Imagine going to the doctor for an HIV test in sub-Saharan
Africa. You will likely have to travel a long distance to get to a clinic and,
once you arrive, the HIV test will require specimens to be sent to a central
testing laboratory for the actual test to be performed. You will then have to
wait for the results to be delivered to the clinic and travel back to get the
diagnosis. In Zambia, it takes approximately 92 days for this process to be
completed. When you are an HIV-positive mother waiting to find out if your
newborn child needs anti-retroviral therapy, each of those 92 days can be the
difference between life and death for your baby.
New work from Dr. William Moss of the Johns Hopkins Bloomberg School of Public Health and his group focuses on finding ways to
shorten the 92-day wait for HIV test results. Capitalizing on the increasing
amount of technology available in rural Zambia, Moss and colleagues conducted a
study using text messaging to deliver the HIV test results directly to mothers
or to the rural health clinics from the central testing lab. They found that by sending a text message to the mother directly,
they could reduce the time from sample collection to receipt of diagnosis to
just 18 days. Unfortunately, the use of mobile phones is still not widespread;
only 30% of mothers in the study had ever used a mobile phone. Luckily, the
local clinics do have mobile phones, so using text messaging to deliver results
to the clinic can still decrease the time to diagnosis to 36 days. By cutting
56 days off the wait for the diagnosis, the HIV-positive children will receive
anti-retroviral therapy nearly 2 months earlier. Reducing the time to treatment
for HIV-positive children has been shown to significantly reduce the
HIV-associated morbidity and mortality, vastly improving their quality of life.
This is not the first time mobile phone technology has been
used in Africa to impact health care. As the number of cell phones throughout
the area has increased, some clinics have chosen to provide expectant mothers
with a mobile phone so that they can get expedited access to an experienced
midwife or healthcare professional. In other areas across the continent, SMS services have been used to target pregnant women and new mothers to ensure early detection of life-threatening emergencies and adherence to treatment regimens for pathogen clearance. These methods and Moss’s study highlight
the same conclusion: increased access to mobile phones throughout the area can have
major positive impacts on health care. Funding and infrastructure for such
technological advances remains a major issue hindering progress.
As noted by Moss in his recent BMC
Pediatrics paper, implementation of the mobile phone messaging system for
test result delivery was by no means trivial. It required the hiring and
training of new staff members, along with the purchase of the study’s mobile
phone and “talk time” for the phone. However, with the right funding and
infrastructure, the spread of technology throughout Africa has the potential to
have significant and widespread impacts on healthcare. Studies such as the one
by Moss and colleagues highlight the great potential of available technology.
This encourages governments and private sector investors to take note and get
involved. Someday soon, nationwide mobile phone messaging systems may become
common place, drastically cutting the time to diagnosis and improving
individual’s access to care and treatment.
