Secure Delivery of HIV-Related and Tuberculosis Laboratory Results to Patient Cell Phones: A Pilot Comparative Study (original) (raw)

Abstract

South Africa processes 5.1 million HIV CD4, viral load (VL), and tuberculosis (TB) tests annually. This pilot non-randomized trial in South Africa explored an intervention (“MatlaMobile”) to deliver laboratory results via mobile phone. Adults completing CD4, VL, and/or TB laboratory tests were enrolled—either receiving results by returning to clinic (control, n = 174) or mobile phone (intervention, n = 226). Study staff instructed control participants to return within 6 days (standard-of-care). MatlaMobile instructed intervention participants with clinically actionable results requiring intervention or treatment change (i.e., < 200 CD4 cells per milliliter, ≥ 400 viral copies per milliliter, or TB positive) to return immediately. A greater proportion of intervention participants than controls saw their results within 7 days of enrollment (73% vs. 8.6%, p < 0.001). Among participants instructed to return, more intervention participants (20%, n = 14/70) returned than controls (8.6%, n = 15/174, p = 0.02). MatlaMobile demonstrated that patients can quickly receive and respond appropriately to digital delivery of health information.

Resumen

Sudáfrica procesa 5.1 millones de pruebas de cuenta de CD4, carga viral de VIH (VL) y tuberculosis (TB) anualmente. En este estudio piloto no aleatorizado en Sudáfrica se exploró la intervención por medio de la aplicación (“MatlaMobile”) para entregar resultados de laboratorio via teléfono celular. Adultos con pruebas de CD4, VL y/o TB, fueron incluidos para recibir los resultados cuando regresaron a la clínica (control, n = 174) o en su teléfono celular (intervención, n = 226). El staff del estudio instruyó a los participantes del grupo control a regresar en los primeros 6 días (práctica estándar). MatlaMobile instruyó a los participantes que necesitaban alguna intervención o ajuste al tratamiento, de acuerdo con sus resultados (i.e., CD4 < 200, VL ≥ 400, o TB +) a regresar inmediatamente a la clínica. Mayor proporción de participantes en el grupo de intervención, vs. control, vio sus resultados en los primeros 7 días (73% vs. 8.6%, p < 0.001). De los pacientes a los que se les pidió regresar, más participantes del grupo intervención (20%, n = 17/70) lo hicieron, comparados con el grupo control (8.6%, n = 15/174, p = 0.02). MatlaMobile demostró que los pacientes pueden recibir información de salud rápidamente de forma digital y responder de manera apropiada.

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Acknowledgments

The authors thank the study participants who volunteered their time, the North West Provincial Department of Health for hosting the study, and the study staff. This study was partially funded by 13 student fellowships through the Global Established Multidisciplinary Sites (GEMS) program at the Johns Hopkins Center for Global Health.

Author information

Author notes

  1. Lisa DiAndreth and Brooke A. Jarrett are co-first authors.
  2. Jonathan E. Golub and Neil A. Martinson are co-last authors.

Authors and Affiliations

  1. Johns Hopkins School of Nursing, 525 N Wolfe St., Baltimore, MD, 21205, USA
    Lisa DiAndreth & Omeid Heidari
  2. Johns Hopkins School of Public Health, Johns Hopkins University, 615 North Wolfe Street, Baltimore, MD, 21205, USA
    Lisa DiAndreth, Brooke A. Jarrett, Thamanna Nishath, Sarah Cox & Jonathan E. Golub
  3. Colorado State University, 1681 Campus Delivery, Fort Collins, CO, 80523, USA
    Jessica L. Elf
  4. Johns Hopkins School of Arts and Sciences, 3400 N. Charles Street, Baltimore, MD, 21218, USA
    Brennan Donville
  5. Tshimologong, University of the Witwatersrand, Johannesburg, South Africa
    Justine Moreton & Aveer Ramnath
  6. Perinatal HIV Research Unit (PHRU), SA MRC Soweto Matlosana Collaborating Centre for HIV/AIDS and TB, University of the Witwatersrand, Johannesburg, South Africa
    Limakatso Lebina, Ebrahim Variava & Neil A. Martinson
  7. Klerksdorp-Tshepong Hospital Complex, Klerksdorp, South Africa
    Ebrahim Variava & Neil A. Martinson
  8. Johns Hopkins Center for TB Research, Baltimore, MD, USA
    Jonathan E. Golub & Neil A. Martinson
  9. Department of Epidemiology, Johns Hopkins University, 615 North Wolfe Street, Baltimore, MD, 21205, USA
    Brooke A. Jarrett

Authors

  1. Lisa DiAndreth
  2. Brooke A. Jarrett
  3. Jessica L. Elf
  4. Thamanna Nishath
  5. Brennan Donville
  6. Omeid Heidari
  7. Sarah Cox
  8. Justine Moreton
  9. Aveer Ramnath
  10. Limakatso Lebina
  11. Ebrahim Variava
  12. Jonathan E. Golub
  13. Neil A. Martinson

Contributions

All authors contributed to the design, planning, and implementation of the study. LD, BAJ, JLE, JEG, and NAM analyzed the data. All authors contributed to the writing and review of the manuscript and approve this version.

Corresponding author

Correspondence toBrooke A. Jarrett.

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DiAndreth, L., Jarrett, B.A., Elf, J.L. et al. Secure Delivery of HIV-Related and Tuberculosis Laboratory Results to Patient Cell Phones: A Pilot Comparative Study.AIDS Behav 24, 3511–3521 (2020). https://doi.org/10.1007/s10461-020-02912-3

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