Malaria Department, Population Services International (PSI), Washington, DC, United States of America.
Audere, Seattle, WA, United States of America.
PLoS One. 2024 Mar 26;19(3):e0295049. doi: 10.1371/journal.pone.0295049. eCollection 2024.
Malaria rapid diagnostic tests (mRDTs) are an essential diagnostic tool in low-resource settings; however, administration and interpretation errors reduce their effectiveness. HealthPulse, a smartphone mRDT reader application, was developed by Audere to aid health workers in mRDT administration and interpretation, with an aim to improve the mRDT testing process and facilitate timely decision making through access to digitized results. Audere partnered with PSI and PS Kenya to conduct a pilot study in Busia County, Kenya between March and September 2021 to assess the feasibility and acceptability of HealthPulse to support malaria parasitological diagnosis by community health volunteers (CHVs) and private clinic health workers (private clinic HWs). Metadata was interpreted to assess adherence to correct use protocols and health worker perceptions of the app. Changes to mRDT implementation knowledge were measured through baseline and endline surveys. The baseline survey identified clear mRDT implementation gaps, such as few health workers correctly knowing the number of diluent drops and minimum and maximum wait times for mRDT interpretation, although health worker knowledge improved after using the app. Endline survey results showed that 99.6% of health workers found the app useful and 90.1% found the app easy to use. Process control data showed that most mRDTs (89.2%) were photographed within the recommended 30-minute time frame and that 91.4% of uploaded photos passed the app filter quality check on the first submission. During 154 encounters (3.5% of all encounters) a health worker dispensed an artemisinin-based combination therapy (ACT) to their patient even with a negative mRDT readout. Overall, study results indicated that HealthPulse holds potential as a mobile tool for use in low-resource settings, with future supportive supervision, diagnostic, and surveillance benefits. Follow-up studies will aim to more deeply understand the utility and acceptance of the HealthPulse app.
疟疾快速诊断检测（mRDT）是资源匮乏环境下的重要诊断工具；然而，管理和解释错误会降低其效果。Audere 开发了智能手机 mRDT 读取应用程序 HealthPulse，旨在帮助卫生工作者进行 mRDT 管理和解释，旨在通过访问数字化结果来改善 mRDT 检测过程并促进及时决策。Audere 与 PSI 和 PS 肯尼亚合作，于 2021 年 3 月至 9 月在肯尼亚布西亚县进行了试点研究，以评估 HealthPulse 支持社区卫生志愿者（CHV）和私人诊所卫生工作者（私人诊所 HW）进行疟疾寄生虫学诊断的可行性和可接受性。元数据进行了解释，以评估对正确使用协议的遵守情况以及卫生工作者对该应用程序的看法。通过基线和终线调查来衡量对 mRDT 实施知识的改变。基线调查发现了明确的 mRDT 实施差距，例如很少有卫生工作者正确知道稀释液滴的数量以及 mRDT 解释的最小和最大等待时间，尽管在使用该应用程序后，卫生工作者的知识有所提高。终线调查结果显示，99.6%的卫生工作者认为该应用程序有用，90.1%的人认为该应用程序易于使用。过程控制数据显示，大多数 mRDT（89.2%）在建议的 30 分钟时间范围内拍照，并且 91.4%的上传照片在第一次提交时通过了应用程序过滤质量检查。在 154 次就诊（所有就诊的 3.5%）中，即使 mRDT 检测结果为阴性，一名卫生工作者还是向其患者开出了青蒿素类复方疗法（ACT）药物。总体而言，研究结果表明，HealthPulse 作为一种在资源匮乏环境下使用的移动工具具有潜力，具有未来的支持性监督、诊断和监测效益。后续研究将旨在更深入地了解 HealthPulse 应用程序的实用性和可接受性。
