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[NEW DELHI] Long awaited proof that mobile phone technology can be used by healthcare workers to save lives in Africa has finally been published.

Findings from the first scientific trial on the link between mobile phones and HIV treatment outcomes — conducted in Kenya by scientists from Canada, Kenya and the United States — are reported in The Lancet this week (9 November).

So far there has been  limited field data about the use of mobile health technologies to improve patient outcomes in developing countries — and there are no published clinical trials.

The trial was conducted on HIV patients, many of whom lived in remote areas and were receiving treatment in three Kenyan clinics. Patients received a weekly text message in their local language, Swahili, from a nurse enquiring how they were feeling. Patients were expected to respond within 48 hours.

If a response was not received within this period, a healthcare worker promptly rang to enquire what was wrong and, if needed, visited them. Patients in the control group received standard care without any text messaging.

The study, conducted from May 2007 to October 2008, showed that nearly 63 per cent of mobile phone users reported treatment adherence; compared with only 50 per cent in the control group. 

Viral loads were undetectable in 57 per cent of patients who received the weekly text messages compared with 48 per cent in the control group.

A scale up of the programme in Kenya could suppress viral loads in 26,000 extra people at the cost of less than US$8 per person per year, said Richard Lester, of the British Columbia Centre for Disease Control and one of the researchers in the Nairobi trial.

But it needs a formal, cost-effectiveness assessment first.

"We have also developed some innovative business models to strategise scaling up the [Kenyan] programme nationally and regionally," he told SciDev.Net. "This may have huge implications for global HIV control since it may be a cost effective way to strengthen health systems for Millennium Development Goals."

This week's 2010 mHealth Summit in Washington DC (8–10 November) repeatedly called for more data to advance evidence-based implementation of mHeath concepts, Lester told SciDev.Net. The conference also heard several examples of mobile phone use for remote diagnostics.

Because mobile phones are wireless they overcome many of the infrastructural barriers to communications in resource-limited settings, Lester said. But other aspects of infrastructure, such as drug supply chains, remain challenges.

The next frontier, he suggested, is the mobile power supply — there are already exciting advances being made in this field.

Link to full article in The Lancet

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