Salvador Fernanda Gonçalves Ferreira, Wakimoto Mayumi Duarte, Duarte Claudia Cristina Jardim, Lapão Luis V, Silveira Henrique, Valete Cláudia Maria
Global Health and Tropical Medicine, GHTM, Associate Laboratory in Translation and Innovation Towards Global Health, LA-REAL, Institute of Hygiene and Tropical Medicine, Universidade Nova de Lisboa, Lisbon, Portugal.
Laboratory of Clinical Research and Surveillance in Leishmaniasis, Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil.
PLoS Negl Trop Dis. 2025 Apr 8;19(4):e0012431. doi: 10.1371/journal.pntd.0012431. eCollection 2025 Apr.
The Neglected Tropical Diseases (NTDs) represent a global public health problem. Telemedicine uses telecommunications to deliver remote healthcare services when patients and providers are separated by distance. Using digital health technologies to offer medical care remotely to NTDs can be an important strategy for reducing inequalities in access but is challenging in low-and middle-income settings. The objective of the current review was to identify and summarize international evidence on the use of telemedicine for clinical care of patients with NTDs around the world based on a scoping review protocol.
METHODOLOGY/PRINCIPAL FINDINGS: A total of 422 articles were extracted from the databases MEDLINE/PubMed, Web of Science and Scopus, and after removing 129 duplicates, 285 studies were excluded because they did not meet the eligibility criteria. A total of 8 articles were included for data extraction, half of them published after 2021 (n=4). Four studies were focused on dermatological diseases, like leprosy and leishmaniasis, and the other diseases found were dengue (n=2), trachoma (n=1) and cysticercosis (n=1). Most telemedicine interventions in NTDs involved Primary Health Care teams (n=5). Studies that evaluated the accuracy of remote diagnosis demonstrated good effectiveness for leprosy, trachoma and complications of neurocysticercosis. There was a reduction in the need for specialized in-person medical consultations with telemedicine for the care of dengue fever and some dermatological NTDs; and an improvement in the quality of clinical monitoring of cutaneous leishmaniasis using mobile health was demonstrated.
CONCLUSIONS/SIGNIFICANCE: Although we observed a small recent increase in academic research on the theme, there is a gap in recommendations for the clinical management of NTDs through telemedicine in the literature. The feasibility and potential for telemedicine-based NTDs diagnosis and treatment have been demonstrated in only a few settings/countries, revealing that this resource is still largely underutilized.
被忽视的热带病是一个全球性的公共卫生问题。远程医疗利用电信技术在患者和医疗服务提供者距离较远时提供远程医疗服务。利用数字健康技术为被忽视的热带病患者提供远程医疗服务可能是减少医疗服务可及性不平等的一项重要策略，但在低收入和中等收入环境中具有挑战性。本次综述的目的是根据一项范围综述方案，识别并总结全球范围内关于使用远程医疗为被忽视的热带病患者提供临床护理的国际证据。
方法/主要发现：从MEDLINE/PubMed、科学网和Scopus数据库中总共提取了422篇文章，去除129篇重复文章后，排除了285项不符合纳入标准的研究。总共纳入8篇文章进行数据提取，其中一半是2021年以后发表的（n = 4）。四项研究聚焦于皮肤病，如麻风病和利什曼病，其他发现的疾病有登革热（n = 2）、沙眼（n = 1）和囊尾蚴病（n = 1）。大多数针对被忽视的热带病的远程医疗干预涉及初级卫生保健团队（n = 5）。评估远程诊断准确性的研究表明，远程诊断对麻风病、沙眼和神经囊尾蚴病并发症具有良好的有效性。通过远程医疗护理登革热和一些皮肤病性被忽视的热带病，减少了面对面进行专科医疗咨询的需求；并且证明使用移动健康改善了皮肤利什曼病的临床监测质量。
结论/意义：尽管我们观察到近期关于该主题的学术研究略有增加，但文献中关于通过远程医疗进行被忽视的热带病临床管理的建议仍存在空白。基于远程医疗的被忽视的热带病诊断和治疗的可行性和潜力仅在少数地区/国家得到证明，这表明这种资源在很大程度上仍未得到充分利用。
