Adaptation and performance of a mobile application for early detection of cutaneous leishmaniasis.
Background Detection and management of neglected tropical diseases such as cutaneous leishmaniasis present unmet challenges stemming from their prevalence in remote, rural, resource constrained areas having limited access to health services. These challenges are frequently compounded by armed confli...
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ftdoajarticles:oai:doaj.org/article:021876eef7964e81b083402bf2e58405 2023-05-15T15:14:44+02:00 Adaptation and performance of a mobile application for early detection of cutaneous leishmaniasis. Luisa Rubiano Neal D E Alexander Ruth Mabel Castillo Álvaro José Martínez Jonny Alejandro García Luna Juan David Arango Leonardo Vargas Patricia Madriñán Lina-Rocío Hurtado Yenifer Orobio Carlos A Rojas Helena Del Corral Andrés Navarro Nancy Gore Saravia Eliah Aronoff-Spencer 2021-02-01T00:00:00Z https://doi.org/10.1371/journal.pntd.0008989 https://doaj.org/article/021876eef7964e81b083402bf2e58405 EN eng Public Library of Science (PLoS) https://doi.org/10.1371/journal.pntd.0008989 https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0008989 https://doaj.org/article/021876eef7964e81b083402bf2e58405 PLoS Neglected Tropical Diseases, Vol 15, Iss 2, p e0008989 (2021) Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 article 2021 ftdoajarticles https://doi.org/10.1371/journal.pntd.0008989 2022-12-31T13:25:27Z Background Detection and management of neglected tropical diseases such as cutaneous leishmaniasis present unmet challenges stemming from their prevalence in remote, rural, resource constrained areas having limited access to health services. These challenges are frequently compounded by armed conflict or illicit extractive industries. The use of mobile health technologies has shown promise in such settings, yet data on outcomes in the field remain scarce. Methods We adapted a validated prediction rule for the presumptive diagnosis of CL to create a mobile application for use by community health volunteers. We used human-centered design practices and agile development for app iteration. We tested the application in three rural areas where cutaneous leishmaniasis is endemic and an urban setting where patients seek medical attention in the municipality of Tumaco, Colombia. The application was assessed for usability, sensitivity and inter-rater reliability (kappa) when used by community health volunteers (CHV), health workers and a general practitioner, study physician. Results The application was readily used and understood. Among 122 screened cases with cutaneous ulcers, sensitivity to detect parasitologically proven CL was >95%. The proportion of participants with parasitologically confirmed CL was high (88%), precluding evaluation of specificity, and driving a high level of crude agreement between the app and parasitological diagnosis. The chance-adjusted agreement (kappa) varied across the components of the risk score. Time to diagnosis was reduced significantly, from 8 to 4 weeks on average when CHV conducted active case detection using the application, compared to passive case detection by health facility-based personnel. Conclusions Translating a validated prediction rule to a mHealth technology has shown the potential to improve the capacity of community health workers and healthcare personnel to provide opportune care, and access to health services for underserved populations. These findings support the ... Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic PLOS Neglected Tropical Diseases 15 2 e0008989 |
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Directory of Open Access Journals: DOAJ Articles |
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English |
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Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
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Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 Luisa Rubiano Neal D E Alexander Ruth Mabel Castillo Álvaro José Martínez Jonny Alejandro García Luna Juan David Arango Leonardo Vargas Patricia Madriñán Lina-Rocío Hurtado Yenifer Orobio Carlos A Rojas Helena Del Corral Andrés Navarro Nancy Gore Saravia Eliah Aronoff-Spencer Adaptation and performance of a mobile application for early detection of cutaneous leishmaniasis. |
topic_facet |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
description |
Background Detection and management of neglected tropical diseases such as cutaneous leishmaniasis present unmet challenges stemming from their prevalence in remote, rural, resource constrained areas having limited access to health services. These challenges are frequently compounded by armed conflict or illicit extractive industries. The use of mobile health technologies has shown promise in such settings, yet data on outcomes in the field remain scarce. Methods We adapted a validated prediction rule for the presumptive diagnosis of CL to create a mobile application for use by community health volunteers. We used human-centered design practices and agile development for app iteration. We tested the application in three rural areas where cutaneous leishmaniasis is endemic and an urban setting where patients seek medical attention in the municipality of Tumaco, Colombia. The application was assessed for usability, sensitivity and inter-rater reliability (kappa) when used by community health volunteers (CHV), health workers and a general practitioner, study physician. Results The application was readily used and understood. Among 122 screened cases with cutaneous ulcers, sensitivity to detect parasitologically proven CL was >95%. The proportion of participants with parasitologically confirmed CL was high (88%), precluding evaluation of specificity, and driving a high level of crude agreement between the app and parasitological diagnosis. The chance-adjusted agreement (kappa) varied across the components of the risk score. Time to diagnosis was reduced significantly, from 8 to 4 weeks on average when CHV conducted active case detection using the application, compared to passive case detection by health facility-based personnel. Conclusions Translating a validated prediction rule to a mHealth technology has shown the potential to improve the capacity of community health workers and healthcare personnel to provide opportune care, and access to health services for underserved populations. These findings support the ... |
format |
Article in Journal/Newspaper |
author |
Luisa Rubiano Neal D E Alexander Ruth Mabel Castillo Álvaro José Martínez Jonny Alejandro García Luna Juan David Arango Leonardo Vargas Patricia Madriñán Lina-Rocío Hurtado Yenifer Orobio Carlos A Rojas Helena Del Corral Andrés Navarro Nancy Gore Saravia Eliah Aronoff-Spencer |
author_facet |
Luisa Rubiano Neal D E Alexander Ruth Mabel Castillo Álvaro José Martínez Jonny Alejandro García Luna Juan David Arango Leonardo Vargas Patricia Madriñán Lina-Rocío Hurtado Yenifer Orobio Carlos A Rojas Helena Del Corral Andrés Navarro Nancy Gore Saravia Eliah Aronoff-Spencer |
author_sort |
Luisa Rubiano |
title |
Adaptation and performance of a mobile application for early detection of cutaneous leishmaniasis. |
title_short |
Adaptation and performance of a mobile application for early detection of cutaneous leishmaniasis. |
title_full |
Adaptation and performance of a mobile application for early detection of cutaneous leishmaniasis. |
title_fullStr |
Adaptation and performance of a mobile application for early detection of cutaneous leishmaniasis. |
title_full_unstemmed |
Adaptation and performance of a mobile application for early detection of cutaneous leishmaniasis. |
title_sort |
adaptation and performance of a mobile application for early detection of cutaneous leishmaniasis. |
publisher |
Public Library of Science (PLoS) |
publishDate |
2021 |
url |
https://doi.org/10.1371/journal.pntd.0008989 https://doaj.org/article/021876eef7964e81b083402bf2e58405 |
geographic |
Arctic |
geographic_facet |
Arctic |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
PLoS Neglected Tropical Diseases, Vol 15, Iss 2, p e0008989 (2021) |
op_relation |
https://doi.org/10.1371/journal.pntd.0008989 https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0008989 https://doaj.org/article/021876eef7964e81b083402bf2e58405 |
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https://doi.org/10.1371/journal.pntd.0008989 |
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PLOS Neglected Tropical Diseases |
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