Fernanda Gonçalves Ferreira Salvador, Mayumi Duarte Wakimoto, Claudia Cristina Jardim Duarte, Luis V Lapão, Henrique Silveira, Cláudia Maria Valete
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引用次数: 0
摘要
背景:被忽视的热带病是一个全球性的公共卫生问题。当患者和提供者因距离而分开时,远程医疗使用电信来提供远程医疗保健服务。利用数字卫生技术向被忽视热带病患者远程提供医疗服务可能是减少获取不平等的一项重要战略,但在低收入和中等收入环境中具有挑战性。本次审查的目的是根据范围审查方案,确定和总结关于在世界各地被忽视热带病患者的临床护理中使用远程医疗的国际证据。方法/主要发现:从MEDLINE/PubMed、Web of Science和Scopus数据库中共提取了422篇文章,在删除129个重复后,285篇研究因不符合入选标准而被排除。共纳入8篇文章进行数据提取,其中一半发表于2021年以后(n=4)。四项研究的重点是皮肤病,如麻风病和利什曼病,发现的其他疾病是登革热(n=2)、沙眼(n=1)和囊虫病(n=1)。大多数被忽视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、沙眼和神经囊虫病的并发症具有良好的疗效。减少了为治疗登革热和一些皮肤病上的被忽视热带病而进行的远程医疗专业面对面医疗咨询;应用移动健康技术,提高了皮肤利什曼病的临床监测质量。结论/意义:虽然我们观察到最近关于该主题的学术研究略有增加,但在文献中通过远程医疗对被忽视热带病的临床管理的建议存在差距。基于远程医疗的被忽视热带病诊断和治疗的可行性和潜力仅在少数环境/国家得到证实,这表明这一资源在很大程度上仍未得到充分利用。
Telemedicine in the clinical care of neglected tropical diseases: A scoping review.
Background: 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.
期刊介绍:
PLOS Neglected Tropical Diseases publishes research devoted to the pathology, epidemiology, prevention, treatment and control of the neglected tropical diseases (NTDs), as well as relevant public policy.
The NTDs are defined as a group of poverty-promoting chronic infectious diseases, which primarily occur in rural areas and poor urban areas of low-income and middle-income countries. Their impact on child health and development, pregnancy, and worker productivity, as well as their stigmatizing features limit economic stability.
All aspects of these diseases are considered, including:
Pathogenesis
Clinical features
Pharmacology and treatment
Diagnosis
Epidemiology
Vector biology
Vaccinology and prevention
Demographic, ecological and social determinants
Public health and policy aspects (including cost-effectiveness analyses).