Lighthouse Trust, Lilongwe, Malawi.
Department of Paediatrics, Division of Pneumonology and Immunology with intensive Medicine, Charité-Universitätsmedizin, Berlin, Germany.
Ann Glob Health. 2021 Apr 16;87(1):39. doi: 10.5334/aogh.3208.
In resource-limited settings, many HIV-infected patients with advanced HIV-related disease need specialized care not represented in guidelines. Training opportunities for healthcare providers on advanced HIV care are limited. The aim of this study was to evaluate the educational content and acceptability of mobile instant messaging (MIM) as a training and telemedicine tool for HIV care providers in Malawi.
At the Lighthouse Clinic, Malawi, a MIM group using WhatsApp® was created for clinical officers and moderated by an infectious disease consultant. Questions encountered in the clinics as well as educational cases were posted; identifying data was not to be posted. MIM conversation was analyzed and in-depth interviews with users on its perceptions were performed.
MIM was utilized by 25 clinical officers and five physicians with an average of 2.3 threads/week over the observation period of 15 months. Discussed topics related to tuberculosis (25 threads), adverse drug reaction (22 threads), antiretroviral treatment (21 threads), cryptococcal meningitis (12 threads), and drug dosing/logistics. In 20% of the threads at least one image file was shared (mainly pictures of skin conditions and chest X-rays). In-depth interviews showed that clinical officers appreciated MIM group as a telemedicine consulting and training tool.
MIM was a successful and well-accepted telemedicine tool for support and training of clinical officers providing HIV care in a resource-limited setting. MIM may be integrated in training strategies to expand the knowledge of HIV care providers.
在资源有限的环境下，许多患有晚期艾滋病的艾滋病病毒感染者需要专业的关怀，而这些关怀在指南中并未涉及。医疗保健提供者接受高级艾滋病护理培训的机会有限。本研究旨在评估移动即时通讯（MIM）作为马拉维艾滋病护理提供者培训和远程医疗工具的教育内容和可接受性。
在马拉维的灯塔诊所，创建了一个使用 WhatsApp®的 MIM 小组，由传染病顾问进行管理。在诊所中遇到的问题以及教育案例都会被发布；但不允许发布识别数据。分析 MIM 对话，并对用户对其的看法进行深入访谈。
在 15 个月的观察期内，25 名临床医生和 5 名医生平均每周使用 MIM 进行 2.3 次交流。讨论的主题涉及结核病（25 个帖子）、药物不良反应（22 个帖子）、抗逆转录病毒治疗（21 个帖子）、隐球菌性脑膜炎（12 个帖子）和药物剂量/物流。在 20%的帖子中，至少分享了一个图像文件（主要是皮肤状况和胸部 X 光片的图片）。深入访谈显示，临床医生认为 MIM 小组是一种远程医疗咨询和培训工具。
MIM 是一种成功且深受认可的远程医疗工具，可用于支持和培训在资源有限环境中提供艾滋病护理的临床医生。MIM 可以整合到培训策略中，以扩大艾滋病护理提供者的知识。
