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. 2023 Apr 17;108(6):1175-1182.
doi: 10.4269/ajtmh.22-0210. Print 2023 Jun 7.

Feasibility of Training Community Health Workers to Use Smartphone-Attached Microscopy for Point-of-Care Visualization of Soil-Transmitted Helminths in the Peruvian Amazon

Eve Ameen  1 , Simon Nin Zhu  1 , Cesar Morales Guzman  2 , Erin Taub  3 , Crystyan Siles  4 , Graciela Meza Sanchez  2 , Stalin Vilcarromero  5 , Cesar Ramal  2 , Nolberto Tangoa  6 , Luis A Marcos  3   7
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Feasibility of Training Community Health Workers to Use Smartphone-Attached Microscopy for Point-of-Care Visualization of Soil-Transmitted Helminths in the Peruvian Amazon

Eve Ameen et al. Am J Trop Med Hyg. .

Abstract

The prevalence of soil-transmitted helminths (STH) is high in communities within the Peruvian Amazon despite repeated mass-drug administration, demanding alternative strategies of control. Smartphone-attached microscopy (SAM) permits visualization of STH from a small portable microscope through a smartphone screen, potentially providing an inexpensive and rapid method of STH visualization in communities where diagnostic laboratories with microscopes are inaccessible. In this study, a total of 45 community health workers who work within the health systems of Loreto, Peru, attended a 1-day training session with lectures and practicums on STH and SAM. Participants received a pre- and post-intervention questionnaire. Post-intervention, participants were significantly more confident using SAM and identifying parasite images, symptoms, transmission, and treatment (P ≤ 0.0045). Post-intervention, participants correctly labeled a median of five of seven SAM apparatus components and five of eight steps of Kato-Katz technique, were less likely to choose taking medicine to prevent parasite infection (P = 0.0075), and were more likely to select Kato-Katz technique as a type of diagnostic test (P < 0.0001). Most participants felt ready to use SAM in their communities and stated that it could help rural communities far from health centers or laboratories (24%); provide faster identification, results, diagnosis (19%); permit at-home or on-the-spot visualization (14%); and save money (14%). Results show that community health workers show a high level of willingness and competency to learn about both STH and SAM and may be a yet-unexplored practical method of augmenting STH visualization, bringing healthcare to communities in Loreto with poor access to diagnostic laboratories and clinics.

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Figures

Figure 1.
Figure 1.
Smartphone-attached microscopy apparatus with corresponding labels.
Figure 2.
Figure 2.
Parasite images (labeled) tested in pre- and post-intervention questionnaires.
Figure 3.
Figure 3.
Kato–Katz technique steps (labeled) tested in the pre- and post-intervention questionnaires.
See this image and copyright information in PMC

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