Soyer HP, Janda M. Skin Doctor Consultations Using Mobile Teledermoscopy: Exploring Virtual Care Business Models. Telemed J E Health. 2020 Nov 14;26(11):1406–1413. doi: 10.1089/tmj.2019.0228.
    1. mHealth Economics 2017 – Current Status and Future Trends in Mobile Health. Research 2 Guidance. 2017. [2020-12-14].
    1. Flaten HK, St Claire C, Schlager E, Dunnick CA, Dellavalle RP. Growth of mobile applications in dermatology - 2017 update. Dermatol Online J. 2018 Feb 15;24(2)
    1. Freeman K, Dinnes J, Chuchu N, Takwoingi Y, Bayliss SE, Matin RN, Jain A, Walter FM, Williams HC, Deeks JJ. Algorithm based smartphone apps to assess risk of skin cancer in adults: systematic review of diagnostic accuracy studies. BMJ. 2020 Feb 10;368:m127. doi: 10.1136/bmj.m127.
    1. Charbonneau DH, Hightower S, Katz A, Zhang K, Abrams J, Senft N, Beebe-Dimmer JL, Heath E, Eaton T, Thompson HS. Smartphone apps for cancer: A content analysis of the digital health marketplace. Digit Health. 2020 Feb 11;6:2055207620905413. doi: 10.1177/2055207620905413.
    1. Moher D, Liberati A, Tetzlaff J, Altman DG, PRISMA Group Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med. 2009 Jul 21;6(7):e1000097. doi: 10.1371/journal.pmed.1000097.
    1. Scottish Intercollegiate Guidelines Network . SIGN 50: A guideline developer's handbook. Edinburgh, Scotland: Scottish Intercollegiate Guidelines Network (SIGN); 2008.
    1. Sime H, Deribe K, Assefa A, Newport MJ, Enquselassie F, Gebretsadik A, Kebede A, Hailu A, Shafi O, Aseffa A, Reithinger R, Brooker SJ, Pullan RL, Cano J, Meribo K, Pavluck A, Bockarie MJ, Rebollo MP, Davey G. Integrated mapping of lymphatic filariasis and podoconiosis: lessons learnt from Ethiopia. Parasit Vectors. 2014 Aug 27;7:397. doi: 10.1186/1756-3305-7-397.
    1. Stanton MC, Mkwanda SZ, Debrah AY, Batsa L, Biritwum N, Hoerauf A, Cliffe M, Best A, Molineux A, Kelly-Hope LA. Developing a community-led SMS reporting tool for the rapid assessment of lymphatic filariasis morbidity burden: case studies from Malawi and Ghana. BMC Infect Dis. 2015 May 16;15:214. doi: 10.1186/s12879-015-0946-4.
    1. Mwingira UJ, Downs P, Uisso C, Chikawe M, Sauvage-Mar M, Malecela MN, Crowley K, Ngondi JM. Applying a mobile survey tool for assessing lymphatic filariasis morbidity in Mtwara Municipal Council of Tanzania. Mhealth. 2017 Mar 15;3:8–8. doi: 10.21037/mhealth.2017.03.01. doi: 10.21037/mhealth.2017.03.01.
    1. Mwingira U, Chikawe M, Mandara WL, Mableson HE, Uisso C, Mremi I, Malishee A, Malecela M, Mackenzie CD, Kelly-Hope LA, Stanton MC. Lymphatic filariasis patient identification in a large urban area of Tanzania: An application of a community-led mHealth system. PLoS Negl Trop Dis. 2017 Jul 14;11(7):e0005748. doi: 10.1371/journal.pntd.0005748.
    1. Karim MJ, Haq R, Mableson HE, Sultan Mahmood ASM, Rahman M, Chowdhury SM, Rahman AKMF, Hafiz I, Betts H, Mackenzie C, Taylor MJ, Kelly-Hope LA. Developing the first national database and map of lymphatic filariasis clinical cases in Bangladesh: Another step closer to the elimination goals. PLoS Negl Trop Dis. 2019 Jul;13(7):e0007542. doi: 10.1371/journal.pntd.0007542.
    1. Martindale S, Mableson HE, Kebede B, Kiros FH, Tamiru A, Mengistu B, Krueger A, Mackenzie CD, Kelly-Hope LA. A comparison between paper-based and m-Health tools for collating and reporting clinical cases of lymphatic filariasis and podoconiosis in Ethiopia. Mhealth. 2018 Oct;4:49–49. doi: 10.21037/mhealth.2018.09.12. doi: 10.21037/mhealth.2018.09.12.
    1. Navarro A, Rubiano L, Arango JD, Rojas CA, Alexander N, Saravia NG, Aronoff-Spencer E. Developing mobile health applications for neglected tropical disease research. PLoS Negl Trop Dis. 2018 Nov 1;12(11):e0006791. doi: 10.1371/journal.pntd.0006791.
    1. Mableson HE, Martindale S, Stanton MC, Mackenzie C, Kelly-Hope LA. Community-based field implementation scenarios of a short message service reporting tool for lymphatic filariasis case estimates in Africa and Asia. Mhealth. 2017 Jul 21;3:28–28. doi: 10.21037/mhealth.2017.06.06. doi: 10.21037/mhealth.2017.06.06.
    1. Luz S, Masoodian M, Cesario M. Disease surveillance and patient care in remote regions: an exploratory study of collaboration among health-care professionals in Amazonia. Behaviour & Information Technology. 2014 Jan 13;34(6):548–565. doi: 10.1080/0144929x.2013.853836.
    1. Pedram B, Pasquetto V, Drame PM, Ji Y, Gonzalez-Moa MJ, Baldwin RK, Nutman TB, Biamonte MA. A novel rapid test for detecting antibody responses to Loa loa infections. PLoS Negl Trop Dis. 2017 Jul 27;11(7):e0005741. doi: 10.1371/journal.pntd.0005741.
    1. Akoko L, Mwanga A, Chikawe M, Lutainulwa E, Ngoma D, Nshalla A, Mwingira U. Supervision and support in surgical practice using mobile platform: a case of mass hydrocele surgeries in remote regions. Mhealth. 2019 Sep;5:41–41. doi: 10.21037/mhealth.2019.09.05. doi: 10.21037/mhealth.2019.09.05.
    1. Rachmani E, Hsu C, Chang PWS, Jumanto J, Fuad A, Ningrum DNA, Yeh C, Lin M. Encouraging On-Time Completion of Leprosy Patients Treatment: Implementing E-Leprosy Framework to Primary Health Care in Indonesia. Asia Pac J Public Health. 2019 May;31(4):296–305. doi: 10.1177/1010539519847355.
    1. Dussault G, Franceschini MC. Not enough there, too many here: understanding geographical imbalances in the distribution of the health workforce. Hum Resour Health. 2006 May 27;4:12. doi: 10.1186/1478-4491-4-12.
    1. Hailey D, Roine R, Ohinmaa A. Systematic review of evidence for the benefits of telemedicine. J Telemed Telecare. 2002 Dec 02;8 Suppl 1(1_suppl):1–30. doi: 10.1258/1357633021937604.

Source: PubMed

Sponzoři a spolupracovníci

Zdravotní podmínky

Drogové intervence

3
Předplatit