Sunny Ibeneme

By Sunny Ibeneme, Nkiruka Ukor, Joseph Okeibunor and Felicitas Zawaira

Background: While multiple studies have documented the impacts of mobile phone use on TB health outcomes for varied settings, it is not immediately clear what the spatial patterns of TB treatment completion rates among African countries are. This paper used Exploratory Spatial Data Analysis (ESDA) techniques to explore the clustering spatial patterns of TB treatment completion rates in 53 African countries as well as their relationships with mobile phone use. Using an ESDA approach to identify countries with low TB treatment completion rates and reduced mobile phone use is the first step towards addressing issues related to poor TB outcomes. Methods: TB notifications and treatment data from 2000 through 2015 obtained from the World Bank database were used to illustrate a descriptive epidemiology of TB treatment completion rates among African health systems. Spatial clustering patterns of TB treatment completion rates were assessed using differential local Moran’s I techniques; and local spatial analytics was performed using local Moran’s I tests. Relationships between TB treatment completion rates and mobile phone use were evaluated using ESDA approach. Results: Spatial autocorrelation patterns generated were consistent with Low-Low and High-Low cluster patterns and were significant at different p-values. Algeria and Senegal had significant clusters across the study periods, while Democratic Republic of Congo, Niger, South Africa, and Cameroon had significant clusters in at least two time-periods. ESDA identified statistically significant associations between TB treatment completion rates and mobile phone use. Countries with higher rates of mobile phone use, showed higher TB treatment completion rates overall, indicating enhanced program uptake (P < 0.05). Conclusions: Study findings provide systematic evidence to inform policy regarding investments in the use of mHealth to optimize TB health outcomes. African governments should identify turnaround strategies to strengthen mHealth technologies and improve outcomes.

Part of the book: Healthcare Access

By Alozie Emeonye, Florence Nkwogu, Joseph Okeibunor and Sunny Ibeneme

The practice of ophthalmology depends largely on ophthalmoscopy and photographic documentation of examination findings from patients. These images are used for patient education, monitoring, storage, expert reviews and treatment. In Africa, due to poor management and poor resources in some health systems, there is a dearth of infrastructure and equipment like fundus cameras. In such resource-poor settings, eye care personnel manage patients with available resources, or improvise with low-cost measures. Smartphone fundoscopy is one of such improvisations. This study describes a novel adapter for smartphone fundoscopy, used in conjunction with a tripod. It was built on existing research on smartphone fundoscopy. Fundus images were captured with a smartphone and a +20D lens, both coupled by an improvised adapter; the Chizaram-Condensing Lens Adapter for Smartphones (C-CLAS) on a tripod. This system works as an indirect ophthalmoscope. Videos of the fundus were recorded, and high-quality still-images were taken from segments of the videos. A total of 54 patients were used in the study, aged between 8 and 74 years. The C-CLAS captured high-quality fundus images from 39 patients (72%), in a variety of normal and pathological conditions. The use of a tripod rendered the procedure hands-free, introducing another dimension to smartphone fundoscopy.

Part of the book: A Comprehensive Overview of Telemedicine [Working title]