Mobile screening app triples eye care use

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[NAIROBI] According to a study, the use of smartphones for eye screening and referrals could triple the number of people seeking primary care for eye problems and increase the use of hospital services in low-resource settings.

According to the World Health Organization (WHO), approximately 2.2 billion people worldwide suffer from near and far vision loss, with rates of near uncorrected near vision loss exceeding 80% in western, eastern and central sub-regions of sub-Saharan Africa.

The study in Kenya shows the potential of smartphone-based testing to enable non-specialist community volunteers to come to homes and perform eye tests, freeing up capacity among specialist eye care services.

“This smartphone technology has the potential to overcome some of these hurdles, as the technology can be used by a layperson in eye care just about anywhere.”

Stuart Keel, WHO

The Peek community screening app, the study explains, is part of the Peek Community Eye Health System that helps community volunteers screen and make referral decisions about patients with eye problems.

The study recruited more than 128,000 people in 36 communities in Trans Nzoia County, Kenya, from November 2018 to June 2019. Half of the communities benefited from the Peek Community Eye Health System while the control group followed the standard approach to outreach clinics based in health centers.

“We have seen an increase in the use of services at all ages and more among women than men, while previous studies have shown that secondary services are used less by young people and women,” says Hillary Rono, study author and ophthalmologist in Kitale County. Referral and teaching hospital, Kenya.

“Our results showed that the average triage participation rate for people with eye problems was 1,429 per 10,000 in the intervention group and 522 per 10,000 in the control group, clearly demonstrating access increased to care.

Research published in The Lancet Digital Health this month demonstrates the potential of using digital tools to improve access to primary care for more patients, allowing hospitals to focus on more complex cases.

The app “generates referrals, automated short messages, service notifications to patients or guardians, and has a program dashboard to view service delivery,” the study says.

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Rono, who is also a researcher at the London School of Hygiene and Tropical Medicine and Peek Vision in the UK, recounts SciDev.Net that access to specialized eye health resources is scarce in sub-Saharan Africa, especially among rural populations.

Kenya has around three ophthalmologists per million population, compared to 33 in Canada and 54 in the UK.

Barriers to eye care include lack of awareness of eye problems and eye care services, as well as the long journeys often required to access services, Rono adds.

Stuart Keel, technical manager of the WHO eye and vision care program, says the technology has the potential to solve some vision problems, but has limitations.

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“Visual screening can detect common eye conditions such as cataracts and uncorrected refractive errors,” says Keel, who was not involved in the study. “However, visual screening alone is unable to detect other common causes of blindness, such as glaucoma and early stages of diabetes-related eye disease, which are common in sub-Saharan Africa.”

In parts of sub-Saharan Africa, he explains, blindness rates are estimated to be more than five times higher than in all high-income regions of the world.

Keel says the WHO is working on a global campaign to use smartphones to deliver targeted messages for people to have regular eye checks.

“This smartphone technology has the potential to overcome some of these hurdles, as the technology can be used by a layperson in eye care just about anywhere,” he adds. “Incorporating routine mobile text messages is also an important part, as it has been consistently shown to increase attendance rates at eye care facilities. ”

This article was produced by the English Sub-Saharan Africa office of SciDev.Net.

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