Abstract
BackgroundPrecise measurements of HIV incidences at community level can help mount a more effective public health response, but the most reliable methods currently require labor-intensive population surveys. Novel mobile phone technologies are being tested for adherence to medical appointments and antiretroviral therapy, but using them to track HIV test results with automatically generated geospatial coordinates has not been widely tested.ObjectiveWe customized a portable reader for interpreting the results of HIV lateral flow tests and developed a mobile phone app to track HIV test results in urban and rural locations in Rwanda. The objective was to assess the feasibility of this technology to collect front line HIV test results in real time and with geospatial context to help measure HIV incidences and improve epidemiological surveillance.MethodsTwenty health care workers used the technology to track the test results of 2190 patients across 3 hospital sites (2 urban sites in Kigali and a rural site in the Western Province of Rwanda). Mobile phones for less than US $70 each were used. The mobile phone app to record HIV test results could take place without internet connectivity with uploading of results to the cloud taking place later with internet.ResultsA total of 91.51% (2004/2190) of HIV test results could be tracked in real time on an online dashboard with geographical resolution down to street level. Out of the 20 health care workers, 14 (70%) would recommend the lateral flow reader, and 100% would recommend the mobile phone app.ConclusionsSmartphones have the potential to simplify the input of HIV test results with geospatial context and in real time to improve public health surveillance of HIV.
Highlights
For the HIV/AIDS epidemic to be curtailed in a sustainable fashion, it will be critical to increase diagnosis, awareness, and tracking of HIV infections among the hardest hit, resource-constrained countries
Smartphones have the potential to simplify the input of HIV test results with geospatial context and in real time to improve public health surveillance of HIV. (JMIR Public Health Surveill 2018;4(3):e11203) doi:10.2196/11203
The results from the study aim to lay the foundation for a scalable method to improve the efficiency and quality of identifying HIV incidences quickly in developing countries
Summary
For the HIV/AIDS epidemic to be curtailed in a sustainable fashion, it will be critical to increase diagnosis, awareness, and tracking of HIV infections among the hardest hit, resource-constrained countries. Precise measurements of HIV incidences at a subnational level are instrumental in mounting an effective global response [1], but the most reliable methods currently require labor-intensive population surveys. For HIV diagnostics, HIV rapid tests (which use lateral flow test technology) are widely used for primary screening These tests are low cost, readily available, and can be performed in field settings, but they have shown lower specificity and sensitivity during field conditions as compared to laboratory http://publichealth.jmir.org/2018/3/e11203/ XSLFO RenderX. Test results are currently first entered by hand into a book and later transcribed into a computer This process can introduce data entry errors and slows availability of the data for use by health care providers and officials. Precise measurements of HIV incidences at community level can help mount a more effective public health response, but the most reliable methods currently require labor-intensive population surveys. Novel mobile phone technologies are being tested for adherence to medical appointments and antiretroviral therapy, but using them to track HIV test results with automatically generated geospatial coordinates has not been widely tested
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