RT Journal Article
SR Electronic
T1 Community-based screening for cardiovascular risk using a novel mHealth tool in rural Kenya
JF BMJ Health & Care Informatics
FD BMJ Publishing Group Ltd
SP 176
OP 182
DO 10.14236/jhi.v25i3.1012
VO 25
IS 3
A1 Jennifer R. Mannik
A1 Andrea Figol
A1 Vanessa Churchill
A1 James Aw
A1 Stacy Francis
A1 Ezekiel Karino
A1 Julius Kibet Chesire
A1 Danet Opot
A1 Benard Ochieng
A1 Michael T. Hawkes
YR 2018
UL http://informatics.bmj.com/content/25/3/176.abstract
AB Background An increasing burden of cardiovascular disease (CVD) in low-resource settings demands innovative public health approaches.Objectives To design and test a novel mobile health (mHealth) tool for use by community health workers (CHWs) to identify individuals at high CVD risk who would benefit from education and/or pharmacologic interventions.Methods We designed and implemented a novel two-way mobile phone application, ‘AFYACHAT’, to rapidly screen for the CVD risk in rural Kenya. AFYACHAT collects and stores a short message system (SMS) text message data entered by a CHW on a subject’s age, sex, smoking, diabetes and systolic blood pressure, and returns as SMS text message the category of 10-year CVD risk: ‘GREEN’ (<10% 10 year risk of cardiovascular event), ‘YELLOW’ (from 10% to <20%), ‘ORANGE’ (from 20% to <30%), or ‘RED’ (≥30%). CHWs were equipped and trained to use an automated blood pressure device and the mHealth tool.Results Five CHWs screened 2865 subjects in remote rural communities in Kenya over a 22-month period (2015–2017). The median age of subjects was 50 (interquartile range 43–60) and 1581 (55%) were female. The point prevalence of hypertension (systolic blood pressure > 140 mmHg), diabetes and tobacco use were 23%, 3.2% and 22%, respectively. Overall, the 10-year risk of CVD among patients was <10% in 2778 (97%) patients, from 10% to <20% in 65 (2.3%), from 20% to <30% in 12 (0.4%) and ≥30% in 10 (0.2%).Conclusions We have developed a mHealth tool that can be used by CHWs to screen for CVD risk factors, demonstrating the proof of concept in rural Kenya.