1. Testing a Conceptual Model for Implementing a mHealth Intervention for the Early Detection of Buruli Ulcer Disease in Ghana and Cote d’Ivoire Courtney Queen, Ph.D. & George Zouridakis, Ph.D. Texas Tech University Health Sciences Center & University of Houston
Background
Buruli Ulcer (BU) is considered one of the most neglected of the Neglected Tropical Diseases (NTDs). Currently in over 33 countries, BU has an unknown mode of transmission and is most often diagnosed in late stages requiring surgical intervention.
Diagnosis in the early stages prevents costly and painful surgical intervention, and decreases risk of disfigurement, amputation and disability.
Intervention
Our early stage intervention proposes a low-cost, non-invasive, mobile image analysis to determine the structural features of BU lesions. This study proposes that initial image collection follow the implementation model for dissemination of the technology based intervention.
Conceptual Model
Findings
Nature of the social systems and barriers to early stage intervention are similar
The health care systems in the two countries are dramatically different with resources, assets, and delivery models being different.
CI: Excellent Stage 4 Surgical Intervention
GH: Excellent Rural Primary Care Network
CI & GH: Type of innovation decision and communication channels emerged as the area needing to develop a greater understanding
13%
16%
Methods
Convenience Sampling of 197 individuals in 15 communities in 2 countries to capture images of early stage skin lesions. Data collection followed an integrated implementation science and diffusion of innovations theory model to gain more insight into acceptance and adoption of the technology-based intervention.
Communities
8 Ghanaian Districts:
Greater Accra, Asunfo South, Asante Akim, Ahafo Ano, Atwima Nwabiagya, Denkyira, Komfo Anokye, Amansie Central
7 Ivorian Districts:
Abidjan, Bouke, Sakassou, Zoukougbeu, Kongouanou, Katiola , Djekanou
Conclusion
Revise model to clearly identify health system structure and communication channels including the identification of opinion leaders at every level of the social and healthcare system, especially at the community level.
Need to fully understand the resources necessary to make an early diagnosis, availability of antibiotics, post-diagnosis counseling, etc.
Most importantly, this intervention demonstrates that isolated rural populations may be successfully reached using mHealth interventions.
Works Cited
Milbank Quarterly,
Nature,
World Health Organization,