Mannik Jennifer, Figol Andrea, Churchill Vanessa, Aw James, Francis Stacy, Karino Ezekiel, Chesire Julius Kibet, Opot Danet, Ochieng Benard, Hawkes Michael Thomas
Naweza.
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J Innov Health Inform. 2018 Oct 31;25(3):176-182. doi: 10.14236/jhi.v25i3.1012.
An increasing burden of cardiovascular disease (CVD) in low-resource settings demands innovative public health approaches.
To design and test a novel mHealth tool for use by community health workers (CHWs) to identify individuals at high CVD risk who would benefit from education and/or pharmacologic interventions.
We designed and implemented a novel two-way mobile phone application, "AFYACHAT," to rapidly screen for CVD risk in rural Kenya. AFYACHAT collects and stores SMS text message data entered by a CHW on a subject's age, sex, smoking, diabetes, and systolic blood pressure, and returns as SMS text message the category of 10-year CVD risk: "GREEN" (<10% 10 year risk of cardiovascular event), "YELLOW" (10 to <20%), "orange"(20 to <30%), or "RED" (≥30%). CHWs were equipped and trained to use an automated blood pressure device and the mHealth tool.
Five CHWs screened 2,865 subjects in remote rural communities in Kenya over a 22 month period (2015-17). The median age of subjects was 50 (IQR 43 to 60) and 1581 (55%) were female. Point prevalence of hypertension (systolic blood pressure>140mmHg), diabetes, and tobacco use were 23%, 3.2%, and 22%, respectively. Overall, the 10-year risk of CVD among patients was <10% in 2778 (97%) patients, 10 to <20% in 65 (2.3%), 20 to <30% in 12 (0.4%), and ≥30% in 10 (0.2%).
We have developed a mHealth tool that can be used by CHWs to screen for CVD risk factors, demonstrating proof-of-concept in rural Kenya.
资源匮乏地区心血管疾病（CVD）负担日益加重，需要创新的公共卫生方法。
设计并测试一种新型移动健康工具，供社区卫生工作者（CHW）使用，以识别能从教育和/或药物干预中获益的高CVD风险个体。
我们设计并实施了一款新型双向移动电话应用程序“AFYACHAT”，用于在肯尼亚农村地区快速筛查CVD风险。AFYACHAT收集并存储社区卫生工作者输入的关于受试者年龄、性别、吸烟情况、糖尿病和收缩压的短信文本数据，并以短信形式返回10年CVD风险类别：“绿色”（10年心血管事件风险<10%）、“黄色”（10%至<20%）、“橙色”（20%至<30%）或“红色”（≥30%）。社区卫生工作者配备并接受了使用自动血压计和移动健康工具的培训。
在22个月期间（2015 - 2017年），5名社区卫生工作者在肯尼亚偏远农村社区筛查了2865名受试者。受试者的年龄中位数为50岁（四分位距43至60岁），1581名（55%）为女性。高血压（收缩压>140mmHg）、糖尿病和烟草使用的点患病率分别为23%、3.2%和22%。总体而言，患者中10年CVD风险<10%的有2778名（97%），10%至<20%的有65名（2.3%），20%至<30%的有12名（0.4%），≥30%的有10名（0.2%）。
我们开发了一种可供社区卫生工作者用于筛查CVD风险因素的移动健康工具，在肯尼亚农村地区展示了概念验证。
