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Abstract
Whereas mobile phone-based surveillance has the potential to provide real-time validated
data for disease clustering and prompt respond and investigation, little evidence
is available on current practice in sub-Sahara Africa. The objective of this review
was to examine mobile phone-based mHealth interventions for Public Health surveillance
in the region. We conducted electronic search in MEDLINE, EMBASE, IEE Xplore, African
Index Medicus (AIM), BioMed Central, PubMed Central (PMC), the Public Library of Science
(PLoS) and IRIS for publications used in the review. In all, a total of nine studies
were included which focused on infectious disease surveillance of malaria (
n = 3), tuberculosis (
n = 1) and influenza-like illnesses (
n = 1) as well as on non-infectious disease surveillance of child malnutrition (
n = 2), maternal health (
n = 1) and routine surveillance of various diseases and symptoms (
n = 1). Our review revealed that mobile phone-based surveillance projects in the sub-Saharan
African countries are on small scale, fragmented and not well documented. We conclude
by advocating for a strong drive for more research in the applied field as well as
a better reporting of lessons learned in order to create an epistemic community to
help build a more evidence-based field of practice in mHealth surveillance in the
region.
This article reviews key communication issues involved in the design of effective and humane eHealth applications to help guide strategic development and implementation of health information technologies. There is a communication revolution brewing in the delivery of health care and the promotion of health fueled by the growth of powerful new health information technologies. The development, adoption, and implementation of a broad range of new eHealth applications (such as online health information websites, interactive electronic health records, health decision support programs, tailored health education programs, health care system portals, mobile health communication programs, and advanced telehealth applications) holds tremendous promise to increase consumer and provider access to relevant health information, enhance the quality of care, reduce health care errors, increase collaboration, and encourage the adoption of healthy behaviors. With the growth of new and exciting health information technology opportunities, however, comes the daunting responsibility to design interoperable, easy to use, engaging, and accessible eHealth applications that communicate the right information needed to guide health care and health promotion for diverse audiences. Copyright 2010. Published by Elsevier Ireland Ltd.
OBJECTIVE: To describe how information communication technology (ICT) is being used by programmes that seek to improve private sector health financing and delivery in low-and middle-income countries, including the main uses of the technology and the types of technologies being used. METHODS: In-country partners in 16 countries directly searched systematically for innovative health programmes and compiled profiles in the Center for Health Market Innovations' database. These data were supplemented through literature reviews and with self-reported data supplied by the programmes themselves. FINDINGS: In many low-and middle-income countries, ICT is being increasingly employed for different purposes in various health-related areas. Of ICT-enabled health programmes, 42% use it to extend geographic access to health care, 38% to improve data management and 31% to facilitate communication between patients and physicians outside the physician's office. Other purposes include improving diagnosis and treatment (17%), mitigating fraud and abuse (8%) and streamlining financial transactions (4%). The most common devices used in technology-enabled programmes are phones and computers; 71% and 39% of programmes use them, respectively, and the most common applications are voice (34%), software (32%) and text messages (31%). Donors are the primary funders of 47% of ICT-based health programmes. CONCLUSION: Various types of ICT are being employed by private organizations to address key health system challenges. For successful implementation, however, more sustainable sources of funding, greater support for the adoption of new technologies and better ways of evaluating impact are required.
More than 34 million people are presently living with HIV infection. Antiretroviral therapy (ART) can help these people to live longer, healthier lives, but adherence to ART can be difficult. Mobile phone text-messaging has the potential to help promote adherence in these patients. To determine whether mobile phone text-messaging is efficacious in enhancing adherence to ART in patients with HIV infection. Using the Cochrane Collaboration's validated search strategies for identifying randomised controlled trials and reports of HIV interventions, along with appropriate keywords and MeSH terms, we searched a range of electronic databases, including the Cochrane Central Register of Controlled Trials (CENTRAL), EMBASE, Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS), MEDLINE (via PubMed), PsycINFO, Web of Science, and the World Health Organization (WHO) Global Index Medicus. The date range was from 01 January 1980 to 01 November 2011. There were no limits to language or publication status. Randomised controlled trials (RCTs) in which patients or their caregivers (in the case of infants and children) of any age, in any setting, and receiving ART were provided with mobile phone text messages as a means of promoting adherence to ART. Two authors independently examined the abstracts of all identified trials. We initially identified 243 references. Seventeen full-text articles were closely reviewed. Both authors abstracted data independently, using a pre-designed, standardised data collection form. When appropriate, data were combined in meta-analysis. Two RCTs from Kenya were included in the review. One trial compared short weekly text messages against standard care. The other trial compared short daily, long daily, short weekly and long weekly messages against standard care. Both trials were with adult patients.In the trial comparing only short weekly messages to standard care, text messaging was associated with a lower risk of non-adherence at 12 months (RR 0.77, 95% CI 0.63 to 0.93) and with the non-occurrence of virologic failure at 12 months (RR 0.83, 95% CI 0.69 to 0.99).In the trial that compared different intervals and lengths for text-messaging to standard care, long weekly text-messaging was not significantly associated with a lower risk of non-adherence compared to standard care (RR 0.79, 95% CI 0.60 to 1.04). Patients receiving weekly text-messages of any length were at lower risk of non-adherence at 48 weeks than were patients receiving daily messages of any length (RR 0.79, 95% CI 0.64 to 0.99). There were no significant differences between weekly text-messaging of any length (RR 1.01, 95% CI 0.75 to 1.37) and between short or long messaging at either interval (RR 0.99, 95% CI 0.78 to 1.27). Compared to standard care, any daily text-messaging, whether short or long, did not reduce the risk for non-adherence (RR 0.99, 95% CI 0.82 to 1.20).In meta-analysis of both trials, any weekly text-messaging (i.e. whether short or long messages) was associated with a lower risk of non-adherence at 48-52 weeks (RR 0.78, 95% CI 0.68 to 0.89). The effect of short weekly text-messaging was also significant (RR 0.77, 95% CI 0.67 to 0.89). There is high-quality evidence from the two RCTs that mobile phone text-messaging at weekly intervals is efficacious in enhancing adherence to ART, compared to standard care. There is high quality evidence from one trial that weekly mobile phone text-messaging is efficacious in improving HIV viral load suppression. Policy-makers should consider funding programs proposing to provide weekly mobile phone text-messaging as a means for promoting adherence to antiretroviral therapy. Clinics and hospitals should consider implementing such programs. There is a need for large RCTs of this intervention in adolescent populations, as well as in high-income countries.
Journal ID (nlm-ta): Int J Environ Res Public Health
Journal ID (iso-abbrev): Int J Environ Res Public Health
Journal ID (publisher-id): ijerph
Title:
International Journal of Environmental Research and Public Health
Publisher:
MDPI
ISSN
(Print):
1661-7827
ISSN
(Electronic):
1660-4601
Publication date
(Electronic):
12
November
2014
Publication date
(Print):
November
2014
Volume: 11
Issue: 11
Pages: 11559-11582
Affiliations
[1
]Department of Public Health Medicine, School of Public Health, University of Bielefeld,
P.O. Box 100131, D-33501 Bielefeld, Germany; E-Mail:
alexander.kraemer@
123456uni-bielefeld.de
[2
]Department of Biological, Environmental, Occupational Health Sciences, School of Public
Health, University of Ghana, P.O. Box LG13, Legon, Ghana; E-Mail:
jfobil@
123456ug.edu.gh
[3
]Infectious Disease Epidemiology Unit, Bernhard Nocht Institute for Tropical Medicine,
Bernhard Nocht-Str. 74, D-20359 Hamburg, Germany; E-Mails:
krumkamp@
123456bnitm.de
(R.K.);
may@
123456bnitm.de
(J.M.)
This article is an open access article distributed under the terms and conditions
of the Creative Commons Attribution license (
http://creativecommons.org/licenses/by/4.0/).
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