Dx in a Bx – Saving lives through mobile diagnosis
Despite two decades of progress, in 2017 more than 5.4 million children died before their 5th birthday– that is a staggering 15,000 preventable deaths every day. The majority of these deaths are due to pneumonia, diarrhea and malaria. In addition, there is growing evidence that suggests that febrile illness caused by malaria, dengue and typhoid fevers are associated with long-term cognitive impairments and household indebtedness. Using 2015 as a baseline, there are approximately 800 million clinic visits each year for the evaluation of fever in children in low- and middle-income countries. Around 40% of these visits are due to malaria, but close to 60% of children who have gone to a clinic with a fever remain undiagnosed, and mortality rates for children under 5 remain unacceptably high. This is a direct consequence of the limited set of tools available to health professionals to diagnose and manage childhood illnesses in settings with limited resources. Proper diagnosis to provide appropriate treatment and care is crucial to circumvent childhood deaths and associated debilitation.
In response to this urgent need to increase access to quality care in resource-limited settings, FIND was recently awarded a grant by Fondation Botnar, a Swiss-based philanthropic Foundation, to develop and implement a toolkit – “Diagnostic in a Box” – that can be used by frontline health workers in resource-limited settings to reach and rapidly diagnose children with fever, thus making treatment or triaging decisions on a timely basis. FIND is convinced that mobile technology can bring quality care to all and that data from these technologies will, in turn, inform healthcare systems responses. With Botnar’s support, FIND will provide the global health community with a diagnostic toolkit “Dx in a Bx” that includes electronic clinical algorithms, point-of-care diagnostics, and implementation guidelines to assist health workers in what is an already challenging daily routine of caring for their patients.
As part of this initiative, FIND is working with different partners (Terre des hommes, THINKMD, Policlinique Médicale Universitaire, to name a few) to assess the use of electronic clinical algorithms combined with point of care diagnostics. Recently, FIND collaborated with eHealth Africa, THINKMD, and the Kano State Primary Health Care Management Board (KSPHCMB) to assess THINKMD’s eHealth platform, MEDSINC. Community Health Workers (CHWs) at health facilities across Kano State, Nigeria were trained on the use of MEDSINC to carry out physician-like clinical assessments on children between the age of 2 months and 5 years presenting at health facilities with different ailments (see conferment ceremony). They were also trained on the use of malaria Rapid Diagnostic Tests (mRDTs) when guided by the algorithm for a febrile case and how to interpret the test results. The data collected through MEDSINC was captured and allowed the team, in almost real-time, to see the types of ailments present in the demographic area, the number of positive malaria cases and user performance metrics.
Karell Pellé, eHealth Scientific Officer who is leading this work at FIND, visited eHealth Africa and met with the Executive Secretary of KSPHCMB, Dr. Nasir Mahmoud, to discuss ongoing plans for scaling up the use of mHealth tools to improve clinical diagnosis of childhood illnesses in Kano State. She also visited some of the pilot health facilities in the State to interact with the CHWs and observe first-hand how quality of care and health delivery had been improved in those facilities.
About Fondation Botnar: Fondation Botnar is a Swiss foundation established in 2003 with the core purpose of improving the health and wellbeing of children and young people in growing secondary cities around the world. To achieve this, Fondation Botnar acts as a catalyst, connecting diverse partners and investing in solutions that leverage artificial intelligence (AI) and digital innovation. www.fondationbotnar.org