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Nanda A, Lam LL, Lynch J, Soudy H. Experiences and Satisfaction With Telehealth During the COVID-19 Pandemic: The Perspectives of Patients With Cancer in Australia. JCO Glob Oncol 2024; 10:e2400081. [PMID: 39088779 DOI: 10.1200/go.24.00081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2024] [Revised: 04/15/2024] [Accepted: 05/30/2024] [Indexed: 08/03/2024] Open
Abstract
PURPOSE There has been a significant rise in telehealth consultations across Australia since COVID-19 was declared a worldwide pandemic. We aimed to obtain patient feedback on telehealth, identify key strengths and weaknesses, and assess the feasibility of telehealth beyond the pandemic. METHODS A survey was developed to obtain patient feedback on telehealth. Patients attending medical oncology clinics at St George Hospital and Sutherland Hospital from April 1, 2020, to May 31, 2020, were identified. Patients who were reviewed via phone or videoconference were included in this study. Eligible patients were texted or emailed a survey link within a week of their telehealth consultation. Surveys were anonymous and completion of the survey implied informed consent. Patients who did not have a mobile number or e-mail were excluded from this study. RESULTS One thousand fifty-nine patients were reviewed during the study period, of whom 644 (60%) were reviewed via telehealth. The survey response rate was 36.3% (230 patients responded of 634 surveys sent). Ten telehealth patients did not have a mobile number or email and were excluded. Sixty-seven percent of telehealth consults were for active surveillance, 31% for prechemotherapy/treatment reviews, 1.6% for best supportive care, and 0.5% for new consults. Seventy percent of patients were satisfied that their medical needs were met via telehealth. Ninety percent wanted another telehealth consult, and 73% wanted telehealth to continue post resolution of the pandemic. Minimizing risk of exposure to COVID-19 and patient convenience were identified as key strengths of telehealth while absence of physical examination was the main disadvantage. CONCLUSION Majority of the patients surveyed were satisfied that telehealth safely met their medical needs. There is a considerable demand for telehealth to continue beyond the pandemic.
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Affiliation(s)
- Arnav Nanda
- Department of Medical Oncology, St George Hospital, Sydney, Australia
- Western Cancer Centre, Dubbo Base Hospital, Dubbo, Australia
| | - Lyn Ley Lam
- Department of Medical Oncology, St George Hospital, Sydney, Australia
| | - Jodi Lynch
- Department of Medical Oncology, St George Hospital, Sydney, Australia
| | - Hussein Soudy
- Department of Medical Oncology, St George Hospital, Sydney, Australia
- Department of Medical Oncology, Sutherland Hospital, Caringbah, Australia
- Faculty of Medicine, Cairo University, Cairo, Egypt
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Marincowitz C, Stone T, Bath P, Campbell R, Turner JK, Hasan M, Pilbery R, Thomas BD, Sutton L, Bell F, Biggs K, Hopfgartner F, Mazumdar S, Petrie J, Goodacre S. Accuracy of telephone triage for predicting adverse outcomes in suspected COVID-19: an observational cohort study. BMJ Qual Saf 2024; 33:375-385. [PMID: 35354665 PMCID: PMC8983415 DOI: 10.1136/bmjqs-2021-014382] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Accepted: 03/04/2022] [Indexed: 12/24/2022]
Abstract
OBJECTIVE To assess accuracy of telephone triage in identifying need for emergency care among those with suspected COVID-19 infection and identify factors which affect triage accuracy. DESIGN Observational cohort study. SETTING Community telephone triage provided in the UK by Yorkshire Ambulance Service NHS Trust (YAS). PARTICIPANTS 40 261 adults who contacted National Health Service (NHS) 111 telephone triage services provided by YAS between 18 March 2020 and 29 June 2020 with symptoms indicating COVID-19 infection were linked to Office for National Statistics death registrations and healthcare data collected by NHS Digital. OUTCOME Accuracy of triage disposition was assessed in terms of death or need for organ support up to 30 days from first contact. RESULTS Callers had a 3% (1200/40 261) risk of serious adverse outcomes (death or organ support). Telephone triage recommended self-care or non-urgent assessment for 60% (24 335/40 261), with a 1.3% (310/24 335) risk of adverse outcomes. Telephone triage had 74.2% sensitivity (95% CI: 71.6 to 76.6%) and 61.5% specificity (95% CI: 61% to 62%) for the primary outcome. Multivariable analysis suggested respiratory comorbidities may be overappreciated, and diabetes underappreciated as predictors of deterioration. Repeat contact with triage service appears to be an important under-recognised predictor of deterioration with 2 contacts (OR 1.77, 95% CI: 1.14 to 2.75) and 3 or more contacts (OR 4.02, 95% CI: 1.68 to 9.65) associated with false negative triage. CONCLUSION Patients advised to self-care or receive non-urgent clinical assessment had a small but non-negligible risk of serious clinical deterioration. Repeat contact with telephone services needs recognition as an important predictor of subsequent adverse outcomes.
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Affiliation(s)
- Carl Marincowitz
- Centre for Urgent and Emergency Care Research (CURE), Health Services Research School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
| | - Tony Stone
- Centre for Urgent and Emergency Care Research (CURE), Health Services Research School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
| | - Peter Bath
- Centre for Urgent and Emergency Care Research (CURE), Health Services Research School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
- Centre for Health Information Management Research (CHIMR) and Health Informatics Research Group, Information School, University of Sheffield, Sheffield, UK
| | - Richard Campbell
- Centre for Urgent and Emergency Care Research (CURE), Health Services Research School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
| | - Janette Kay Turner
- Centre for Urgent and Emergency Care Research (CURE), Health Services Research School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
| | - Madina Hasan
- Centre for Urgent and Emergency Care Research (CURE), Health Services Research School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
| | | | - Benjamin David Thomas
- Clinical Trials Research Unit (CTRU), Health Services Research School of Health and Related Research (ScHARR), The University of Sheffield, Sheffield, UK
| | - Laura Sutton
- Clinical Trials Research Unit (CTRU), Health Services Research School of Health and Related Research (ScHARR), The University of Sheffield, Sheffield, UK
| | - Fiona Bell
- Yorkshire Ambulance Service NHS Trust, Wakefield, UK
| | - Katie Biggs
- Clinical Trials Research Unit (CTRU), Health Services Research School of Health and Related Research (ScHARR), The University of Sheffield, Sheffield, UK
| | - Frank Hopfgartner
- Centre for Health Information Management Research (CHIMR) and Health Informatics Research Group, Information School, University of Sheffield, Sheffield, UK
| | - Suvodeep Mazumdar
- Centre for Health Information Management Research (CHIMR) and Health Informatics Research Group, Information School, University of Sheffield, Sheffield, UK
| | - Jennifer Petrie
- Clinical Trials Research Unit (CTRU), Health Services Research School of Health and Related Research (ScHARR), The University of Sheffield, Sheffield, UK
| | - Steve Goodacre
- Centre for Urgent and Emergency Care Research (CURE), Health Services Research School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
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Niżnik Ł, Toporowska-Kaźmierak J, Jabłońska K, Głąb N, Stach S, Florek J, Sowińska M, Adamczyk A, Jurowski K. Toxicovigilance 2.0 - modern approaches for the hazard identification and risk assessment of toxicants in human beings: A review. Toxicology 2024; 503:153755. [PMID: 38367941 DOI: 10.1016/j.tox.2024.153755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Revised: 02/01/2024] [Accepted: 02/12/2024] [Indexed: 02/19/2024]
Abstract
The attempt to define toxicovigilance can be based on defining its fundamental principles: prevention of infections with toxic substances, collecting information on poisonings, both in terms of their sources and side effects, and confirming poisonings, with the aim of improving treatment. Substances referred to include both those originating from animal bites, ingested inadvertently, and those resulting from environmental poisoning in industrial regions of countries, etc. In this review, we provide information about the crucial function of poison control centres in toxicovigilance, the importance of incorporating big data analytics and artificial intelligence to streamline toxicovigilance processes, and examples of toxicovigilance in different countries. In conclusion, we will present the direction that modern toxicovigilance should take, incorporating available artificial intelligence methods to maximise efficiency.
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Affiliation(s)
- Łukasz Niżnik
- Department of Regulatory and Forensic Toxicology, Institute of Medical Expertise, Łódź, ul. Aleksandrowska 67/93, Łódź 91-205, Poland; Toxicological Science Club 'Paracelsus', Institute of Medical Studies, Medical College, Rzeszów University, Al. mjr. W. Kopisto 2a, Rzeszów 35-959, Poland
| | - Joanna Toporowska-Kaźmierak
- Toxicological Science Club 'Paracelsus', Institute of Medical Studies, Medical College, Rzeszów University, Al. mjr. W. Kopisto 2a, Rzeszów 35-959, Poland
| | - Karolina Jabłońska
- Toxicological Science Club 'Paracelsus', Institute of Medical Studies, Medical College, Rzeszów University, Al. mjr. W. Kopisto 2a, Rzeszów 35-959, Poland
| | - Natalia Głąb
- Toxicological Science Club 'Paracelsus', Institute of Medical Studies, Medical College, Rzeszów University, Al. mjr. W. Kopisto 2a, Rzeszów 35-959, Poland
| | - Sabina Stach
- Toxicological Science Club 'Paracelsus', Institute of Medical Studies, Medical College, Rzeszów University, Al. mjr. W. Kopisto 2a, Rzeszów 35-959, Poland
| | - Julia Florek
- Toxicological Science Club 'Paracelsus', Institute of Medical Studies, Medical College, Rzeszów University, Al. mjr. W. Kopisto 2a, Rzeszów 35-959, Poland
| | - Marta Sowińska
- Toxicological Science Club 'Paracelsus', Institute of Medical Studies, Medical College, Rzeszów University, Al. mjr. W. Kopisto 2a, Rzeszów 35-959, Poland
| | - Aleksandra Adamczyk
- Toxicological Science Club 'Paracelsus', Institute of Medical Studies, Medical College, Rzeszów University, Al. mjr. W. Kopisto 2a, Rzeszów 35-959, Poland
| | - Kamil Jurowski
- Department of Regulatory and Forensic Toxicology, Institute of Medical Expertise, Łódź, ul. Aleksandrowska 67/93, Łódź 91-205, Poland; Laboratory of Innovative Toxicological Research and Analyses, Institute of Medical Studies, Medical College, Rzeszów University, Al. mjr. W. Kopisto 2a, Rzeszów 35-959, Poland.
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Safikhani M, Rezaieyazdi Z, Khodashahi M. Evaluation of assessable telemedicine in patients with rheumatoid arthritis: A systematic review. Int J Rheum Dis 2024; 27:e15007. [PMID: 38287561 DOI: 10.1111/1756-185x.15007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 10/08/2023] [Accepted: 11/29/2023] [Indexed: 01/31/2024]
Abstract
OBJECTIVE Nowadays, the use of telemedicine diagnosis and treatment of various diseases has been considered by physicians, especially in such diseases as rheumatoid arthritis (RA), where patients have more weakness and inability to move. This systematic review aimed to evaluate the extent of measurable and nonmeasurable factors in patients with RA and their satisfaction with this method of care. METHODS The articles published by March 3, 2022, were searched in four databases, including Web of Sciences, Medline, PubMed, and Scopus. This research was conducted using the seven steps of the Cochrane Handbook as a guide. The searched keywords included telemedicine, tele-rheumatoid, rheumatoid arthritis, and immune diseases. RESULTS A total of 18 articles were included in the present study. In most of these studies, physicians and patients were satisfied with this approach. Nonetheless, there was a dearth of studies on the measurement of evaluable and nonevaluable factors. CONCLUSION Studies on the benefits of telemedicine for rheumatology are still limited. The effectiveness of this new healthcare approach in diagnosing and evaluating disease activity is still unclear. Some studies demonstrated patient and physician satisfaction with this treatment. In some cases, there is a tendency to show a high risk of bias. In addition, it is unclear to what extent the use of rheumatology traps affects the establishment of medical relationships. It is recommended that more clinical trials be conducted to examine this relationship.
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Affiliation(s)
- Morteza Safikhani
- Rheumatic Diseases Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Zahra Rezaieyazdi
- Rheumatic Diseases Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mandana Khodashahi
- Rheumatic Diseases Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
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Rine S, Lara ST, Bikomeye JC, Beltrán-Ponce S, Kibudde S, Niyonzima N, Lawal OO, Mulamira P, Beyer KMM. The impact of the COVID-19 pandemic on cancer care including innovations implemented in Sub-Saharan Africa: A systematic review. J Glob Health 2023; 13:06048. [PMID: 37976409 PMCID: PMC10656081 DOI: 10.7189/jogh.13.06048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2023] Open
Abstract
Background The coronavirus 2019 (COVID-19) pandemic has caused disruptions in the delivery and utilisation of cancer services. The impact of these interruptions is disproportionately borne by low- and middle-income countries in Sub-Saharan Africa (SSA). There are speculations of increased late-stage presentation and mortality as services are returning to the pre-pandemic state. This review aims to explore the extent to which the COVID-19 pandemic impacted cancer services across SSA and to identify innovations implemented across SSA to mitigate the impacts. Methods Using database-specific search strategies, a systematic literature search was conducted in PubMed, Ovid (MedLine), Web of Science, and African Index Medicus. Eligible studies included original research, reports, perspectives and summaries of national or regional outcomes published in the English language. The primary outcome was changes in the delivery and utilisation of cancer prevention and screening, diagnosis, treatment and follow-up services. The secondary outcome was to identify implemented innovations to mitigate the impact of the pandemic on service delivery. Results Out of the 167 articles identified in the literature search, 46 were included in the synthesis. A majority (95.7%) of the included articles described suspension and/or delay of screening, diagnosis, and treatment services, although two studies (4.3%) described the continuation of services despite the lockdown. Care was additionally impacted by transportation limitations, shortages of staff and personal protective equipment, disruption of the medication supply chain and patients' fears and stigma associated with contracting COVID-19. A major innovation was the use of telemedicine and virtual platforms for patient consultation and follow-up during the pandemic in SSA. Furthermore, drones and mobile applications were used for sample collection, medication delivery and scheduling of treatment. In some instances, medication routes and treatment protocols were changed. Conclusions The delivery and utilisation of cancer services decreased substantially during the pandemic. Cancer centres initiated innovative methods of care delivery, including telehealth and drone use, with long-term potential to mitigate the impact of the pandemic on service delivery. Cancer centres in SSA must explore sustainable, facility or country-specific innovations as services return to the pre-pandemic state. Registration The review was registered in PROSPERO with registration number CRD42022351455.
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Affiliation(s)
- Sarah Rine
- Division of Epidemiology & Social Sciences, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Shana T Lara
- Division of Epidemiology & Social Sciences, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Jean C Bikomeye
- Division of Epidemiology & Social Sciences, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Sara Beltrán-Ponce
- Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | | | | | - Olatunji O Lawal
- Department of Obstetrics and Gynecology, University College Hospital, Ibadan, Nigeria
| | | | - Kirsten MM Beyer
- Division of Epidemiology & Social Sciences, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
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Sturt J, Griffiths F, Ajisola M, Akinyemi JO, Chipwaza B, Fayehun O, Harris B, Owoaje E, Rogers R, Pemba S, Watson SI, Omigbodun A. Safety and upscaling of remote consulting for long-term conditions in primary health care in Nigeria and Tanzania (REaCH trials): stepped-wedge trials of training, mobile data allowance, and implementation. Lancet Glob Health 2023; 11:e1753-e1764. [PMID: 37858586 DOI: 10.1016/s2214-109x(23)00411-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 08/15/2023] [Accepted: 08/21/2023] [Indexed: 10/21/2023]
Abstract
BACKGROUND In-person health care poses risks to health workers and patients during pandemics. Remote consultations can mitigate these risks. The REaCH intervention comprised training and mobile data allowance provision for mobile phones to support remotely delivered primary care in Africa compared with no training and mobile data allowance. The aim of this study was to estimate the effects of REaCH among adults with non-communicable diseases on remote and face-to-face consultation rates, patient safety, and trustworthiness of consultations. METHODS In these two independent stepped-wedge cluster randomised controlled trials, we enrolled 20 primary care clusters in each of two settings (Oyo State, Nigeria, and Morogoro Region, Tanzania). Eligible clusters had 100 or more patients with diabetes, hypertension, and cardiovascular or pulmonary disease employing five health workers. Clusters were computer-randomised to one of ten (Nigeria) or one of seven (Tanzania) sequences to receive the REaCH intervention. Only outcome assessors were masked. Primary outcomes were consultation, prescription, and investigation rates, and trustworthiness collected monthly for 12 months (Nigeria) and 9 months (Tanzania) from open cohorts. Ten randomly sampled consulting patients per cluster-month completed patient reported outcome measures. This trial was registered with ISRCTN, ISRCTN17941313. FINDINGS Overall, 40 clusters comprising 8776 (Nigeria) and 3246 (Tanzania) patients' open cohort data were analysed (6377 [72·7%] of 8776 females in Nigeria, and 2235 [68·9%] of 3246 females in Tanzania). The mean age of the participants was 55·3 years (SD 13·9) in Nigeria and 59·2 years (14·2) in Tanzania. In Nigeria, no evidence of change in face-to-face consulting rate was observed (rate ratio [RR] 1·06, 95% CI 0·98 to 1·09; p=0·16); however, remote consultations increased four-fold (4·44, 1·34 to >10; p=0·01). In Tanzania, face-to-face (0·94, 0·61 to 1·67; p=0·99) and remote consulting rates (1·17, 0·56 to 5·57; p=0·39) were unchanged. There was no evidence of difference in prescribing rates (Nigeria: 1·05, 0·60 to 1·14; p=0·23; Tanzania: 0·92, 0·60 to 1·67; p=0·97), investigation rates (Nigeria: 1·06, 0·23 to 2·12; p=0·49; Tanzania: 1·15, 0·35 to 1·64; 0·58) or trustworthiness scores (Nigeria: mean difference 0·05, 95% CI -0·45 to 0·42; p=0·89; Tanzania: 0·07, -0·15 to 0·76; p=0·70). INTERPRETATION REaCH can be implemented and could improve intervention versus control health-care access. Remote consultations appear safe and trustworthy, supporting universal health coverage. FUNDING The UK Research and Innovation Collective Fund. TRANSLATIONS For the Swahili and Yoruba translations of the abstract see Supplementary Materials section.
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Affiliation(s)
- Jackie Sturt
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, London, UK.
| | - Frances Griffiths
- Warwick Medical School, University of Warwick, Coventry, UK; Centre for Health Policy, University of the Witwatersrand, Johannesburg, South Africa
| | | | - Joshua Odunayo Akinyemi
- College of Medicine, University of Ibadan Nigeria, Ibadan, Nigeria; Department of Epidemiology and Medical Statistics, University of Ibadan Nigeria, Ibadan, Nigeria
| | - Beatrice Chipwaza
- School of Medicine, St Francis University College of Health and Allied Sciences, Ifakara, Tanzania
| | - Olufunke Fayehun
- Department of Sociology, University of Ibadan Nigeria, Ibadan, Nigeria
| | - Bronwyn Harris
- Warwick Medical School, University of Warwick, Coventry, UK
| | - Eme Owoaje
- Department of Community Medicine, University of Ibadan Nigeria, Ibadan, Nigeria
| | - Rebecca Rogers
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, London, UK
| | - Senga Pemba
- School of Medicine, St Francis University College of Health and Allied Sciences, Ifakara, Tanzania
| | - Samuel I Watson
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
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Anto-Ocrah M, Asiedu M, Rao S, DeSplinter L, Hollenbach S. If you build it, they will come…or not. Considerations for women's health in the post-pandemic era of digital innovation. Front Public Health 2023; 11:1228212. [PMID: 37900016 PMCID: PMC10606549 DOI: 10.3389/fpubh.2023.1228212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 09/25/2023] [Indexed: 10/31/2023] Open
Affiliation(s)
- Martina Anto-Ocrah
- Department of Medicine, Division of General Internal Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States
| | - Mercy Asiedu
- Google, Mountain View, CA, United States
- Massachusetts Institute of Technology, Cambridge, MA, United States
| | - Simrun Rao
- University of Rochester, Rochester, NY, United States
| | | | - Stefanie Hollenbach
- Department of ObGyn, School of Medicine and Dentistry, University of Rochester, Rochester, NY, United States
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Ndejjo R, Kabwama SN, Namale A, Tusubira AK, Wanyana I, Kizito S, Kiwanuka SN, Wanyenze RK. Harnessing digital technology for COVID-19 response in Uganda: lessons and implications for future public health emergencies. BMJ Glob Health 2023; 8:e013288. [PMID: 37793838 PMCID: PMC10551983 DOI: 10.1136/bmjgh-2023-013288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 09/14/2023] [Indexed: 10/06/2023] Open
Abstract
COVID-19 was one of the greatest disruptors of the 21st century, causing significant morbidity and mortality globally. Countries around the world adopted digital technologies and innovations to support the containment of the pandemic. This study explored the use of digital technology and barriers to its utilisation in responding to COVID-19 and sustaining essential health services in Uganda to inform response to future public health emergencies in low-resource settings. We reviewed published and grey literature on the use of digital technology in Uganda's response from March 2020 to April 2021 and conducted interviews with key informants. We thematically synthesised and summarised information on digital technology use as well as related challenges. During the COVID-19 response, digital technology was used in testing, contact tracing and surveillance, risk communication, supportive supervision and training, and maintenance of essential health services. The challenges with technology use were the disparate digital tools and health information systems leading to duplication of effort; limited access and coverage of digital tools, poor data quality; inaccessibility of data and an inability to support data manipulation, analysis and visualisation. Moreover, the inherent inadequate technology support systems such as poor internet and electricity infrastructure in some areas posed challenges of inequity. The harnessing of technology was key in supporting the COVID-19 response in Uganda. However, gaps existed in access, adoption, harmonisation, evaluation, sustainability and scale up of technology options. These issues should be addressed in preparedness efforts to foster technology adoption and application in public health emergencies with a focus on equity.
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Affiliation(s)
- Rawlance Ndejjo
- Department of Disease Control and Environmental Health, School of Public Health, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Steven Ndugwa Kabwama
- Department of Community Health and Behavioural Sciences, School of Public Health, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Alice Namale
- Department of Disease Control and Environmental Health, School of Public Health, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Andrew K Tusubira
- Department of Community Health and Behavioural Sciences, School of Public Health, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Irene Wanyana
- Department of Epidemiology and Biostatistics, School of Public Health, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Susan Kizito
- Department of Disease Control and Environmental Health, School of Public Health, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Suzanne N Kiwanuka
- Department of Health Policy, Planning and Management, School of Public Health, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Rhoda K Wanyenze
- Department of Disease Control and Environmental Health, School of Public Health, College of Health Sciences, Makerere University, Kampala, Uganda
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Murewanhema G, Mpabuka E, Moyo E, Tungwarara N, Chitungo I, Mataruka K, Gwanzura C, Musuka G, Dzinamarira T. Accessibility and utilization of antenatal care services in sub-Saharan Africa during the COVID-19 pandemic: A rapid review. Birth 2023; 50:496-503. [PMID: 36877622 DOI: 10.1111/birt.12719] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Revised: 02/03/2023] [Accepted: 02/08/2023] [Indexed: 03/07/2023]
Abstract
Control measures for the COVID-19 pandemic brought unprecedented challenges to health care delivery. Some countries in sub-Saharan Africa (SSA) stopped the provision of essential health care except for those services that were deemed emergencies or life-threatening. A rapid review was conducted on March 18, 2022, on the accessibility and utilization of antenatal care services in sub-Saharan Africa during the COVID-19 pandemic. PubMed, Google Scholar, SCOPUS, and the World Health Organization library databases were searched for relevant studies. A modified Population, Intervention, Control, and Outcomes (PICO) framework informed the development of the search strategy. The review included studies conducted within Africa that described the availability, access, and utilization of antenatal services during the COVID-19 pandemic. Eighteen studies met the inclusion criteria. This review revealed a reduction in access to ANC services, an increase in the number of home deliveries, and a reduction in the number of women attending ANC visits during the COVID-19 pandemic. A decrease in ANC service utilization was reported in some studies in the review. Barriers to ANC access and utilization during the COVID-19 pandemic included movement restrictions, limited transport access, fear of contracting COVID-19 at the health facilities, and facility barriers. The use of telemedicine needs to be improved in African countries to allow for the continued provision of health services during pandemics. In addition, there should strengthening of community involvement in the provision of maternal health services post-COVID-19 so that services may be able to better withstand future public health emergencies.
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Affiliation(s)
- Grant Murewanhema
- Unit of Obstetrics and Gynaecology, Department of Primary Health Care Sciences, Faculty of Medicine and Health Sciences, University of Zimbabwe, Harare, Zimbabwe
| | | | - Enos Moyo
- Medical Centre Oshakati, Oshakati, Namibia
| | - Nigel Tungwarara
- Department of Health Studies, University of South Africa, Pretoria, South Africa
| | - Itai Chitungo
- Chemical Pathology Unit, Department of Laboratory Diagnostic and Investigative Sciences, Faculty of Medicine and Health Sciences, University of Zimbabwe, Harare, Zimbabwe
| | - Kidson Mataruka
- Biomedical Research and Training Institute, Harare, Zimbabwe
| | - Chipo Gwanzura
- Unit of Obstetrics and Gynaecology, Department of Primary Health Care Sciences, Faculty of Medicine and Health Sciences, University of Zimbabwe, Harare, Zimbabwe
| | | | - Tafadzwa Dzinamarira
- ICAP at Columbia University, Kigali, Rwanda
- ICAP at Columbia University, Harare, Zimbabwe
- School of Health Systems & Public Health, University of Pretoria, Pretoria, South Africa
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Belachew EA, Getachew D, Netere AK, Gizachew E, Sendekie AK. Perception, willingness, and practices of telemedicine in patients with chronic diseases: implication of digital health in patients' perspective at a tertiary care hospital in Ethiopia. Front Public Health 2023; 11:1234436. [PMID: 37608985 PMCID: PMC10440689 DOI: 10.3389/fpubh.2023.1234436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2023] [Accepted: 07/24/2023] [Indexed: 08/24/2023] Open
Abstract
Background Technology-based healthcare services have important implications for the diagnosis, prevention, and treatment of diseases, as well as providing access to high-quality care that both the patient and the healthcare practitioner can benefit from. To access medical information, patients have also searched for methods of technology-based healthcare services like telemedicine (TM). However, little is known regarding the perceptions, willingness, and practices of TM among Ethiopian patients, especially in the study setting. Objective This study assessed the perceptions, willingness, and practice of TM among patients with chronic disease at the University of Gondar Comprehensive Specialized Hospital (UoGCSH), Northwest Ethiopia. Methods A cross-sectional study was conducted from June 1 to July 30, 2022, among patients with chronic diseases who were on follow-up at the UoGCSH. Eligible participants were included in the study using a systematic random sampling technique. A structured questionnaire was used and recorded in the Kobo data collection tool. The collected data were managed and analyzed using the Statistical Package for Social Science (SPSS) version 26. Results Out of 422 patients approached, 384 (91% response rate) were included in the final analysis. The mean (±SD) age of the participants was 48.07 ± 16.17 years. The overall perceptions mean (±SD) score of the respondents was 3.92 ± 1.06. Generally, near to three-fourths (71.1%) of the participants had a positive perception of TM services, and around two-thirds (63.3%) had a willingness to be involved in the TM service. However, only around one-fourth (24.5%) of the participants were perceived to have a high level of TM practice currently. Conclusion The findings suggest that although the level of perception and willingness of TM services among patients with chronic diseases was positive, their level of practice was low. Therefore, creating awareness and suitable conditions to improve their utilization of TM could be important.
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Affiliation(s)
- Eyayaw Ashete Belachew
- Department of Clinical Pharmacy, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Demis Getachew
- Department of Pharmacology, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Adeladlew Kassie Netere
- Department of Clinical Pharmacy, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Eshetie Gizachew
- Department of Information System, College of Informatics, University of Gondar, Gondar, Ethiopia
| | - Ashenafi Kibret Sendekie
- Department of Clinical Pharmacy, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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11
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Rahim FO, Jain B, Bloomfield GS, Jain P, Rugakingira A, Thielman NM, Sakita F, Hertz JT. A holistic framework to integrate HIV and cardiovascular disease care in sub-Saharan Africa. AIDS 2023; 37:1497-1502. [PMID: 37199570 DOI: 10.1097/qad.0000000000003604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/19/2023]
Affiliation(s)
- Faraan O Rahim
- Duke Global Health Institute, Duke University, Durham, North Carolina
| | - Bhav Jain
- Massachusetts Institute of Technology, Cambridge, Massachusetts
- Stanford University School of Medicine, Stanford, California
| | - Gerald S Bloomfield
- Duke Global Health Institute, Duke University, Durham, North Carolina
- Department of Internal Medicine, Duke University School of Medicine, Durham, North Carolina
| | - Pankaj Jain
- Highmark Health, Pittsburgh
- Indiana University of Pennsylvania, Indiana, Pennsylvania, USA
| | | | - Nathan M Thielman
- Duke Global Health Institute, Duke University, Durham, North Carolina
- Stanford University School of Medicine, Stanford, California
| | - Francis Sakita
- Kilimanjaro Christian Medical Centre
- Kilimanjaro Christian Medical University College, Moshi, Tanzania
| | - Julian T Hertz
- Duke Global Health Institute, Duke University, Durham, North Carolina
- Department of Emergency Medicine, Duke University School of Medicine, Durham, North Carolina, USA
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12
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Kiguli-Malwadde E, Forster M, Eliaz A, Celentano J, Chilembe E, Couper ID, Dassah ET, De Villiers MR, Gachuno O, Haruzivishe C, Khanyola J, Martin S, Motlhatlhedi K, Mubuuke R, Mteta KA, Moabi P, Rodrigues A, Sears D, Semitala F, von Zinkernagel D, Reid MJA, Suleman F. Comparing in-person, blended and virtual training interventions; a real-world evaluation of HIV capacity building programs in 16 countries in sub-Saharan Africa. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0001654. [PMID: 37486898 PMCID: PMC10365303 DOI: 10.1371/journal.pgph.0001654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Accepted: 06/05/2023] [Indexed: 07/26/2023]
Abstract
We sought to evaluate the impact of transitioning a multi-country HIV training program from in-person to online by comparing digital training approaches implemented during the pandemic with in-person approaches employed before COVID-19. We evaluated mean changes in pre-and post-course knowledge scores and self-reported confidence scores for learners who participated in (1) in-person workshops (between October 2019 and March 2020), (2) entirely asynchronous, Virtual Workshops [VW] (between May 2021 and January 2022), and (3) a blended Online Course [OC] (between May 2021 and January 2022) across 16 SSA countries. Learning objectives and evaluation tools were the same for all three groups. Across 16 SSA countries, 3023 participants enrolled in the in-person course, 2193 learners participated in the virtual workshop, and 527 in the online course. The proportions of women who participated in the VW and OC were greater than the proportion who participated in the in-person course (60.1% and 63.6%, p<0.001). Nursing and midwives constituted the largest learner group overall (1145 [37.9%] vs. 949 [43.3%] vs. 107 [20.5%]). Across all domains of HIV knowledge and self-perceived confidence, there was a mean increase between pre- and post-course assessments, regardless of how training was delivered. The greatest percent increase in knowledge scores was among those participating in the in-person course compared to VW or OC formats (13.6% increase vs. 6.0% and 7.6%, p<0.001). Gains in self-reported confidence were greater among learners who participated in the in-person course compared to VW or OC formats, regardless of training level (p<0.001) or professional cadre (p<0.001). In this multi-country capacity HIV training program, in-person, online synchronous, and blended synchronous/asynchronous strategies were effective means of training learners from diverse clinical settings. Online learning approaches facilitated participation from more women and more diverse cadres. However, gains in knowledge and clinical confidence were greater among those participating in in-person learning programs.
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Affiliation(s)
- E Kiguli-Malwadde
- African Center for Global Health and Social Transformation, Kampala, Uganda
| | - M Forster
- Institute for Global Health Sciences, University of California, San Francisco, California, United States of America
| | - A Eliaz
- Department of Medicine, Stanford University School of Medicine, Stanford, California, United States of America
| | - J Celentano
- Institute for Global Health Sciences, University of California, San Francisco, California, United States of America
| | - E Chilembe
- Kamuzu College of Nursing, University of Malawi, Kamuzu, Malawi
| | - I D Couper
- Department of Global Health, Ukwanda Centre for Rural Health, Stellenbosch University, Stellenbosch, South Africa
| | - E T Dassah
- School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - M R De Villiers
- Department of Global Health, Ukwanda Centre for Rural Health, Stellenbosch University, Stellenbosch, South Africa
| | - O Gachuno
- Faculty of Medicine, Department of Obstetrics and Gynecology, University of Nairobi, Nairobi, Kenya
| | - C Haruzivishe
- Faculty of Health Sciences, University of Zimbabwe College of Health Sciences, Harare, Zimbabwe
| | - J Khanyola
- University of Global Health Equity, Kigali, Rwanda
| | - S Martin
- Institute for Global Health Sciences, University of California, San Francisco, California, United States of America
| | - K Motlhatlhedi
- Faculty of Medicine, Department of Family Medicine and Public Health, University of Botswana, Botswana
| | - R Mubuuke
- School of Medicine, Makerere University, Kampala, Uganda
| | - K A Mteta
- Kilimanjaro Christian Medical University College, Kilimanjaro, Tanzania
| | - P Moabi
- Scott College of Nursing, Morija, Lesotho
| | - A Rodrigues
- Faculty of Medicine, Eduardo Mondlane University, Maputo, Mozambique
| | - D Sears
- Department of Medicine, Division of Infectious Diseases, University of California, San Francisco, California, United States of America
| | - F Semitala
- Faculty of Medicine, Department of Family Medicine and Public Health, University of Botswana, Botswana
| | - D von Zinkernagel
- Institute for Global Health Sciences, University of California, San Francisco, California, United States of America
| | - M J A Reid
- Institute for Global Health Sciences, University of California, San Francisco, California, United States of America
- Department of Medicine, Division of Infectious Diseases, University of California, San Francisco, California, United States of America
| | - F Suleman
- School of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
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Feldacker C, Pienaar J, Wasunna B, Ndebele F, Khumalo C, Day S, Tweya H, Oni F, Sardini M, Adhikary B, Waweru E, Wafula MB, Dixon A, Jafa K, Su Y, Sherr K, Setswe G. Expanding the Evidence on the Safety and Efficiency of 2-Way Text Messaging-Based Telehealth for Voluntary Medical Male Circumcision Follow-up Compared With In-Person Reviews: Randomized Controlled Trial in Rural and Urban South Africa. J Med Internet Res 2023; 25:e42111. [PMID: 37159245 DOI: 10.2196/42111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 12/22/2022] [Accepted: 02/24/2023] [Indexed: 05/10/2023] Open
Abstract
BACKGROUND There is a dearth of high-quality evidence from digital health interventions in routine program settings in low- and middle-income countries. We previously conducted a randomized controlled trial (RCT) in Zimbabwe, demonstrating that 2-way texting (2wT) was safe and effective for follow-up after adult voluntary medical male circumcision (VMMC). OBJECTIVE To demonstrate the replicability of 2wT, we conducted a larger RCT in both urban and rural VMMC settings in South Africa to determine whether 2wT improves adverse event (AE) ascertainment and, therefore, the quality of follow-up after VMMC while reducing health care workers' workload. METHODS A prospective, unblinded, noninferiority RCT was conducted among adult participants who underwent VMMC with cell phones randomized in a 1:1 ratio between 2wT and control (routine care) in North West and Gauteng provinces. The 2wT participants responded to a daily SMS text message with in-person follow-up only if desired or an AE was suspected. The control group was requested to make in-person visits on postoperative days 2 and 7 as per national VMMC guidelines. All participants were asked to return on postoperative day 14 for study-specific review. Safety (cumulative AEs ≤day 14 visit) and workload (number of in-person follow-up visits) were compared. Differences in cumulative AEs were calculated between groups. Noninferiority was prespecified with a margin of -0.25%. The Manning score method was used to calculate 95% CIs. RESULTS The study was conducted between June 7, 2021, and February 21, 2022. In total, 1084 men were enrolled (2wT: n=547, 50.5%, control: n=537, 49.5%), with near-equal proportions of rural and urban participants. Cumulative AEs were identified in 2.3% (95% CI 1.3-4.1) of 2wT participants and 1.0% (95% CI 0.4-2.3) of control participants, demonstrating noninferiority (1-sided 95% CI -0.09 to ∞). Among the 2wT participants, 11 AEs (9 moderate and 2 severe) were identified, compared with 5 AEs (all moderate) among the control participants-a nonsignificant difference in AE rates (P=.13). The 2wT participants attended 0.22 visits, and the control participants attended 1.34 visits-a significant reduction in follow-up visit workload (P<.001). The 2wT approach reduced unnecessary postoperative visits by 84.8%. Daily response rates ranged from 86% on day 3 to 74% on day 13. Among the 2wT participants, 94% (514/547) responded to ≥1 daily SMS text messages over 13 days. CONCLUSIONS Across rural and urban contexts in South Africa, 2wT was noninferior to routine in-person visits for AE ascertainment, demonstrating 2wT safety. The 2wT approach also significantly reduced the follow-up visit workload, improving efficiency. These results strongly suggest that 2wT provides quality VMMC follow-up and should be adopted at scale. Adaptation of the 2wT telehealth approach to other acute follow-up care contexts could extend these gains beyond VMMC. TRIAL REGISTRATION ClinicalTrials.gov NCT04327271; https://www.clinicaltrials.gov/ct2/show/NCT04327271.
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Affiliation(s)
- Caryl Feldacker
- Department of Global Health, University of Washington, Seattle, WA, United States
- International Training and Education Center for Health, Department of Global Health, University of Washington, Seattle, WA, United States
| | | | | | | | | | - Sarah Day
- Centre for HIV-AIDS Prevention Studies (CHAPS), Johannesburg, South Africa
- Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Hannock Tweya
- Department of Global Health, University of Washington, Seattle, WA, United States
| | | | | | | | | | | | | | | | - Yanfang Su
- Department of Global Health, University of Washington, Seattle, WA, United States
| | - Kenneth Sherr
- Department of Global Health, University of Washington, Seattle, WA, United States
| | - Geoffrey Setswe
- Aurum Institute, Johannesburg, South Africa
- Department of Health Studies, University of South Africa (UNISA), Pretoria, South Africa
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Arenas Gaitán J, Ramírez Correa PE. COVID-19 and telemedicine: A netnography approach. TECHNOLOGICAL FORECASTING AND SOCIAL CHANGE 2023; 190:122420. [PMID: 36816867 PMCID: PMC9928743 DOI: 10.1016/j.techfore.2023.122420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 11/03/2022] [Accepted: 12/19/2022] [Indexed: 06/18/2023]
Abstract
The COVID-19 pandemic has consolidated some trends that already existed in our society. Perhaps one of the most visible is the transformation of society towards greater digitisation. Digitalisation has gained weight in all aspects of our lives, and from the point of view of the health system we find an example in the slow historical adoption of telemedicine, which contrasts sharply with the massive conversion to this technology as a tool for social distancing. In this sense, the homebound population is the one most affected by the pandemic and the one that could benefit the most from the use of telemedicine. Using a netnography approach and based on the stimulus-organism-response paradigm, this study proposes to analyse the evolution of perception about telemedicine using the opinions expressed on Twitter. The primary technical tasks of the study incorporate the analysis of topics and the review of emotions and positive image perception using natural language processing. Specifically, tweets about telemedicine generated by the Spanish community are analysed in this work. The findings show that the COVID-19 pandemic has affected emotions and topics of interest related to telemedicine. This has changed the image that it had and the behaviour of the Twitter community in Spain. In conclusion, the study results suggest that changes in health systems affect people's emotions and behaviours.
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15
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Rosenlund M, Kinnunen UM, Saranto K. The Use of Digital Health Services Among Patients and Citizens Living at Home: Scoping Review. J Med Internet Res 2023; 25:e44711. [PMID: 36972122 PMCID: PMC10131924 DOI: 10.2196/44711] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 01/31/2023] [Accepted: 03/07/2023] [Indexed: 03/29/2023] Open
Abstract
BACKGROUND The development of digital health services reflects not only the technical development of services but also a change in attitude and the way of thinking. It has become a cornerstone for engaging and activating patients and citizens in health management while living at home. Digital health services are also aimed at enhancing the efficiency and quality of services, while simultaneously providing services more cost-effectively. In 2020, the COVID-19 pandemic accelerated worldwide the development and use of digital services in response to requirements for social distancing and other regulations. OBJECTIVE The aim of this review is to identify and summarize how digital health services are being used among patients and citizens while living at home. METHODS The Joanna Briggs Institute (JBI) methodology for scoping reviews was used as guidance. A search conducted in 3 databases (CINAHL, PubMed, Scopus) resulted in 419 papers. The reporting was conducted by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping review (PRISMA-ScR), and the analysis of the included papers was performed using a framework consisting of 5 clusters describing the use of digital health services. After screening and excluding papers that did not match the inclusion criteria, 88 (21%) papers from 2010 to 2022 were included in the final analysis. RESULTS Results indicated that digital health services are used in different situations and among different kinds of populations. In most studies, digital health services were used in the form of video visits or consultations. The telephone was also used regularly for consultations. Other services, such as remote monitoring and transmitting of recorded information and the use the of internet or portals for searching information, were observed as well. Alerts, emergency systems, and reminders were observed to offer possibilities of use, for example, among older people. The digital health services also showed to have potential for use in patient education. CONCLUSIONS The development of digital services reflects a shift toward the provision of care regardless of time and place. It also reflects a shift toward emphasis on patient-centered care, meaning activating and engaging patients in their own care as they use digital services for various health-related purposes. Despite the development of digital services, many challenges (eg, adequate infrastructure) still prevail worldwide.
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Affiliation(s)
- Milla Rosenlund
- Department of Health and Social Management, University of Eastern Finland, Kuopio, Finland
| | - Ulla-Mari Kinnunen
- Department of Health and Social Management, University of Eastern Finland, Kuopio, Finland
- The Finnish Centre for Evidence-Based Health Care: A Joanna Briggs Institute Centre of Excellence, Helsinki, Finland
| | - Kaija Saranto
- Department of Health and Social Management, University of Eastern Finland, Kuopio, Finland
- The Finnish Centre for Evidence-Based Health Care: A Joanna Briggs Institute Centre of Excellence, Helsinki, Finland
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Eslami Jahromi M, Ayatollahi H. Utilization of telehealth to manage the Covid-19 pandemic in low- and middle-income countries: a scoping review. J Am Med Inform Assoc 2023; 30:738-751. [PMID: 36565464 PMCID: PMC10018263 DOI: 10.1093/jamia/ocac250] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 10/04/2022] [Accepted: 12/10/2022] [Indexed: 12/25/2022] Open
Abstract
OBJECTIVE Recently, the coronavirus disease 2019 (Covid-19) pandemic has led to an increase in the use of telehealth technology. It seems that the application of this technology in low- and middle-income countries (LMICs) has been limited, and few studies have been undertaken to review the current state of knowledge in this area. The aim of the present study was to explore the utilization of telehealth to manage the Covid-19 pandemic in LMICs. MATERIALS AND METHODS This scoping review was conducted in 2022. PubMed, Web of Science, Scopus, the Cochrane Library, IEEE Xplore, and ProQuest were searched, and all quantitative research, qualitative studies, case reports, and case studies related to the use of telehealth to manage Covid-19 in LMICs and published since 2020 were included in the study. The findings were analyzed and reported narratively. RESULTS In total, 18 articles were included in the research. These studies were conducted in South Asia, sub-Saharan Africa, the Middle East and North Africa, and East Asia and Oceania. Telehealth interventions included teleconsultation, telecoaching, teledermatology, televisit, mhealth applications, telerehabilitation, telepharmacy, and telepsychiatry. WhatsApp was the most common way for service delivery and in most studies, patients and health care providers were satisfied with services. CONCLUSION Although the use of telehealth interventions was limited in LMICs during the Covid-19 pandemic, in most cases, it was an effective solution to combat the outbreak of Covid-19 and had positive outcomes. A comparison between the characteristics and clinical effectiveness of similar interventions in different countries including LMICs are worth investigation in the future studies.
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Affiliation(s)
- Maryam Eslami Jahromi
- Department of Health Information Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Haleh Ayatollahi
- Health Management and Economics Research Center, Health Management Research Institute, Iran University of Medical Sciences, Tehran, Iran
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Jovellar-Isiegas P, Jiménez-Sánchez C, Buesa-Estéllez A, Gómez-Barreiro P, Alonso-Langa I, Calvo S, Francín-Gallego M. Feasibility of Developing Audiovisual Material for Training Needs in a Vietnam Orphanage: A Mixed-Method Design. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3118. [PMID: 36833811 PMCID: PMC9966681 DOI: 10.3390/ijerph20043118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 01/31/2023] [Accepted: 02/08/2023] [Indexed: 06/18/2023]
Abstract
Disabled children living in orphanages in low-income countries may not have access to the therapy they need. The COVID-19 pandemic has complicated the situation dramatically, making online training activities a possible innovative option to meet the real needs of local staff. This study aimed to detect the training needs of the local staff of an orphanage in Vietnam, as well as develop an audiovisual training material and measure its feasibility. Training needs were identified through a focus group carried out by the volunteers of Fisios Mundi, a nongovernmental organization. The audiovisual training material was developed to meet these specific needs. Lastly, its feasibility was evaluated, in terms of both content and format, through an ad hoc questionnaire. Nine volunteers participated in the project. Twenty-four videos were created and structured around five themes. This study expands the body of knowledge on how an international cooperation project can be developed in a pandemic situation. The audiovisual training material content and format created in this project was considered by the volunteers as very feasible and useful for training the staff of a Vietnamese orphanage.
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Affiliation(s)
- Patricia Jovellar-Isiegas
- Department of Physical Therapy, Faculty of Health Sciences, Universidad San Jorge, Villanueva de Gállego, 50830 Zaragoza, Spain
| | - Carolina Jiménez-Sánchez
- Department of Physical Therapy, Faculty of Health Sciences, Universidad San Jorge, Villanueva de Gállego, 50830 Zaragoza, Spain
| | - Almudena Buesa-Estéllez
- Department of Physical Therapy, Faculty of Health Sciences, Universidad San Jorge, Villanueva de Gállego, 50830 Zaragoza, Spain
| | - Pilar Gómez-Barreiro
- Department of Physical Therapy, Faculty of Health Sciences, Universidad San Jorge, Villanueva de Gállego, 50830 Zaragoza, Spain
| | - Inés Alonso-Langa
- Department of Physical Therapy, Faculty of Health Sciences, Universidad San Jorge, Villanueva de Gállego, 50830 Zaragoza, Spain
| | - Sandra Calvo
- Department of Physiatry and Nursing, Faculty of Health Sciences, IIS Aragon, University of Zaragoza, 50001 Zaragoza, Spain
| | - Marina Francín-Gallego
- Department of Physical Therapy, Faculty of Health Sciences, Universidad San Jorge, Villanueva de Gállego, 50830 Zaragoza, Spain
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Abstract
PURPOSE OF REVIEW Home oxygen monitoring and therapy have been increasingly used in the management of patients with chronic diseases. The COVID-19 pandemic has prompted the rapid uptake of remote monitoring programmes to support people with COVID-19 at home. This review discusses the recent evidence and learning in home oxygen monitoring and therapy from the pandemic. RECENT FINDINGS Many home oxygen monitoring programmes were established around the world during the pandemic, mostly in high-income countries to support early detection of hypoxaemia and/or early hospital discharge. The characteristics of these programmes vary widely in the type of monitoring (self-monitoring or clinician-monitoring) and the patient risk groups targeted. There is a lack of evidence for benefits on clinical outcomes, including mortality, and on reductions in healthcare utilisation or cost-effectiveness, but programmes are viewed positively by patients. Recent studies have highlighted the potential bias in pulse oximetry in people with darker skin. SUMMARY Recent evidence indicates that home oxygen monitoring therapy programmes are feasible in acute disease, but further research is needed to establish whether they improve patient outcomes, are cost-effective and to understand their equity impact.
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Affiliation(s)
| | - Jonathan Clarke
- Department of Mathematics, Imperial College London, London, UK
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Dammak S, Mbarek S, Moalla M. E-government, political system and COVID-19 in Africa: lessons for future disruptive shocks. TRANSFORMING GOVERNMENT- PEOPLE PROCESS AND POLICY 2023. [DOI: 10.1108/tg-07-2022-0100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Purpose
This study aims to explore the role of mobile tracing applications as part of e-government services in combating the COVID-19 pandemic effects in Africa by analyzing the moderating role of sustainable development. This study also investigated the role of the political and economic systems in mitigating the negative consequences of COVID-19 and how e-government interacts in this relationship.
Design/methodology/approach
This study included the COVID-19 performance index for 94 countries belonging to different regions, including 20 African countries. Multiple linear regression was used for data analysis via Stata software. The study was conducted from the start of the pandemic to March 13, 2021.
Findings
The results show that less economically and technologically developed countries with generally authoritarian political systems, including African countries, could limit the spread of the pandemic better than some democratic, economically and technologically developed countries in the first wave of the pandemic. The promotion of sustainable development goals moderates the relationship between mobile tracing applications as part of the e-government service and the fight against COVID-19.
Originality/value
This study provides insight into the role of mobile application technology as an e-governance service in mitigating the negative consequences of the COVID-19 pandemic in a context characterized by economic limitations, fragile public health infrastructure and relatively high political instability, especially in Africa. The findings shed light on some of the difficulties African countries may face in incorporating technology into their development projects.
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Govender S, Vallabhjee AL, Charles CR, Roesch D, Balton S. Bridging the Access Gap: The Telepractice Experience of Speech Therapists and Audiologists at a Public Health Care Facility in South Africa. Int J Telerehabil 2022; 14:e6517. [PMID: 38026559 PMCID: PMC10681049 DOI: 10.5195/ijt.2022.6517] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2023] Open
Abstract
South Africa is a low to middle income country (LMIC) with a population of 60 million people. The public health sector serves more than 80% of the population. Chris Hani Baragwanath Academic Hospital is a central level public health care facility situated in Gauteng. The Speech Therapy and Audiology Department provides insight into their telepractice services through a qualitative approach. The onset of the COVID-19 pandemic resulted in therapists exploring telepractice as a sustainable model of service delivery. Therapists and patients encountered many challenges to the implementation of telepractice, however, the commitment of therapists ensured that creative solutions were developed. A comprehensive needs analysis at public health institutions is required to ensure the sustainability of telepractice. A hybrid model (telepractice and in-person consults) holds the potential to reduce the financial burden on patients and increase access to quality patient-centered care.
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Affiliation(s)
- Shelissa Govender
- Department of Speech Therapy and Audiology, Chris Hani Baragwanath Academic Hospital, Johannesburg, South Africa
| | - Annika L. Vallabhjee
- Department of Speech Therapy and Audiology, Chris Hani Baragwanath Academic Hospital, Johannesburg, South Africa
| | - Chenay R. Charles
- Department of Speech Therapy and Audiology, Chris Hani Baragwanath Academic Hospital, Johannesburg, South Africa
| | - Darike Roesch
- Department of Speech Therapy and Audiology, Chris Hani Baragwanath Academic Hospital, Johannesburg, South Africa
| | - Sadna Balton
- Department of Speech Therapy and Audiology, Chris Hani Baragwanath Academic Hospital, Johannesburg, South Africa
- Centre for Augmentative and Alternative Communication, University of Pretoria, Pretoria, South Africa
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COVID-19 associated changes in HIV service delivery over time in Central Africa: Results from facility surveys during the first and second waves of the pandemic. PLoS One 2022; 17:e0275429. [PMID: 36449454 PMCID: PMC9710788 DOI: 10.1371/journal.pone.0275429] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Accepted: 09/16/2022] [Indexed: 12/03/2022] Open
Abstract
INTRODUCTION The COVID-19 pandemic has impacted population health around the globe, directly and indirectly. The objective of this study was to document changes in HIV care associated with the COVID-19 pandemic at selected clinics in Central Africa, along with clinic-level strategies for minimizing disruptions in HIV care and treatment for people with HIV (PWH). METHODS A 51-item questionnaire on COVID-19 pandemic-associated changes in HIV service delivery was completed by clinicians involved in HIV care at 21 clinics in five countries participating in Central Africa International epidemiology Databases to Evaluate AIDS (CA-IeDEA). The survey was completed at two timepoints: June-July 2020 and October 2020 to February 2021. Descriptive statistics were used to characterize changes in HIV care and related services. RESULTS While 81% of sites reported at least one negative consequence of COVID-19 for clinic operations during the first survey, none reported suspending antiretroviral therapy (ART) initiation services for new patients, and 24% reported adopting telemedicine. In the follow-up survey, fewer sites (48%) reported at least one disruption to clinic operations, and more sites reported mitigation strategies, including expanding rapid ART initiation services and providing extra supplies of ART medications to reduce visit frequency. In the follow-up survey, more sites, especially in Rwanda, reported stockouts of commodities, including HIV and viral load testing and HIV pre-exposure prophylaxis. More than one-fifth of sites reported stockouts of second- or third-line ART at each survey timepoint. CONCLUSIONS While the initial wave of the COVID-19 pandemic resulted in concerning disruptions to HIV service delivery at CA-IeDEA sites, most of these disruptions attenuated over time, and many sites introduced measures to help PWH avoid frequent visits to the clinic for care and medications. The impact of HIV commodity stockouts and clinic mitigation strategies on treatment outcomes needs to be assessed.
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22
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Kim EJ, Moretti ME, Kimathi AM, Chan SY, Wootton R. Use of provider-to-provider telemedicine in Kenya during the COVID-19 pandemic. Front Public Health 2022; 10:1028999. [PMID: 36478732 PMCID: PMC9720268 DOI: 10.3389/fpubh.2022.1028999] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Accepted: 11/01/2022] [Indexed: 11/22/2022] Open
Abstract
Introduction According to the World Health Organization (WHO), about 90 percent of countries continue to report COVID-related disruptions to their health systems. The use of telemedicine has been especially common among high-income countries to safely deliver and access health services where enabling infrastructure like broadband connectivity is more widely available than low- and middle-income countries (LMICs). The Addis Clinic implements a provider-to-provider (P2P) asynchronous telemedicine model in Kenya. We sought to examine the use of the P2P telemedicine platform during the second year of COVID-19. Methods To assess sustainability, we compared the data for two 12-month calendar periods (period A = year 2020, and period B = year 2021). To examine performance, we compared the data for two different 12-month periods (period C = pandemic period of February 2021 to January 2022, and period D = baseline period of February 2019 to January 2020). Results Sustainability of the P2P telemedicine platform was maintained during the pandemic with increased activity levels from 2,604 cases in 2020 to 3,525 cases in 2021. There was an average of 82 specialists and 5.9 coordinators during 2020, and an average of 81 specialists and 6.0 coordinators during 2021. During 2020, there were 444 cases per coordinator, and 587 cases per coordinator in 2021(P = 0.078). During 2020, there were 32 cases per specialist, and 43 cases per specialist in 2021(P = 0.068). Performance decreased with 99 percent of cases flagged as "answered" during the baseline period (period D), and 75 percent of cases flagged as "answered" during the pandemic period (period C). Conclusion Results suggest that despite a decline in certain sustainability and performance indicators, The Addis Clinic was able to sustain a very high level of activity during the second year of the pandemic, as shown by the continued use of the system. Furthermore, despite some of the infrastructure challenges present in LMICs, the P2P telemedicine platform was a viable option for receiving clinical recommendations from medical experts located remotely. As health systems in LMICs grapple with the effects of the pandemic, it is worthwhile to consider the use of telemedicine to deliver essential health services.
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Affiliation(s)
- Erin J. Kim
- The Addis Clinic Inc., Nashville, TN, United States
| | | | | | - Stephen Y. Chan
- Division of Cardiology, Department of Medicine, Pittsburgh Heart, Lung, Blood, and Vascular Medicine Institute, University of Pittsburgh School of Medicine and University of Pittsburgh Medical Center, Pittsburgh, PA, United States
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Elhakeem I, Iqbal P, Nashwan AJ, Abubakar M, Jawad AT, AlHiyari MA, Chandra P, Osman MA, Mohamad SS, Alkhatib M, Yassin MA. Patients' experience and satisfaction using telemedicine for outpatient services in a Tertiary Cancer Center in Qatar during COVID-19: A cross-sectional study. Health Sci Rep 2022; 5:e883. [PMID: 36320657 PMCID: PMC9617592 DOI: 10.1002/hsr2.883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2022] [Revised: 09/20/2022] [Accepted: 09/21/2022] [Indexed: 11/07/2022] Open
Abstract
Background and Aim The coronavirus-19 is an ongoing global pandemic resulting in millions of deaths worldwide. For a patient population at higher risk of infection, telemedicine is a promising means of providing safe and alternative care routes while minimizing their risk of exposure. This study gives insight into patients' experiences and satisfaction with telemedicine during this pandemic. Methods We conducted a cross-sectional study on 297 patients (RR: 85%) at the National Center for Cancer Care and Research (NCCCR), Qatar. Data was collected through electronic medical records of the eligibe patient population, and phone calls were made whereby the physician read a standard introductory script followed by a survey questionnaire. We focused on patients' experience with telemedicine services amid the pandemic. This was done using a six-point Likert scoring system of seven questions that were scaled from 1 to 6. Results More than 80% of patients somewhat to strongly agreed that telemedicine met their healthcare needs, improved their confidence in their healthcare system, and were generally satisfied with the quality of care provided. Nearly all patients (90%) understood their physicians' recommendations over the phone. In addition, more than half of the patients (89%) felt they could freely communicate their concerns. Patients also showed an inclination towards face-to-face consultations at 68%; however, 90% were willing to participate in future teleconsultations. Conclusion Our study indicates an overall positive experience among patients towards the use of telemedicine. Telemedicine is a safe, futuristic approach toward patient care management and, thus, provides healthcare professionals a platform to implement further patient and physician education. Even though our data also showed that patients liked in-person visits to some degree, this needs to be looked into more in future studies.
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Affiliation(s)
- Israa Elhakeem
- Medical EducationHamad Medical CorporationDohaQatar,Hematology/Oncology DepartmentHamad Medical CorporationDohaQatar
| | - Phool Iqbal
- Internal Medicine DepartmentNew York Medical College/Metropolitan Hospital CenterNew YorkUSA
| | | | | | | | | | - Prem Chandra
- Academic Health SystemHamad Medical CorporationDohaQatar
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24
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Jardim CGR, Zamani R, Akrami M. Evaluating the Impact of the COVID-19 Pandemic on Accessing HIV Services in South Africa: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph191911899. [PMID: 36231201 PMCID: PMC9565529 DOI: 10.3390/ijerph191911899] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 09/11/2022] [Accepted: 09/14/2022] [Indexed: 05/21/2023]
Abstract
Progress has been made towards controlling the Human Immunodeficiency Virus (HIV) epidemic in South Africa. However, the emergence of coronavirus disease 2019 (COVID-19) has disrupted access to health care. This systematic review aims to evaluate the impact of the pandemic on accessing HIV services at a primary health care (PHC) level in South Africa. HIV services that have been significantly impacted are highlighted, and recommendations for future public health emergencies are made. Three databases were searched in January 2022. The studies included were those that reported on HIV services at a PHC level in South Africa. From the searches, 203 papers were identified, of which 34 full texts were screened. Eleven studies met the inclusion criteria and were included in this review. Overall, decreases in HIV testing, positive HIV tests, and initiation of antiretroviral therapy (ART) were reported. Resilience of ART provision was reported, meaning that adherence to treatment was sustained throughout the pandemic. The findings showed that HIV services at private PHC facilities were unaffected, however, an overall decrease in HIV services at public PHC facilities was reported, excluding antenatal care which showed resilience.
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Affiliation(s)
| | - Reza Zamani
- Medical School, College of Medicine and Health, University of Exeter, Exeter EX1 2LU, UK
- Correspondence: (R.Z.); (M.A.)
| | - Mohammad Akrami
- Department of Engineering, University of Exeter, Exeter EX4 4QF, UK
- Correspondence: (R.Z.); (M.A.)
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25
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An ISN-DOPPS survey of the global impact of the Coronavirus 2019 pandemic on peritoneal dialysis services. Kidney Int Rep 2022; 7:2196-2206. [PMID: 35941999 PMCID: PMC9349355 DOI: 10.1016/j.ekir.2022.07.013] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 06/08/2022] [Accepted: 07/11/2022] [Indexed: 12/18/2022] Open
Abstract
Introduction Home dialysis may minimize SARS-CoV2 exposure risks compared to center-based dialysis. We explored how the pandemic may have introduced challenges related to peritoneal dialysis (PD) supply availability, routine patient care, and how facility practices changed during this time. Methods The PD/Dialysis Outcomes and Practice Patterns Study (PDOPPS/DOPPS) and International Society of Nephrology (ISN) administered a web-based survey from November 2020 to March 2021. Medical director responses were compared across 10 ISN regions. Results One hundered sixy-five PD facilities in 51 countries returned surveys. During the initial COVID-19 wave, the reported frequency of in-person patient visits decreased in 9 of 10 ISN regions. Before the pandemic, most facilities required a mask during PD exchanges which continued over the course of the pandemic. Although most facilities in different regions did not report PD supply disruptions, sites in Africa and South Asia reported major disruptions. Reductions in laparoscopic surgical procedures for PD catheters were reported by facilities in 9 of 10 regions whereas nonsurgical percutaneous procedures increased in facilities in 6 regions. Training of new PD patients declined in facilities in each region. Increased use of remote technology by patients to communicate with clinics was observed in all regions compared to prepandemic levels. Conclusion Marked within-region and across-region variability was noted in PD facility burden, clinical practice, and adaptation to the COVID-19 pandemic. This study highlights opportunities to improve routine PD care, adapt to the ongoing pandemic, and increase preparedness for potential future interruptions in PD care.
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26
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Mehta A, Andrew Awuah W, Tunde Aborode A, Cheng Ng J, Candelario K, Vieira IMP, Bulut HI, Toufik AR, Hasan MM, Sikora V. Telesurgery's potential role in improving surgical access in Africa. Ann Med Surg (Lond) 2022; 82:104511. [PMID: 36268331 PMCID: PMC9577435 DOI: 10.1016/j.amsu.2022.104511] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Accepted: 08/21/2022] [Indexed: 11/08/2022] Open
Abstract
An estimated five billion people worldwide lack access to surgical care, while LMICs including African nations require an additional 143 million life-saving surgical procedures each year.African hospitals are under-resourced and understaffed, causing global attention to be focused on improving surgical access in the continent. The African continent saw its first telesurgery application when the United States Army Special Operations Forces in Somalia used augmented reality to stabilize lifethreatening injuries.Various studies have been conducted since the first telesurgery implementation in 2001 to further optimize its application.In context of a relative shortage of healthcare resources and personnel telesurgery can considerably improve quality and access to surgical services in Africa.telesurgery can provide remote African regions with access to knowledge and tools that were previously unavailable, driving innovative research and professional growth of surgeons in the region.At the same time, telesurgery allows less trained surgeons in remote areas with lower social determinants of health, such as access, to achieve better health outcomes. However, lack of stable internet access, expensive equipment costs combined with low expenditure on healthcare limits expansive utilization of telesurgery in Africa. Regional and international policies aimed at overcoming these obstacles can improve access, optimize surgical care and thereby reduce disease burden associated with surgical conditions in Africa.
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27
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Rabe M. Telehealth in South Africa: A guide for healthcare practitioners in primary care. S Afr Fam Pract (2004) 2022; 64:e1-e6. [PMID: 35792625 PMCID: PMC9257714 DOI: 10.4102/safp.v64i1.5533] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 04/24/2022] [Accepted: 04/28/2022] [Indexed: 11/25/2022] Open
Abstract
The use of telehealth is becoming a prevalent feature in clinical practice worldwide, partly because of advances in medical and telecommunications technology. The coronavirus disease 2019 (COVID-19) pandemic has been a key driver in justifying the accelerated use of telehealth, leading to healthcare practitioners (HCPs) utilising virtual consultations more avidly. Although challenges remain, recent data have shown that remote consultations are feasible, safe and effective in South Africa (SA) and that HCPs should become proficient in conducting telehealth, virtual or remote consultations. These guidelines are based on the revised Health Professions Council of South Africa (HPCSA) General Ethical Guidelines for Good Practice in Telehealth (Booklet 10) and guidelines on remote or video consultations from the University of Oxford, the Royal Australian College of General Practitioners and the Royal College of Psychiatrists. These guidelines aim to equip HCPs with the basic knowledge and skills pertaining to medicolegal, communication and practical aspects of telehealth and how to practise telehealth safely and effectively in primary care settings in SA during the COVID-19 pandemic and beyond.
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Affiliation(s)
- Mareike Rabe
- Family Physician, Locum in Public and Private Practice, Cape Town.
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28
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Formenti B, Gregori N, Crosato V, Marchese V, Tomasoni LR, Castelli F. The impact of COVID-19 on communicable and non-communicable diseases in Africa: a narrative review. LE INFEZIONI IN MEDICINA 2022; 30:30-40. [PMID: 35350264 DOI: 10.53854/liim-3001-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Accepted: 02/20/2022] [Indexed: 01/06/2023]
Abstract
The global pandemic of coronavirus disease 2019 (COVID-19) has disproportionately impacted global human health, economy, and security. Because of weaker health-care systems, existing comorbidities burden (HIV, malaria, tuberculosis, and non-communicable conditions), and poor socioeconomic determinants, initial predictive models had forecast a disastrous impact of COVID-19 in Africa in terms of transmission, severity, and deaths. Nonetheless, current epidemiological data seem not to have matched expectations, showing lower SARS-CoV-2 infection and fatality rates compared to Europe, the Americas and Asia. However, only few studies were conducted in low- and middle-income African settings where high poverty and limited access to health services worsen underlying health conditions, including endemic chronic infectious diseases such as HIV and tuberculosis. Furthermore, limited, and heterogeneous research was conducted to evaluate the indirect impact of the pandemic on general health services and on major diseases across African countries. International mitigation measures, such as resource reallocation, lockdowns, social restrictions, and fear from the population have had multi-sectoral impacts on various aspects of everyday life, that shaped the general health response. Despite the vast heterogeneity of data across African countries, available evidence suggests that the COVID-19 pandemic has severely impacted the control and prevention programs, the diagnosis capacity and the adherence to treatment of major infectious diseases (HIV, TB, and Malaria) - including neglected diseases - and non-communicable diseases. Future research and efforts are essential to deeply assess the medium- and long-term impact of the pandemic, and to implement tailored interventions to mitigate the standstill on decades of improvement on public health programs.
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Affiliation(s)
- Beatrice Formenti
- UNESCO Training and Empowering Human Resources for Health Development in Resource-Limited Countries, University of Brescia, Italy
| | - Natalia Gregori
- Department of Infectious and Tropical Diseases, University of Brescia and ASST Spedali Civili of Brescia, Italy
| | - Verena Crosato
- Department of Infectious and Tropical Diseases, University of Brescia and ASST Spedali Civili of Brescia, Italy
| | - Valentina Marchese
- Department of Infectious and Tropical Diseases, University of Brescia and ASST Spedali Civili of Brescia, Italy
| | | | - Francesco Castelli
- UNESCO Training and Empowering Human Resources for Health Development in Resource-Limited Countries, University of Brescia, Italy.,Department of Infectious and Tropical Diseases, University of Brescia and ASST Spedali Civili of Brescia, Italy
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Murewanhema G, Musuka G, Gwanzura C, Makurumidze R, Chitungo I, Chimene M, Tungwarara N, Dzinamarira T, Madziyire MG. Maternal, Sexual and Reproductive Health in Marginalised Areas: Renewing Community Involvement Strategies beyond the Worst of the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:3431. [PMID: 35329118 PMCID: PMC8953553 DOI: 10.3390/ijerph19063431] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/19/2022] [Revised: 03/05/2022] [Accepted: 03/13/2022] [Indexed: 01/27/2023]
Abstract
The COVID-19 pandemic and resultant lockdowns have brought unprecedented challenges for Maternal, Sexual and Reproductive Health (MSRH) services. Components of MSRH services adversely affected include antenatal, postnatal, and newborn care; provision of family planning and post-abortion care services; sexual and gender-based violence care and prevention; and care and treatment for sexually transmitted infections including HIV. Resuscitating, remodeling or inventing interventions to restore or maintain these essential services at the community level, as a gateway to higher care, is critical to mitigating short and long-term effects of the COVID-19 pandemic on essential MSRH. We propose a possible framework for community involvement and propose integrating key information, education, and communication of MSRH messages within COVID-19 messages.
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Affiliation(s)
- Grant Murewanhema
- Unit of Obstetrics and Gynaecology, Department of Primary Health Care Sciences, Faculty of Medicine and Health Sciences, University of Zimbabwe, Harare P.O. Box MP167, Zimbabwe; (G.M.); (C.G.); (M.G.M.)
| | - Godfrey Musuka
- ICAP at Columbia University, Harare P.O. Box MP167, Zimbabwe;
| | - Chipo Gwanzura
- Unit of Obstetrics and Gynaecology, Department of Primary Health Care Sciences, Faculty of Medicine and Health Sciences, University of Zimbabwe, Harare P.O. Box MP167, Zimbabwe; (G.M.); (C.G.); (M.G.M.)
| | - Richard Makurumidze
- Unit of Community Medicine, Faculty of Medicine and Health Sciences, University of Zimbabwe, Harare P.O. Box MP167, Zimbabwe;
| | - Itai Chitungo
- Chemical Pathology Unit, Faculty of Medicine and Health Sciences, University of Zimbabwe, Harare P.O. Box MP167, Zimbabwe;
| | - Munashe Chimene
- Department of Health Sciences, Africa University, Mutare P.O. Box 1320, Zimbabwe;
| | - Nigel Tungwarara
- Department of Health Studies, University of South Africa, Pretoria 0002, South Africa;
| | - Tafadzwa Dzinamarira
- ICAP at Columbia University, Harare P.O. Box MP167, Zimbabwe;
- School of Health Systems & Public Health, University of Pretoria, Pretoria 0002, South Africa
| | - Mugove Gerald Madziyire
- Unit of Obstetrics and Gynaecology, Department of Primary Health Care Sciences, Faculty of Medicine and Health Sciences, University of Zimbabwe, Harare P.O. Box MP167, Zimbabwe; (G.M.); (C.G.); (M.G.M.)
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Gaobotse G, Mbunge E, Batani J, Muchemwa B. The future of smart implants towards personalized and pervasive healthcare in Sub-Saharan Africa: Opportunities, barriers and policy recommendations. SENSORS INTERNATIONAL 2022. [DOI: 10.1016/j.sintl.2022.100173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Mbunge E, Muchemwa B, Batani J. Are we there yet? Unbundling the potential adoption and integration of telemedicine to improve virtual healthcare services in African health systems. SENSORS INTERNATIONAL 2022; 3:100152. [PMID: 34901894 PMCID: PMC8648577 DOI: 10.1016/j.sintl.2021.100152] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Revised: 12/02/2021] [Accepted: 12/02/2021] [Indexed: 01/14/2023] Open
Abstract
Since the outbreak of COVID-19, the attention has now shifted towards universal vaccination to gracefully lift strict COVID-19 restrictions previously imposed to contain the spread of the disease. Sub-Saharan Africa is experiencing an exponential increase of infections and deaths coupled with vaccines shortages, personal protective equipment, weak health systems and COVID-19 emerging variants. Some developed countries integrated telemedicine to reduce the impacts of the shortage of healthcare professionals and potentially reduce the risk of exposure, ensuring easy delivery of quality health services while limiting regular physical contact and direct hospitalization. However, the adoption of telemedicine and telehealth is still nascent in many sub-Saharan Africa countries. Therefore, this study reflects on progress made towards the use of telemedicine, virtual health care services, challenges encountered, and proffers ways to address them. We conducted a systematic literature review to synthesise literature on telemedicine in sub-Saharan Africa. The study revealed that telemedicine provides unprecedented benefits such as improving efficiency, effective utilization of healthcare resources, forward triaging, prevention of medical personnel infection, aiding medical students' clinical observation and participation, and assurance of social support for patients. However, the absence of policy on virtual care and political will, cost of sustenance of virtual health care services, inadequate funding, technological and infrastructural barriers, patient and healthcare personnel bias on virtual care and cultural barriers are identified as limiting factors to the adoption of virtual health care in many African health systems. To alleviate some of these barriers, we recommend the development of robust policies and frameworks for virtual health care, the inclusion of virtual care in the medical school curriculum, supporting virtual care research and development, increasing health funding, removing monopolisation of telecommunication services, developing of virtual health solutions that address eccentricities of African health systems.
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Affiliation(s)
- Elliot Mbunge
- Department of Computer Science, Faculty of Science and Engineering, University of Eswatini, Private Bag 4, Kwaluseni, Eswatini,Corresponding author
| | - Benhildah Muchemwa
- Department of Computer Science, Faculty of Science and Engineering, University of Eswatini, Private Bag 4, Kwaluseni, Eswatini
| | - John Batani
- Faculty of Engineering and Technology, Botho University, Maseru, Lesotho
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Assaye BT, Shimie AW. Telemedicine use during COVID-19 pandemics and associated factors among health professionals working in health facilities at resource-limited setting 2021. INFORMATICS IN MEDICINE UNLOCKED 2022; 33:101085. [PMID: 36105540 PMCID: PMC9462923 DOI: 10.1016/j.imu.2022.101085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 09/08/2022] [Accepted: 09/08/2022] [Indexed: 11/28/2022] Open
Abstract
Background Digitizing healthcare has been a potential solution for transforming healthcare service delivery in the era of COVID-19 pandemics. To limit and minimize the virus spread, telemedicine helps control and prevent the pandemic by delivering healthcare services over long distances using Information communication technology. The objective of the study was to determine the level of telemedicine utilization among health professionals in the era of the COVID-19 Pandemic and the factors associated with it. Methods An institutional-based cross-sectional study design was used to collect data from 845 healthcare professionals. A pilot study was conducted on 5% of the study participants before the actual data collection process. After completion, changes were made based on the pilot study results, and a Cronbach alpha value of 0.76 was obtained. Descriptive and binary logistic regression models were used. Variables with a P-Value of less than or equal to 0.2 from the bivariable analysis were entered into the multivariable analysis. The odds ratio, 95% confidence interval, and p-value less than 0.05 were used to interpret a significant association, Hosmer-Lemeshow goodness-of-fit test, and the multicollinearity test were used to assess the assumptions. Result 64.2% of the respondents had good use of telemedicine during COVID-19 with a response rate of 87.2%. 507 (62.8%) were male, and 525(71.2%) reported by nearly threefold (AOR = 2.96, % CI: [1.54-5.76]), IT support staff in the health facility (AOR = 8.32, 95 %CI: [4.77-14.52]), ICT training (AOR = 4.15, % CI: [2.13-8.02]), the frequency of searching health information (AOR = 6.19, % CI: [2.12-18.07]), and social media used (AOR = 3.46, % CI: [1.43-8.32]) were found significantly associated with health professionals' use of telemedicine. Conclusion The majority of healthcare providers practice telemedicine to control and prevent the spread of the COVID-19 virus. However, the availability of the internet, the presence of IT support staff, ICT training, the frequency of searching for health information, and the use of social media were significantly associated with the level of telemedicine utilization. Initiatives for full implementation of telemedicine in the health facility and motivating the health professionals are needed to carry out their medical practice by providing training and improving internet access in health facilities.
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Affiliation(s)
- Bayou Tilahun Assaye
- Department of Health Informatics, College of Health Science, Debre Markos University, Debre Markos, Ethiopia,Corresponding author
| | - Aynadis worku Shimie
- Department of Health Informatics, College of Health Science, Debre Markos University, Debre Markos, Ethiopia
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33
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Non-invasive smart implants in healthcare: Redefining healthcare services delivery through sensors and emerging digital health technologies. SENSORS INTERNATIONAL 2022. [DOI: 10.1016/j.sintl.2022.100156] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
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