Diagnosing SSIs Using mHealth

Mobile phones, tablets, and other wireless devices are increasingly being deployed to improve health in low-resource settings. To help the field advance, the Fogarty International Center (FIC) https://www.fic.nih.gov part of NIH, has awarded $4.4 million to 12 Universities to support Mobile Health (mHealth) research in low and middle income countries.

FIC awarded one of the grants with funding for $212,617 to the Harvard Medical School https://hms.harvard.edu to study a project titled “Telemedicine to Improve the Diagnosis of Surgical Site Infections (SSI) Post Cesarean Delivery in Rural Rwanda”.

Currently, Sub-Saharan Africa is facing a new challenge involving an increase in SSIs. An estimated 7-12 percent of women have Cesarean sections in the region develop SSIs particularly after they are discharged from hospitals.

Recent expansion of broadband cellular network coverage in Sub-Saharan Africa suggest that it makes sense to consider using telemedicine to follow up with women remotely after their Cesareans to use technology to accurately diagnose SSIs and link those women back to care.

Harvard researchers are going to work on the project referred to as “mHealth-CHW Photo-Enhanced Screening” (mC-PES) which will monitor for SSIs. Fifteen community health workers will visit women about ten days after surgery, administer a three question clinical assessment, take a photo of the wound, and then transmit this information to a general practitioner who will provide an SSI diagnosis in real-time. Patients diagnosed with an SSI will be referred to a hospital for care.

Finally, the researchers will compare SSI diagnosed women that received the mC-PES intervention to those patients receiving physical exams by general practitioners. Researchers will also assess the diagnostic accuracy using wound photos and SSI diagnoses for 521 woman whose data had been previously collected as part of an ongoing study.

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