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How HIV-Focused Telehealth Can Improve HIV/AIDS Treatment

hiv-focused telehealthSome of the largest barriers to HIV treatment and prevention in rural areas are access to care and affordability. Luckily, telehealth technology can help provide people in more isolated areas with access to information about HIV prevention and treatment. For individuals without a car whose nearest health center is 15 or more miles away, HIV-focused telehealth or telemedicine is a potential solution.

Through telehealth, individuals can hold appointments with health practitioners over the phone, through messaging services or via video chat. Telehealth is one of the more accessible technological services, as expensive devices like smartphones and personal laptops are not necessarily required. Additionally, the appointments themselves reduce in cost, as they are cheaper than in-person appointments and do not require any travel on the part of the patient or health practitioner.

Here are a few ways that HIV-focused telehealth programs can assist people with HIV, from diagnosis to treatment.

Testing

Telehealth can encourage HIV self-testing in remote, resource-limited areas. With the establishment of many HIV self-testing initiatives in countries like Zambia and South Africa, telehealth coupled with home-testing kits allow individuals to have the guidance of a health professional in the privacy of their homes. With an at-home HIV test, the patient can take the test at their convenience while talking, video chatting or texting with a health practitioner. This way, the patient would not have to rely on inaccessible health clinics to get tested, and would have the guidance of a professional assisting them with administering the test themselves.

At-home testing with telehealth also ensures that the health practitioner can link the patient to a confirmatory test and other resources following the test results. If a person is alone after taking a self-test, it is possible that they will not follow up with the necessary appointments. 

Diagnosis

In most countries, HIV is highly stigmatized and many people face discrimination, isolation and a sense of hopelessness following a diagnosis. People who experience depression after finding out their status are less likely to adhere to medication or care about their overall physical health.

In resource-constrained areas, many of which struggle with high instances of HIV, telepsychiatry may be the only option for therapy. Research from the World Health Organization (WHO) showed that low-income countries have a median of 0.05 psychiatrists for every 100,000 people, versus high-income countries with 10.50 psychiatrists for every 100,000 people.

With telepsychiatry, people in remote areas can receive low-cost therapy at home from a therapist that is located anywhere in the world. While studies have shown telepsychiatry to be effective and affordable in resource-constrained areas, it is the least widely implemented telehealth practice, with most countries prioritizing teleradiology and telepathology.

Treatment

When people with HIV do not have the means to travel to a health center for treatment and proper check-ups, telehealth technology combined with traveling medical services can ensure better medication adherence and better outcomes for people living with HIV. Telehealth can assist HIV positive people by scheduling check-ins and antiretroviral medication deliveries over the phone.

However, some organizations are developing new ways to assist patients through mobile phone apps. The Vodafone Foundation recently introduced a mobile telephone app designed to assist people with HIV that live in resource-constrained areas. The HIV-focused telehealth app was first launched in Lesotho, Africa, and it allows health practitioners to track their patient’s treatment, health information and payment methods. The app also connects patients with funding to pay for appointments and transportation to the closest health center.

While technology has given the global fight against HIV/AIDS a much-needed upgrade, lack of funding, infrastructure and legislation were still named as the top three barriers to implementing national telehealth programs for WHO member states. Regardless, more than 57 percent of WHO member states acknowledge telehealth in national policy and many are looking to implement new telehealth programs through legislation in the future. If the legislation leads to the initiation of more HIV-focused telehealth programs, people with HIV in remote areas will have a better chance at leading healthy lives.

– Danielle Poindexter

Photo: Flickr

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The Appeal and Usefulness of Web-Based Health Programs

Web-Based Health Programs
Recent advancements in technology have transformed and improved countless aspects of peoples’ lives. Some of the word’s greatest health concerns are obesity and the abuse of alcohol and tobacco. Can web-based health programs make a dent in these problems?

Web-based health programs encourage setting concrete goals and can interact with users throughout the day. They have the added benefit of 24/7 accessibility.

One example is an online tool designed for the Obesity Prevention Tailored for Health II project. The tool locates and displays health food stores, parks and recreational programs near users. It also suggests health-and-eco-friendly transportation options such as biking, walking and using public transit.

Discussed below are two examples of studies examining the usefulness of web-based health programs.

University of Washington

At the University of Washington in Seattle, researchers have been reviewing studies about the effectiveness of mobile and web-based health programs in helping users curb unhealthy behaviors such as overeating and smoking.

The team of researchers found that web-based programs helped users increase their physical activity and lose weight. Eighty-eight percent of the tested programs helped people exercise more. In addition to this, 77% of tested programs designed to help users quit smoking proved effective.

Health Affairs Journal

Health Affairs published a study examining nearly 2,000 overweight adult participants whom researchers divided into groups. In some groups, participants were given access to a social-networking intervention program, and in other groups, they were not. The program featured motivational emails and phone calls, an online discussion forum and a tool for recording food intake. Participants who used the web-based health program experienced slightly greater body mass index (BMI) reduction on average than did participants who didn’t use the program.

Overall, web-based health programs offer a promising alternative to traditional health interventions. They are generally low in cost and widely accessible. Web-based health programs have the potential both to change the way we look at health and improve countless peoples’ quality of life.

– Nathaniel Siegel

Photo: Flickr

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Viral Diagnostic Technology

Viral Diagnostic Technology
In today’s world, there are about 35 million people living with HIV. New HIV treatments are in near-constant development, but monitoring their effectiveness is almost as important as the treatment itself. By keeping track of what is working (and what is not), new and more effective HIV treatments can be developed, and regimens can be individualized to see what is working the best for each patient.

Viral load tests (tests that measure the concentration of the HIV virus in the blood) are done to monitor treatment. If there are over 1000 copies of the virus per mL of blood, then doctors will adjust the patient’s HIV treatment. Unfortunately, in the current method of viral load testing, results can take weeks to come back to doctors, making it difficult for them to make decisions about adjusting care. Not only that, but they can be expensive and hard to administer in a clinical setting.

Kathyrn Kundrod and Jay Fraser, undergraduate students at Lehigh University, were part of a team that developed a microfluidic device to measure viral load. Their project is called Viral Diagnostic Technology. With this innovation, only a small sample volume of blood would be needed for testing, and it could be done more quickly and efficiently. If the entire system comes to fruition, the test could be done on-site with doctor and patient.

As Kundrod says, their device is “more portable, easier to operate, and less expensive than other approaches currently in use or in development.” In fact, the estimated price tag for each unit of this Viral Diagnostic Technology is about $2.38.

The science behind the development has to do with how the HIV is being looked for.
In a nutshell (and for those who aren’t engineers), the device would run an electrical current cyclically between two electrodes, through the porous membrane of the microfluidic device. If there is a high concentration of HIV in the bloodstream, antibodies (specifically, anti-gp120) built into the device will capture it, basically building little antibody walls around the virus. These little walls keep the electrical current from making it to the second electrode, thereby reducing peak current values.

In an even smaller nutshell, if there is a certain amount of HIV in the bloodstream, the “peak current values” of the Viral Diagnostic Technology device will be lower, and the doctor will know to adjust HIV treatment. If there is no HIV (or below a certain amount of HIV), peak current values will be higher and the doctor will know to continue treatment in the same way.

The innovative design, created by five students at LeHigh, earned first place at the National Institute of Health’s Design by Biomedical Undergraduate Teams (DEBUT) challenge. It will therefore receive $20,000 to advance the development of their project.

The group, which is now known as Cyclic Solutions, hopes to have their design for Viral Diagnostic Technology procured by an organization such as UNITAID or the World Health Organization (WHO). With over 15 million people globally currently receiving HIV treatment, a device that can measure its effects in low-resource settings could save millions of lives.

– Emily Dieckman

Sources: Lehigh University, News Medical, NIH 1, NIH 2
Photo: Flickr

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UC Irvine’s ‘Solutions for Poverty Challenge’

global_aid
New technology and modern innovations have played an ever-increasing role in the fight against global poverty in the 21st century, but where do these new tools and practices come from? Most come from established technology and manufacturing firms like GE, IBM and Apple. Major universities are also hotbeds for invention. However, in the last five years there has been a surge in innovation coming from grassroots and non-traditional organizations with the help of social media and other sites, such as Kickstarter. Keeping with the changing tides, the University of California at Irvine launched a contest in May of this year encouraging students to propose original solutions for poverty relief.

The contest took development out of its traditional setting and encouraged all to participate. Undergraduates, graduate students, faculty and UCI alumni were all invited to come together and take part. The Blum Center for Global Engagement hosted the challenge. The goal of the challenge, as Blum Center Director Richard Mathew states, was “to bring the vast stock of ingenuity, creativity, knowledge and passion that exists across the campus to bear on alleviating poverty at home and abroad.” The Solutions Challenge presented an unorthodox approach to relief development as it aimed to bring minds of all backgrounds together in the hopes of producing greater results.

Participants were only required to submit a “feasible idea.” That is to say that the participants did not need to be engineers. All submissions had to meet three criteria, however. First, the proposals had to elaborate on the specific impact on poverty that the device or technology would address. Second, the proposal had to be reasonably realistic and achievable given limited time and resources. Finally, participants had to enumerate the scope their proposal would cover as long as their long-term goals. Three finalists were chosen and met with potential investors in a private venue.

First place was given to PhD student Katya Cherukumilli. Her proposal was to use certain minerals to remove toxic fluoride from drinking water in rural India. Erik Peterson, a resident of Irvine, won second place with his proposal for Lifesign, which would be a device given to homeless citizens as a register that would include data such as health information, hometown and needed services. Replacing handwritten signs, the device would show a code to be entered on the Lifesign website to donate to certain causes and services. Irene Beltran, an undergrad at UCI, took home third place with her “Lab on a Chip” proposal. The chip is tiny and only requires a drop of blood to test for tuberculosis. All three finalists are now consulting with industry leaders and investors.

UC Irvine’s challenge was inspired in part by another school in the University of California system. UC Berkeley’s Development Impact Lab runs a similar contest every year, encouraging engineers, computer scientists and IT specialists to develop technology-based ideas for global aid. UC Irvine’s contest encourages a more theoretical approach, prioritizing creativity in ideas ahead of a physical prototype.

– Joe Kitaj

Sources: Govtech, Blumcenter, Berkeley
Photo: UCI

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Cancer Seeing Glasses Developed by Nigerian Scientist

cancer_seeing_glasses

Dr. Samuel Achilefu, a Nigerian born scientist, has developed glasses that can see cancer cells. For this new technology, Dr. Achilefu was awarded the 2014 St. Louis Award.

This award is given to a recipient who has made outstanding contributions to the profession of chemistry and has demonstrated potential to further the profession.

Dr. Achilefu, a professor of radiology and biomedical engineering, and his team developed glasses that contain imaging technology. The glasses are intended to help surgeons view cancer cells while operating, instead of operating “in the dark.”

The project began in 2012 when Dr. Achilefu and his team received a $2.8 million grant from the National Institutes of Health. Before the grant, the team received limited funding from the Department of Defense’s Breast Cancer Research Program.

The glasses were in the development stage for years, testing the technology on mice, rats and rabbits to confirm the effectiveness of the glasses.

In order to see the infected cells, two steps must be followed.

First, the surgeons must inject a small quantity of an infrared fluorescent marker into the patient’s bloodstream. The marker, also known as a tracer, contains peptides that are able to locate the cancer cells, and buries itself inside.

The tracer lasts about four hours. As it moves through the patient’s body, it will clear away from non-cancerous tissue.

By wearing the glasses, the surgeon can inspect the tumors under an infrared light that reacts with the dye. The combination of the tracer and infrared light causes the tumor to glow from within and allows the surgeon to see the infected cells.

This technology was first tested on humans at the Washington University School of Medicine in June 2015. Four patients with breast cancer and over two-dozen patients with melanoma or liver cancer have been operated on using the goggles.

Ryan Fields, a surgical oncologist who is collaborating with Dr. Achilefu says, “[the glasses] allow us to see the cells in real time, which is critical. Because the marker has not been FDA approved, doctors are currently using a different, somewhat inferior marker that also reacts with infrared light.”

Julie Margenthaler, a breast cancer surgeon, explains that many breast cancer patients must go back for second operations because the human eye cannot see the extent of the infected cells alone.

“Imagine what it would mean if these glasses eliminated the need for follow-up surgery and the associated pain, inconvenience, and anxiety”.

The Food and Drug Administration are still reviewing the cancer seeing glasses and the tracer developed by Dr. Achilefu and his co-researchers. But, if the glasses are approved, the removal of cancerous cells has been changed forever. And most importantly, patients will receive the care in order to treat their cancer.

– Kerri Szulak

Sources: IT News Africa, Premium Times, St. Louis Section of American Chemical Society
Photo: Pax Nigerian

“Wearables” for the World’s Poor

wearbles
The new release of the Apple Watch has been incredibly successful. Now that many have purchased the new technology, analysts predict a revenue-generating marketplace of $22.9 billion by 2020.

Apple Watches, “Fitbits.” and other personal technology, coined “wearables,” are hardly considered vital to a person’s life. In fact, consumers purchase this technology for selfish reasons: to sleep better, exercise harder or work more efficiently.

However, what if “wearables” could be transformed and used for good in the developing world? Could these smart devices offer more than convenience? Could they be considered life-changing or even life-saving?

UNICEF has partnered with design firms ARM and Frog to launch the “Wearables for Good” initiative. The contest involves designing and programming a wearable device to offer a solution “to pressing maternal, newborn or child health problems.”

Two winners will be selected after the early August deadline, and each will receive $15,000 in funding and a “mentorship” from both ARM and Frog.

Technology used for health monitoring and education in developing countries isn’t new. UNICEF currently uses a small arm band to monitor children’s nutrition levels. Similar to a blood pressure cuff, the non-digital tape wraps around the child’s upper arm, measuring its circumference and changing colors based on how well the child is fed.

The Embrace bag, which resembles a miniature sleeping bag, protects premature and low-weight babies from hypothermia. It was built for families in developing countries to regulate infants’ temperatures as hospital infrastructure can be inconsistent.

Some technology has proven helpful in the developing world; yet, this initiative is meeting various challenges. How would information and data control be monitored? How do developers plan to approach the issue of battery life? This is one of the major issues that could seriously limit “wearables'” reach in developing markets. Access to electricity could be minimal or non-existent in parts of the world where the technology is to serve.

A proposed solution is developing and integrating low-power chips that run the wearable devices, Ian Ferguson, vice president of segment marketing at ARM, said. ARM serves as a chip developer whose current designs are found in many smart phones. Another solution is to move the data collected by the wearable device to the cloud in efforts to prolong battery life.

Another issue is the potential markets in developing countries. ARM CEO Simon Segars said he often hears from others that there is little money to be made in developing countries. Many believe that new technology will be misunderstood and useless in countries without education and established infrastructure.

The most encouraging comparison to the “wearables” market is the cellphone. Affordable cellphones have become widespread and transformative in many developing regions. They are used not only to communicate, but to open bank accounts, manage small loans and connect up to pay-as-you-go solar technology.

While the cost of new technology is decreasing, the potential for good is increasing. UNICEF’s initiative is a reminder that the latest in personal consumer technology might also provide increasing solutions to life-threatening problems for the world’s poor.

– Alison Decker

Sources: UNICEF, Forbes, CNET, Huffington Post, UNICEF
Photo: Voice oF America

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New Technology Can End Poverty

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As we near the 2015 deadline for the Millennium Development Goals, there needs to be something done to increase our progress towards ending poverty. Last month, the Frontiers in Development Forum had many visitors who had bright ideas about what would be best to try to achieve our main goal. Leaders like the Tanzanian President Jakaya Kikwete and Secretary of State John Kerry attended the forum, along with many different innovators, who have been creating mobile apps to combat human trafficking.

What was decided at the forum was that bringing new technologies into play and creating new partnerships is essential in the plan to end extreme poverty. In the U.S., many new technologies have changed the way Americans communicate, work and earn with one another. But there was something launched about two decades ago called the Leland Initiative, which was an effort to help increase access to information for 20 African countries.

To build more onto this idea, USAID has partnered with the U.K., Google.org and the Omidyar Network to create something new called the Alliance for Affordable Internet. This was created in an effort to reduce the cost of internet access and to bring to the table new opportunities for doctors, entrepreneurs and local leaders across the developing world.

Another way that USAID is trying to speed up the process of ending poverty is by using mTrac in Uganda. mTrac is a tool that helps local health workers send the government reports via text message. For example, the Ministry of Health used mTrac to survey 10,000 health workers on whether their health unit had a fridge that was used to keep perishable drugs and vaccines cold. The survey ended up costing only $150 and was done in just less than three days.

New technology is something that many in the Western World are used to and often take for granted, but in Senegal, rice millers are learning about how important technology can be for their community. For example, the rice millers buy expensive Asian imports, while local rice farmers are having a hard time selling their crops. USAID is helping to build the supply chains and improve the quality of the harvests by teaching the farmers to share their information through Excel and Dropbox. This allows the millers to track the local crops, schedule shipments and collect payments online.

This is just the start of what technology can do for the world in helping end poverty, and there is still a long way to go. USAID iterates that creating apps just for the sack of having them is not what will help the world achieve the overall objective of ending poverty. But by looking at the need in countries where technology is not overflowing and creating a solution for that will be the key component in ending extreme poverty.

– Brooke Smith

Sources: USAID Blog, USAID
Photo: Flickr