JMIR Publications

ABSTRACT

Background:

Neglected tropical diseases (NTDs) is a diverse group of 20 communicable diseases that occur in tropical and subtropical conditions in 149 countries, affecting over one billion people and costing developing economies billions of dollars every year. Within these diseases, those that present lesions on the skin surface are classed as skin NTDs (sNTDs). Mobile health interventions are currently being used worldwide to manage skin diseases and can be a good strategy in the epidemiological and clinical management of sNTDs.

Objective:

To analyze existing evidence about mobile health interventions to control and manage sNTDs in low- and middle-income countries (LMIC) and make recommendations for what should be considered in future interventions.

Methods:

A systematic review was conducted of the Medline, Embase and Scopus databases over 10 years up to April 30, 2020. All types of clinical studies were considered. Data were synthesized into evidence tables. Apps were selected through a comprehensive systematic search in Google Play and Apple Store conducted between 20 March and 15 April 2020.

Results:

From 133 potentially relevant publications, 13 studies met the criteria. These analyze 8 different interventions (3 SMS text messaging and 5 app interventions). Six (46%) of the studies are community-based, cross-sectional studies intended to epidemiologically map a specific disease, mainly Lymphatic Filariasis (LF), but also Cutaneous Leishmaniasis (CL), Leprosy and NTDs and sNTDs in general. Most of the studies were considered to have a high (n=5) or moderate (n=4) risk of bias. Fifteen apps have been identified in Google Play, three of which are also in Apple Store. Most of the apps (73%) are targeted at healthcare professionals with only 4 targeted at patients. The apps focus on: Scabies (n=3); LF (n=3); CL (n=1); Leprosy (n=1); Yaws and Buruli Ulcer (n=1); a general overview of tropical diseases including more than one sNTDs (n=3); and NTDs including sNTDs (n=2). Only one app focuses on the clinical management of sNTDs.

Conclusions:

There is a remarkable heterogeneity among studies and the majority have methodological limitations that leave considerable room for improvement. The few apps that are available are not supported by adequate methodological trials. Based on existing evidence, a number of recommendations are made for future interventions.