Digital platforms and mobile applications hold the promise of delivering specialist remote care in low-resource settings. Recently, the World Health Organization (WHO) introduced the SkinNTD app to train and guide frontline health workers encountering neglected tropical diseases (NTDs) in low- and middle-income countries (LMICs).
As with all innovations, rigorous validation is essential before SkinNTDs can be widely used. In a recent study published in the Journal of Medical Internet Research, researchers discuss the results of an early evaluation of its usability and usefulness.
Study: Evaluation of the World Health Organization's SkinNTDs app as a training tool for skin neglected tropical diseases in Ghana and Kenya: a cross-sectional study. Image credit: greenbutterfly / Shutterstock.com
What are NTDs?
NTDs consist of 20 diseases that affect more than 1.5 billion people worldwide, mostly women and children. To prioritize research on NTDs, WHO classifies NTDs into those suitable for mass prevention and those requiring individualized management, the latter including skin NTDs.
Examples of cutaneous NTDs include Buruli ulcer, cutaneous leishmaniasis, leprosy, and lymphatic filariasis. All of these conditions are difficult to diagnose and treat without specialized staff and require financial investment. People most at risk for skin NTDs are often unaware of these symptoms, which facilitates the spread and progression of the infection. Stigma against people with these illnesses can also discourage them from seeking timely medical help.
As a result, some skin NTDs can become chronic, disabling, disabling, and stigmatizing diseases, with significant impacts on the quality of life and economic productivity of affected individuals. there is. Taken together, these factors highlight the importance of mobilizing and training frontline health workers at the local level. This is because these people are often the first to encounter patients with skin NTDs.
Telehealth services involve the use of modern communications and information technology and are intended to facilitate and speed up the delivery and management of health care. Nearly 700 digital interventions and training programs have been implemented in Africa, many with reliable results. However, these programs often focus on one or only a few conditions, limiting their cost-effectiveness and practicality.
Evaluate the usefulness of SkinNTD
SkinNTD enables frontline healthcare workers to identify the signs and symptoms of skin NTDs, access more information about potential diagnoses, and make better clinical decisions. In the current study, SkinNTDs were tested over 5 days in Ghana and Kenya by frontline healthcare workers accustomed to application.
Study participants then completed a questionnaire based on the User Mobile Application Rating Score (uMARS). This score examines the objective areas of engagement of an application, its functionality, aesthetics, quality of information, and subjective quality ratings. A subgroup of study participants was also asked to participate in interviews and one focus group.
What did the research show?
This study included 60 participants for quantitative analysis, of whom 57% were male. The qualitative study involved 17 research participants.
Most of the participants worked in public healthcare institutions, and approximately 75% of them were front-line healthcare workers, although they were not dermatologists. Approximately 70% of survey participants responded that they are comfortable with mobile technology.
According to the uMARS survey, SkinNTD has an average score of 4 out of 5 for quality, with information quality rated highest of the four domains. Other notable features of the application include its simple language, offline friendliness, and ease of use, all of which may make it suitable for rural use.
Most study participants indicated that the application reduced the time needed to diagnose skin NTDs. Mean quality scores did not vary by age, gender, health worker category, country, or job type. Neither previous skin NTD experience nor dermatology experience affected quality ratings.
Subjective quality was rated 3.8 out of 5, while SkinNED's perceived impact was approximately 4.5. Survey participants said the application was easy to use, worked well offline, and could be a valuable tool for workers in remote locations or in the field who lack the necessary resources. Although many were reluctant to pay for the application, nearly all study participants recommended its use.
Conversely, there are several areas that need further improvement, such as a more detailed and informative chapter on the signs and symptoms of neglected NTDs, photographs of skin conditions unique to Africans, and the need to be able to enter patient records and monitor patients. was identified. Some participants requested personalization and customization features, such as the ability to change font size.
Approximately 33% of survey participants said they had insufficient internet access, making offline functionality an important factor. Additionally, 53% of survey participants emphasized the importance of making SkinNTD available in other languages, particularly Twi and Swahili. It was also shown that public authorities at all levels need to be involved in the dissemination of applications to ensure reliability and high training standards in the future.
conclusion
Study results demonstrate the user-friendly nature, ease of use, and offline functionality of SkinNTD, suggesting its potential utility. Further evaluation and validation studies may facilitate the development of his SkinNTD as a medical diagnostic device beyond training purposes.
Other similar applications currently in use include the Skin app, which is integrated into SkinNTD, and the Guaral app, which was explicitly designed for the detection of cutaneous leishmaniasis in rural Colombia. In addition, the eSkinHealth app was developed for remote diagnosis, decision support, and monitoring of skin diseases in LMICs, especially people with dark skin.
The SkinNTDs app can play a vital role in the global effort to combat skin NTDs and reduce the burden on affected communities. ”
Journal reference:
Cano, M., Ruiz-Postigo, J.A., Macharia, P., et al. (2024). Evaluation of the World Health Organization's SkinNTDs app as a training tool for skin neglected tropical diseases in Ghana and Kenya: a cross-sectional study. Medical Internet Research Journal. doi:10.2196/51628.
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