1.8 A Leishmania knowledge center to support health care professionals and patients

Institute of Tropical Medicine (ITM), Antwerp, Belgium - BMD Software (BMD), Aveiro, Portugal   - University of Gondar (GONDAR), Gondar, Ethiopia

Area of research: Diagnostic/Treatment
Research programme: Implementation

Objective:

To develop ICT solutions to streamline the diagnosis and treatment of cutaneous leishmaniasis in underserved regions

Expected results:

(1) A centralized health record database to link patient’s data collection, clinical images, and lab test results for diagnosis and treatment monitoring 

(2) A geographical information system for epi-surveillance.

Summary:

Background: The access to dermatologic care is quite limited in underserved regions where specialists' advice and dedicated diagnostic tools are available mostly at tertiary level of care. Several studies have already reported on the experience of using mobile teledermatology as a valid solution to fill these gaps. However, a systematic integration of the knowledge coming from these studies as also the longitudinal support for all actors (HPC, patients, educators, police decision maker, population) is still missing. Moreover, the typical lack of ICT resources at these regions rise challenges that go beyond the technological ones.

Methodology: 1) Clinical Repository and data collection.  A mobile application will be developed to facilitate the collection, storage, and transmission of pertinent dermatologic medical information to an online database located in a reference center. Android smartphones will be used for the image and patients’ data collection. A central health record system platform will be set, allowing the collection and storage of coded pictures, patients’ clinical details, and laboratory-confirmed diagnosis. A database cohort builder function will allow generating groups of items for data exports and reporting, through a flexible management reporting tool. This platform will function as a labeled image repository which enables creation and maintenance of robust patient data linked to diagnostic photographs of lesions. All the data will be used for the seeking of expert medical advice (telemedicine), for treatment outcome monitoring and generation of interactive clinical cases for educational purposes (e.g., http://e.itg.be/cme/subcutaneous/quiz.html). 2) Epi-surveillance. We will link the images, clinical and diagnostic information to a demographic location, together with clinical observations and frequency of clinical events in specific geographic areas. This geographical information system will facilitate the identification of areas and population groups presenting with leishmania skin disease linked to the specific location, allowing more tailored preventive or curative medicine for the most at risk population. This component will facilitate decision-making processes in the population’s health promotion. Together with the clinical repository, this component will be further explored to support educational purposes.