Application of mobile-technology for disease and treatment monitoring of malaria in the "Better Border Healthcare Programme".
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Date
2010-09-09
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Abstract
BACKGROUND The main objective of this study was to assess the effectiveness of integrating the use of cell phones into a routine malaria prevention and control programme to improve the management of malaria cases among an under served population in a border area The module for disease and treatment monitoring of malaria DTMM consisted of case investigation and case follow up for treatment compliance and patients symptoms METHODS The module combining web based and mobile technologies was developed as a proof of concept in an attempt to replace the existing manual paper based activities that malaria staff used in treating and caring for malaria patients in the villages for which they were responsible After a patient was detected and registered onto the system case investigation and treatment details were recorded into the malaria database A follow up schedule was generated and the patient s status was updated when the malaria staff conducted their routine home visits using mobile phones loaded with the follow up application module The module also generated text and graph messages for a summary of malaria cases and basic statistics and automatically fed to predetermined malaria personnel for situation analysis Following standard public health practices access to the patient database was strictly limited to authorized personnel in charge of patient case management RESULTS The DTMM module was developed and implemented at the trial site in late November 2008 and was fully functioning in 2009 The system captured 534 malaria patients in 2009 Compared to paper based data in 2004 2008 the mobile phone based case follow up rates by malaria staff improved significantly The follow up rates for both Thai and migrant patients were about 94 99 on Day 7 Plasmodium falciparum and Day 14 Plasmodium vivax and maintained at 84 93 on Day 90 Adherence to anti malarial drug therapy based on self reporting showed high completion rate for P falciparum infected cases but lower rate for P vivax cases Patients symptoms were captured onto the mobile phone during each follow up visit either during the home visit or at Malaria Clinic most patients had headache muscle pain and fatigue and some had fever within the first follow up day day 7 14 after the first anti malarial drug dose CONCLUSIONS The module was successfully integrated and functioned as part of the malaria prevention and control programme Despite the bias inherent in sensitizing malaria workers to perform active case follow up using the mobile device the study proved for its feasibility and the extent to which community healthcare personnel in the low resource settings could potentially utilize it efficiently to perform routine duties even in remote areas The DTMM has been modified and is currently functioning in seven provinces in a project supported by the WHO and the Bill And Melinda Gates Foundation to contain multi drug resistant malaria on the Thai Cambodian border
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Keywords
At risk for a particular disease or infection, Facility-based health worker, Access to information or data, Loss to follow up, Effectiveness, Pilot, Feasibility, Malaria, Appointment reminders, Provider training and education, Disease management, Registries/vital events tracking, SMS