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Varo R, Postigo M, Bila R, Dacal E, Chiconela H, García-Villena J, Cuadrado D, Vladimirov A, Díez N, Vallés-López R, Sitoe A, Vitorino P, Mucasse C, Beltran-Agullo L, Pujol O, García V, Abdala M, Sallé L, Anton A, Santos A, Ledesma-Carbayo MJ, Luengo-Oroz M, Bassat Q. Evaluation of the Performance of a 3D-Printed Smartphone-Based Retinal Imaging Device as a Screening Tool for Retinal Pathology in Mozambique. Am J Trop Med Hyg 2023; 109:1192-1198. [PMID: 37918001 PMCID: PMC10622463 DOI: 10.4269/ajtmh.23-0378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 08/07/2023] [Indexed: 11/04/2023] Open
Abstract
Low-income countries carry approximately 90% of the global burden of visual impairment, and up to 80% of this could be prevented or cured. However, there are only a few studies on the prevalence of retinal disease in these countries. Easier access to retinal information would allow differential diagnosis and promote strategies to improve eye health, which are currently scarce. This pilot study aims to evaluate the functionality and usability of a tele-retinography system for the detection of retinal pathology, based on a low-cost portable retinal scanner, manufactured with 3D printing and controlled by a mobile phone with an application designed ad hoc. The study was conducted at the Manhiça Rural Hospital in Mozambique. General practitioners, with no specific knowledge of ophthalmology or previous use of retinography, performed digital retinographies on 104 hospitalized patients. The retinographies were acquired in video format, uploaded to a web platform, and reviewed centrally by two ophthalmologists, analyzing the image quality and the presence of retinal lesions. In our sample there was a high proportion of exudates and hemorrhages-8% and 4%, respectively. In addition, the presence of lesions was studied in patients with known underlying risk factors for retinal disease, such as HIV, diabetes, and/or hypertension. Our tele-retinography system based on a smartphone coupled with a simple and low-cost 3D printed device is easy to use by healthcare personnel without specialized ophthalmological knowledge and could be applied for the screening and initial diagnosis of retinal pathology.
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Affiliation(s)
- Rosauro Varo
- ISGlobal, Hospital Clínic—Universitat de Barcelona, Barcelona, Spain
- Centro de Investigação em Saúde de Manhiça, Maputo, Mozambique
| | | | - Rubao Bila
- Centro de Investigação em Saúde de Manhiça, Maputo, Mozambique
| | | | - Hélio Chiconela
- Centro de Investigação em Saúde de Manhiça, Maputo, Mozambique
| | | | | | | | | | | | - Antonio Sitoe
- Centro de Investigação em Saúde de Manhiça, Maputo, Mozambique
| | - Pio Vitorino
- Centro de Investigação em Saúde de Manhiça, Maputo, Mozambique
| | - Campos Mucasse
- Centro de Investigação em Saúde de Manhiça, Maputo, Mozambique
| | | | - Olivia Pujol
- Institut Català de Retina, Barcelona, Spain
- Hospital Vall d´Hebron, Barcelona, Spain
| | | | - Mariamo Abdala
- Departamento de Oftalmologia, Hospital Central de Maputo, Maputo, Mozambique
- Faculdade de Medicina, Universidade Eduardo Mondlane, Maputo, Mozambique
| | - Lucía Sallé
- Biomedical Image Technologies Group, Departamento de Ingeniería Electrónica, Escuela Técnica Superior de Ingenieros Telecomunicación, Universidad Politécnica de Madrid, Madrid, Spain
| | - Alfonso Anton
- Institut Català de Retina, Barcelona, Spain
- CIBER de Bioingeniería, Biomateriales y Nanomedicina, Instituto de Salud Carlos III, Madrid, Spain
| | - Andrés Santos
- Biomedical Image Technologies Group, Departamento de Ingeniería Electrónica, Escuela Técnica Superior de Ingenieros Telecomunicación, Universidad Politécnica de Madrid, Madrid, Spain
- CIBER de Bioingeniería, Biomateriales y Nanomedicina, Instituto de Salud Carlos III, Madrid, Spain
| | - María J. Ledesma-Carbayo
- Biomedical Image Technologies Group, Departamento de Ingeniería Electrónica, Escuela Técnica Superior de Ingenieros Telecomunicación, Universidad Politécnica de Madrid, Madrid, Spain
- CIBER de Bioingeniería, Biomateriales y Nanomedicina, Instituto de Salud Carlos III, Madrid, Spain
| | | | - Quique Bassat
- ISGlobal, Hospital Clínic—Universitat de Barcelona, Barcelona, Spain
- Centro de Investigação em Saúde de Manhiça, Maputo, Mozambique
- Institut Català de Recerca i Estudis Avançats, Barcelona, Spain
- Pediatrics Department, Hospital Sant Joan de Déu, Universitat de Barcelona, Esplugues, Barcelona, Spain
- CIBER de Epidemiología y Salud Pública, Instituto de Salud Carlos III, Madrid, Spain
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Montoya I de Manuel-Rimbau A, Nguenha D, Mambuque E, Ehrlich J, Munguambe S, Saavedra B, Matsena T, Chiconela H, Casellas A, López-Varela E, Acacio S, Garcia-Basteiro AL. Initiation and adherence to isoniazid preventive therapy in children under 5 years of age in Manhiça, Southern Mozambique. J Trop Pediatr 2022; 69:7010560. [PMID: 36718019 DOI: 10.1093/tropej/fmad009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
The WHO recommends preventive treatment for all pediatric contacts of a confirmed TB case, but coverage remains low in many high TB burden countries. We aimed to assess the coverage and adherence of the isoniazid preventive therapy (IPT) program among children under 5 years of age with household exposure to an adult pulmonary TB case in a rural district of Southern Mozambique. The estimated IPT coverage was 11.7%. A longer distance to the health center and lower age of the children hindered IPT initiation. Among patients who started IPT, 12/18 (69.9%) were adherent to the 6-month treatment.
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Affiliation(s)
| | - Dinis Nguenha
- Centro de Investigação em Saude de Manhiça, Manhiça, Maputo, Mozambique.,Amsterdam Institute for Global Health and Development (AIGHD), Amsterdam, The Netherlands
| | - Edson Mambuque
- Centro de Investigação em Saude de Manhiça, Manhiça, Maputo, Mozambique
| | - Joanna Ehrlich
- ISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain
| | - Shilzia Munguambe
- Centro de Investigação em Saude de Manhiça, Manhiça, Maputo, Mozambique
| | - Belén Saavedra
- ISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain.,Centro de Investigação em Saude de Manhiça, Manhiça, Maputo, Mozambique
| | - Teodimiro Matsena
- Centro de Investigação em Saude de Manhiça, Manhiça, Maputo, Mozambique
| | - Hélio Chiconela
- Centro de Investigação em Saude de Manhiça, Manhiça, Maputo, Mozambique.,National Tuberculosis Control Programme, District of Manhiça, Mozambique
| | - Aina Casellas
- ISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain
| | - Elisa López-Varela
- ISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain.,Centro de Investigação em Saude de Manhiça, Manhiça, Maputo, Mozambique
| | - Sozinho Acacio
- Centro de Investigação em Saude de Manhiça, Manhiça, Maputo, Mozambique
| | - Alberto L Garcia-Basteiro
- ISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain.,Centro de Investigação em Saude de Manhiça, Manhiça, Maputo, Mozambique.,Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Barcelona, Spain
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