Mobile phone-based screening for anemia in young children in western Kenya

基于手机的肯尼亚西部幼儿贫血筛查

• 批准号: 10752968
• 负责人: Patrick Thomas McGann
• 金额: $ 38.32万
• 依托单位: RHODE ISLAND HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-09-21 至 2025-08-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10752968
• 关键词: 5 year old; Address; Affect; Anemia; Birth; Cellular Phone; Child; Chronic Disease; Clinical; Collaborations; Communities; Country; Development; Diagnosis; Diagnostic; Diagnostic Procedure; Disease; Etiology; Feasibility Studies; Funding; Goals; Guidelines; HIV; Health; Health system; Hemoglobin; High Prevalence; Income; Individual; Infant; Infection; Intervention; Iron; Kenya; Laboratories; Laboratory Study; Life; Link; Longevity; Malaria; Measurable; Measurement; Measures; Methods; Modeling; Morbidity - disease rate; Outcome; Outcome Study; Pathway interactions; Persons; Phase; Physical Examination; Population; Populations at Risk; Public Health; Recurrence; Research; Research Proposals; Screening procedure; Sickle Cell Anemia; Structure of palpebral conjunctiva; Technology; Testing; United States National Institutes of Health; Vascular blood supply; Visit; Work; acceptability and feasibility; accurate diagnostics; cohort; community engaged research; community engagement; conjunctiva; cost; diagnostic accuracy; diagnostic algorithm; diagnostic tool; early childhood; effective therapy; evidence base; follow-up; health care availability; high risk; high risk population; implementation barriers; implementation facilitators; implementation measures; implementation outcomes; implementation science; improved; innovation; iron deficiency; low and middle-income countries; mHealth; mortality; neglect; noninvasive diagnosis; novel; novel diagnostics; point of care testing; point-of-care diagnostics; prevent; programs; prospective; routine care; routine screening; screening; screening guidelines; screening program; technology development; tool; treatment guidelines; treatment planning; treatment program

PROJECT SUMMARY/ABSTRACT Anemia is a common, serious, and neglected global public health problem, affecting over 2 billion people with especially high prevalence among children in low-and middle-income countries (LMICs). Unfortunately, despite the high prevalence and negative health consequences of anemia, few routine screening programs exist in LMICs. There is a critical need to identify an easy-to-implement, low-cost strategy to screen and treat anemia and its causes in LMICs, where > 50% of the population and as many as 75% of children under-5 years of age suffer from anemia. In many LMICs, anemia goes undiagnosed, primarily due to lack of access to accurate and affordable laboratory diagnostics. The most common global causes of anemia (iron deficiency, malaria, sickle cell disease) are relatively easy to diagnose with highly effective treatments. Children with chronic illnesses such as HIV are at an even higher risk of anemia with a significant impact on health outcomes. In most high-income countries, infants are universally screened at birth for sickle cell disease and are routinely screened for anemia at least once in early childhood. This screening and treatment paradigm is highly effective and averts the significant morbidity and early mortality associated with anemia. In LMICs, although >50% of children are anemic, there is no systematic screening and limited capacity to diagnose sickle cell disease, iron deficiency, or other underlying causes of anemia when it is detected. The lack of diagnostic laboratory capacity to measure hemoglobin concentration accurately and affordably is a primary limitation to the systematic identification of anemia. In this study, we will use a smartphone-based, noninvasive method to measure hemoglobin and detect anemia by analyzing photos of the palpebral conjunctiva. This smartphone-based method has been shown to accurately measure hemoglobin in a controlled setting in the US but has not been rigorously evaluated in settings where more severe anemia is common. In this study, we will evaluate the utility and accuracy of this mobile health (mHealth) tool to diagnose anemia among young children in western Kenya. Through the R21 phase, we will (Aim 1) develop a community advisory board to proactively consider acceptability and feasibility of this screening intervention and develop an implementation plan and (Aim 2) evaluate the diagnostic accuracy of this mHealth tool in detecting anemia among Kenyan children who are HIV-exposed and unexposed, within the context of multiple etiologies of anemia. If found to be valid, use of this anemia screening tool will be integrated into the health system, according to the implementation plan developed by the Community Advisory Board. We will measure implementation outcomes of the screening program and prospectively evaluate a disease-specific follow-up and treatment plan to assess the clinical impact of this mHealth-based anemia screening and treatment program for children living in western Kenya. This research has important implications to demonstrate the feasibility of an mHealth anemia screening tool and will address a critical gap towards addressing the neglected global burden of anemia.

项目摘要/摘要 贫血是一种常见，严重和被忽视的全球公共卫生问题，影响了超过20亿人 尤其是中低收入国家（LMIC）儿童的高龄。不幸的是，尽管如此 贫血的高患病率和负面健康后果，几乎没有常规筛查计划 LMICS。迫切需要确定易于实施的低成本策略来筛查和治疗贫血 及其在LMIC中的原因，> 50％的人口和多达75％的5岁以下儿童 患有贫血。在许多LMIC中，贫血未被诊断，这主要是由于缺乏准确的和 负担得起的实验室诊断。贫血最常见的全球原因（铁缺乏，疟疾，镰刀 细胞疾病）相对容易诊断高效治疗。患有慢性疾病的孩子 由于艾滋病毒的贫血风险更高，对健康结果产生了重大影响。在大多数高收入中 国家，婴儿在出生时因镰状细胞疾病而被普遍筛查，并经常筛查贫血 至少在童年时期一次。这种筛查和治疗范式非常有效，并避免了 与贫血相关的显着发病率和早期死亡率。在LMIC中，尽管> 50％的儿童贫血，但 没有系统的筛查和有限的诊断镰状细胞病，铁缺乏或其他的能力 检测到贫血的根本原因。缺乏测量诊断实验室的能力 血红蛋白浓度准确且负担得起是系统识别的主要限制 贫血。在这项研究中，我们将使用基于智能手机的无创方法来测量血红蛋白并检测 通过分析脑膜结膜的照片来分析贫血。这种基于智能手机的方法已被证明 准确测量美国受控环境中的血红蛋白，但在设置中尚未进行严格评估 更严重的贫血很常见。在这项研究中，我们将评估该手机的效用和准确性 健康（MHealth）工具可诊断肯尼亚西部幼儿的贫血。通过R21阶段，我们 将（目标1）建立一个社区顾问委员会，以主动考虑可接受性和可行性 筛选干预并制定实施计划并（目标2）评估此的诊断准确性 MHealth在发现艾滋病毒暴露和暴露的肯尼亚儿童中的贫血工具 贫血多种病因的背景。如果发现有效，将集成此贫血筛查工具 根据社区顾问委员会制定的实施计划，进入卫生系统。我们 将衡量筛查计划的实施结果，并前瞻性评估疾病特定的 随访和治疗计划，以评估这种基于MHealth的贫血筛查和治疗的临床影响 居住在肯尼亚西部的儿童计划。这项研究具有重要的意义来证明 MHealth贫血筛查工具的可行性，将解决应对被忽视的问题的关键差距 全球贫血负担。