Randomized trial evaluating an mHealth intervention for the early community-based detection and follow-up of cutaneous leishmaniasis in rural Colombia.
Background In Latin America, cutaneous leishmaniasis primarily affects dispersed rural communities, that have limited access to the public health system and medical attention. Mobile health (mHealth) strategies have shown potential to improve clinical management and epidemiological surveillance of n...
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ftdoajarticles:oai:doaj.org/article:a3ca92daf9d244048b6248846764ee6b 2023-06-06T11:51:42+02:00 Randomized trial evaluating an mHealth intervention for the early community-based detection and follow-up of cutaneous leishmaniasis in rural Colombia. Mabel Castillo Neal Alexander Luisa Rubiano Carlos Rojas Andrés Navarro Domiciano Rincon Leonardo Vargas Bernal Yenifer Orobio Lerma Nancy Gore Saravia Eliah Aronoff-Spencer 2023-03-01T00:00:00Z https://doi.org/10.1371/journal.pntd.0011180 https://doaj.org/article/a3ca92daf9d244048b6248846764ee6b EN eng Public Library of Science (PLoS) https://doi.org/10.1371/journal.pntd.0011180 https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0011180 https://doaj.org/article/a3ca92daf9d244048b6248846764ee6b PLoS Neglected Tropical Diseases, Vol 17, Iss 3, p e0011180 (2023) Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 article 2023 ftdoajarticles https://doi.org/10.1371/journal.pntd.0011180 2023-04-16T00:34:13Z Background In Latin America, cutaneous leishmaniasis primarily affects dispersed rural communities, that have limited access to the public health system and medical attention. Mobile health (mHealth) strategies have shown potential to improve clinical management and epidemiological surveillance of neglected tropical diseases, particularly those of the skin. Methods The Guaral +ST app for Android was designed to monitor cutaneous leishmaniasis treatment and assess therapeutic response. We carried out a randomized trial in the coastal municipality of Tumaco in southwestern Colombia, with parallel arms comparing a) follow-up aided by the app to b) standard institution-based follow-up. Treatment was prescribed according to national guidelines. Follow-up of therapeutic response was scheduled at the end of treatment and at 7, 13 and 26 weeks after the start of treatment. The primary endpoint was the proportion of participants who were monitored at or around week 26, allowing outcome and effectiveness of treatment to be determined. Results Follow-up of treatment and outcome assessment was achieved in significantly more patients in the intervention arm than the controls, Of the 75 participants in the two randomized arms, 74 had information on whether or not treatment was followed and outcome determined at or around week 26. Among these, 26/49 (53.1%) were evaluated in the intervention arm, and none (0/25, 0%) in the control arm (difference = 53.1%, 95% confidence interval 39.1-67.0%, p<0.001). Of the 26 participants evaluated at or around week 26 in the intervention arm, 22 (84.6%) had cured. There were no serious adverse events, nor events of severe intensity among patients monitored by CHW using the app. Conclusion This study provides proof of concept for mHealth to monitor treatment of CL in remote and complex settings, deliver improved care and to provide information to the health system on the effectiveness of treatment as it is delivered to affected populations. Clinical trial registration ISRCTN54865992. Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic PLOS Neglected Tropical Diseases 17 3 e0011180 |
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Directory of Open Access Journals: DOAJ Articles |
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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 Mabel Castillo Neal Alexander Luisa Rubiano Carlos Rojas Andrés Navarro Domiciano Rincon Leonardo Vargas Bernal Yenifer Orobio Lerma Nancy Gore Saravia Eliah Aronoff-Spencer Randomized trial evaluating an mHealth intervention for the early community-based detection and follow-up of cutaneous leishmaniasis in rural Colombia. |
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Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
description |
Background In Latin America, cutaneous leishmaniasis primarily affects dispersed rural communities, that have limited access to the public health system and medical attention. Mobile health (mHealth) strategies have shown potential to improve clinical management and epidemiological surveillance of neglected tropical diseases, particularly those of the skin. Methods The Guaral +ST app for Android was designed to monitor cutaneous leishmaniasis treatment and assess therapeutic response. We carried out a randomized trial in the coastal municipality of Tumaco in southwestern Colombia, with parallel arms comparing a) follow-up aided by the app to b) standard institution-based follow-up. Treatment was prescribed according to national guidelines. Follow-up of therapeutic response was scheduled at the end of treatment and at 7, 13 and 26 weeks after the start of treatment. The primary endpoint was the proportion of participants who were monitored at or around week 26, allowing outcome and effectiveness of treatment to be determined. Results Follow-up of treatment and outcome assessment was achieved in significantly more patients in the intervention arm than the controls, Of the 75 participants in the two randomized arms, 74 had information on whether or not treatment was followed and outcome determined at or around week 26. Among these, 26/49 (53.1%) were evaluated in the intervention arm, and none (0/25, 0%) in the control arm (difference = 53.1%, 95% confidence interval 39.1-67.0%, p<0.001). Of the 26 participants evaluated at or around week 26 in the intervention arm, 22 (84.6%) had cured. There were no serious adverse events, nor events of severe intensity among patients monitored by CHW using the app. Conclusion This study provides proof of concept for mHealth to monitor treatment of CL in remote and complex settings, deliver improved care and to provide information to the health system on the effectiveness of treatment as it is delivered to affected populations. Clinical trial registration ISRCTN54865992. |
format |
Article in Journal/Newspaper |
author |
Mabel Castillo Neal Alexander Luisa Rubiano Carlos Rojas Andrés Navarro Domiciano Rincon Leonardo Vargas Bernal Yenifer Orobio Lerma Nancy Gore Saravia Eliah Aronoff-Spencer |
author_facet |
Mabel Castillo Neal Alexander Luisa Rubiano Carlos Rojas Andrés Navarro Domiciano Rincon Leonardo Vargas Bernal Yenifer Orobio Lerma Nancy Gore Saravia Eliah Aronoff-Spencer |
author_sort |
Mabel Castillo |
title |
Randomized trial evaluating an mHealth intervention for the early community-based detection and follow-up of cutaneous leishmaniasis in rural Colombia. |
title_short |
Randomized trial evaluating an mHealth intervention for the early community-based detection and follow-up of cutaneous leishmaniasis in rural Colombia. |
title_full |
Randomized trial evaluating an mHealth intervention for the early community-based detection and follow-up of cutaneous leishmaniasis in rural Colombia. |
title_fullStr |
Randomized trial evaluating an mHealth intervention for the early community-based detection and follow-up of cutaneous leishmaniasis in rural Colombia. |
title_full_unstemmed |
Randomized trial evaluating an mHealth intervention for the early community-based detection and follow-up of cutaneous leishmaniasis in rural Colombia. |
title_sort |
randomized trial evaluating an mhealth intervention for the early community-based detection and follow-up of cutaneous leishmaniasis in rural colombia. |
publisher |
Public Library of Science (PLoS) |
publishDate |
2023 |
url |
https://doi.org/10.1371/journal.pntd.0011180 https://doaj.org/article/a3ca92daf9d244048b6248846764ee6b |
geographic |
Arctic |
geographic_facet |
Arctic |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
PLoS Neglected Tropical Diseases, Vol 17, Iss 3, p e0011180 (2023) |
op_relation |
https://doi.org/10.1371/journal.pntd.0011180 https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0011180 https://doaj.org/article/a3ca92daf9d244048b6248846764ee6b |
op_doi |
https://doi.org/10.1371/journal.pntd.0011180 |
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PLOS Neglected Tropical Diseases |
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17 |
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3 |
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e0011180 |
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