The Brief Review on Telemedicine: New Dream in Developing Countries

: In the new modern world, technology has a remarkable role in human life and affects all aspects of it. Indeed, the need for rapid counteractions, especially in medical requirements, can lead to interesting innovations. Telemedicine was disregarded for being an unwieldy, unreliable, and unaffordable technology. Rapidly evolving telecommunications and information technologies have provided a solid foundation for telemedicine as a feasible, dependable, and useful technology. Telemedicine has been conceived as an integrated system of healthcare delivery that employs telecommunications and computer technology as a substitute for face-to-face contact between provider and client. It has the potential for ameliorating seemingly intractable problems in healthcare such as limited access to care among segments in the population, especially the geographically disadvantaged, uneven quality of care, and cost of inflation. Its true merit has yet to be determined by systematic empirical studies. In another survey, the authors defined telemedicine as a branch of e-health, which works by communication networks and delivers healthcare and medical educations from remote locations. The main aim of telemedicine is to overcome the improper distribution of human and fundamental resources. Telemedicine could be considered from the viewpoint of two basic conditions: (1) as an alternative way for emergency services in remote locations and (2) it is a better option rather than conventional health services; for example, teleradiology for rural hospitals. It can result in appropriate availability of health services and acceptable efficiency. However, this aspect of medicine was considered in the late 1990, and then, developing countries have a long way for research about it.

Novel multi-linear quantitative brain volume formula for manual radiological evaluation of brain atrophy

Objectives

The brain atrophy commonly occurs in elderly and in some childhood conditions making the techniques for quantifying brain volume needful. Since the automated quantitative methods of brain volume assessment have limited availability in developing countries, it was the purpose of this study to design and test an alternative formula that is applicable to all healthcare levels.

Methods

The multi-linear diagonal brain fraction formula (DBF) was designed from dimensions of brain relative to skull and ventricles. To test a developed formula, a total of 347 subjects aged between 0 and 18 years who had brain CT scans performed recruited and subjected to a systematic measurement of their brains in a diagonal brain fashion.

Results

Out of 347 patients evaluated, 62 subjects (17.8 %) were found to be cases of brain atrophy. The three radiological measurements which included sulcal width (SW), ventricular width (VW) and Evans Index (EI) were concurrently performed. SW and VW showed good age correlation. Similar tests were extended to diagonal brain fraction (DBF) and skull vertical horizontal ratio (VHR) in which DBF showed significant age correlation.

Conclusions

The DBF formula shows significant ability of differentiating changes of brain volume suggesting that it can be utilized as an alternative brain fraction quantification method bearing technical simplicity in assessing gross brain volume.

Advances in knowledge

The designed formula is unique in that it captures even the possible asymmetrical volume loss of brain through diagonal lines. The proposed scores being in term of ratios give four grades of brain atrophy.

The influence of a telehealth project on healthcare professional recruitment and retention in remote areas in Mali: A longitudinal study

Objectives:

The telehealth project EQUI-ResHuS (in French, Les TIC pour un accès Équitable aux Ressources Humaines en Santé) aimed to contribute to more equitable access to care and support practice in remote regions in Mali. This study explored the evolution of perceptions concerning telehealth among healthcare professionals in the four district health centres that participated in the EQUI-ResHus project and identified variables influencing their perceptions of telehealth impact on recruitment and retention of health professionals.

Methods:

One year after a first survey (T1), a second data collection (T2) was carried out among healthcare professionals using a 91-item questionnaire. Questions assessing telehealth use and perceptions and perceived impact on recruitment and retention of healthcare professionals were rated on a 5-point Likert scale. A total of 10 independent variables were considered for the analyses. A Wilcoxon signed-rank test was performed to detect differences between T1 and T2, and a bivariate linear regression model for repeated measures was carried out to assess the impact of independent variables on dependent variables.

Results:

There were no noticeable changes in perceptions related to telehealth influence on recruitment and retention. Only access to information and communication technology significantly differed between T1 and T2 according the Wilcoxon rank test (p = 0.001). Perceived influence of telehealth on recruitment and retention was mostly explained by attitude towards telehealth, perceived effect on recruitment and retention and barriers to recruitment and retention.

Conclusion:

Based on our results, telehealth was perceived as having a positive influence but mostly indirect influence on healthcare professional recruitment and retention. Also, there were no major changes after 1 year of telehealth use.

Analysis of Information and Communication Needs in Rural Primary Health Care in Developing Countries

This article presents three studies dealing with information and communication needs in rural primary health care from Peru and Nicaragua. Results show that primary health-care systems in rural areas of developing countries are very inefficient. Among the main reasons we found factors related to communication infrastructure, information sharing, and continuous training of health professionals. We conclude that telemedicine systems can improve this situation, but the lack of infrastructures, low income levels, and other conditions, impose strong limits to the introduction of new technologies. The main conclusion is that differences in needs and conditions between developing countries and industrialized ones force to use different solutions and approaches. This article presents some proposals on technology requirements and how to deal with the use of telemedicine in rural areas of developing countries. These proposals can be useful to all kind of actors (national public administrations, multilateral institutions, industry, academy, civil society, etc.) in order to promote really relevant and sustainable proposals in telemedicine for rural regions of developing countries.