scholarly journals Developing Medical Technologies for Low-Resource Settings: Lessons From a Wireless Wearable Vital Signs Monitor–neoGuard

2021 ◽  
Vol 3 ◽  
Author(s):  
Assumpta Nantume ◽  
Sona Shah ◽  
Teresa Cauvel ◽  
Matthew Tomback ◽  
Ryan Kilpatrick ◽  
...  
Keyword(s):  
Oxygen Saturation ◽  
Respiratory Rate ◽  
Medical Technology ◽  
Health Workers ◽  
Vital Signs ◽  
Clinical Validation ◽  
Saturation Pulse ◽  
Low Resource Settings ◽  
Low Resource ◽  
Medical Technologies

The neoGuard™ technology is a wireless wearable vital signs monitor attached to a patient's forehead to continuously measure oxygen saturation, pulse rate, respiratory rate and temperature. Developed with feedback from more than 400 health workers, primarily in East Africa, the product has been designed to meet the unique constraints of low-resource settings. This perspective piece by the innovators of neoGuard™ and some of their key partners examines the complicated journey of taking a medical technology from concept through clinical validation and finally to market. By shedding light on some of the most critical steps and common challenges encountered along the pathway to commercialization, the authors hope that their experiences will provide some valuable insights to other aspiring innovators in this space.

scholarly journals A Low Cost Wearable Medical Device for Vital Signs Monitoring in Low-Resource Settings

2019 ◽  
Vol 9 (4) ◽  
pp. 2321
Author(s):  
Muhammad Niswar ◽  
Muhammad Nur ◽  
Idar Mappangara
Keyword(s):  
Heart Rate ◽  
Respiratory Rate ◽  
Medical Device ◽  
Low Cost ◽  
Vital Signs ◽  
Oxygen Saturation Level ◽  
Low Resource Settings ◽  
Low Resource ◽  
Vital Signs Monitoring ◽  
Wearable Medical

Medical devices are often expensive, so people in low-income countries cannot afford them. This paper presents the design of a low-cost wearable medical device to measure vital signs of a patient including heart rate, blood oxygen saturation level (SpO2) and respiratory rate. The wearable medical device mainly consists of a microcontroller and two biomedical sensors including airflow thermal sensor to measure respiratory rate and pulse oximeter sensor to measure SpO2 and heart rate. We can monitor the vital signs from a smartphone using a web browser through IEEE802.11 wireless connectivity to the wearable medical device. Furthermore, the wearable medical device requires simple management to operate; hence, it can be easily used. Performance evaluation results show that the designed wearable medical device works as good as a standard SpO2 device and it can measure the respiratory rate properly.  The designed wearable medical device is inexpensive and appropriate for low-resource settings. Moreover, as its components are commonly available in the market, it easy to assembly and repair locally.

Development of a novel device for objective respiratory rate measurement in low-resource settings

2018 ◽  
Vol 4 (4) ◽  
pp. 185-191 ◽  
Author(s):  
Hayley Turnbull ◽  
Masumbuko Claude Kasereka ◽  
Israel Amirav ◽  
Sivasivugha Eugénie Sahika ◽  
Ian Solomon ◽  
...  
Keyword(s):  
Respiratory Rate ◽  
Low Income ◽  
Health Workers ◽  
Limits Of Agreement ◽  
Low Resource Settings ◽  
Low Resource ◽  
Novel Device ◽  
Prototype Development ◽  
Lower Limits ◽  
Adult Volunteers

ObjectiveTo evaluate a novel device (Respimometer) for objective measurement of respiratory rate (RR) in low-resource settings.DesignDescription of prototype development, with proof-of-concept pilot field study at four paediatric healthcare facilities in Butembo, Democratic Republic of the Congo (DRC). The instrument was tested in healthy adult volunteers (n=10) and Congolese children (n=42) and compared with timed breaths (adults) or by reference comparator capnography (children). Correlation and Bland-Altman plots were generated for paired measurements.ResultsThe Respimometer is shaped like an oral thermometer and is placed in the mouth of the participants. RR is measured by thermistors positioned at the nasal outlet, which detect the temperature change between inhaled and exhaled breaths. In adult volunteers, the correlation coefficient between the delivered RR and the Respimometer measurement was median 0.992 (IQR 0.980–0.999). Measurement bias was −0.50 min−1 (95% CI −1.1 to +0.07, p=0.093), with upper and lower limits of agreement of −5.2 min−1 and 4.2 min−1, respectively. Among Congolese children, there was no evidence of bias: mean difference in RR +1.0 min−1 (95% CI −2.1 to +4.1, p=0.52). The upper and lower limits of agreement were −18 and +20 min−1, respectively.ConclusionThe Respimometer can accurately measure the RR in healthy adults and children in DRC. A simple and accurate instrument could facilitate the diagnosis of pneumonia by community health workers in low-income and middle-income countries, leading to reduced pneumonia-related deaths.

scholarly journals Effectiveness of App-Based Cognitive Screening for Dementia by Lay Health Workers in Low Resource Settings. A Validation and Feasibility Study in Rural Tanzania

2020 ◽  
pp. 089198872095710
Author(s):  
Stella-Maria Paddick ◽  
Marcella Yoseph ◽  
William K. Gray ◽  
Damas Andrea ◽  
Robyn Barber ◽  
...  
Keyword(s):  
Health Workers ◽  
Geriatric Medicine ◽  
Screening Tools ◽  
Sub Saharan Africa ◽  
Low Resource Settings ◽  
Low Resource ◽  
Dsm 5 ◽  
Dementia Screening ◽  
Rural Tanzania ◽  
Cognitive Screen

Background: The majority of people with dementia live in low-and middle-income countries (LMICs). In sub-Saharan Africa (SSA) human-resource shortages in mental health and geriatric medicine are well recognized. Use of technological solutions may improve access to diagnosis. We aimed to assess the diagnostic accuracy of a brief dementia screening mobile application (app) for non-specialist workers in rural Tanzania against blinded gold-standard diagnosis of DSM-5 dementia. The app includes 2 previously-validated culturally appropriate low-literacy screening tools for cognitive (IDEA cognitive screen) and functional impairment (abbreviated IDEA-IADL questionnaire). Methods: This was a 2-stage community-based door-to-door study. In Stage1, rural primary health workers approached all individuals aged ≥60 years for app-based dementia screening in 12 villages in Hai district, Kilimanjaro Tanzania. In Stage 2, a stratified sub-sample were clinically-assessed for dementia blind to app screening score. Assessment included clinical history, neurological and bedside cognitive assessment and collateral history. Results: 3011 (of 3122 eligible) older people consented to screening. Of these, 610 were evaluated in Stage 2. For the IDEA cognitive screen, the area under the receiver operating characteristic (AUROC) curve was 0.79 (95% CI 0.74-0.83) for DSM-5 dementia diagnosis (sensitivity 84.8%, specificity 58.4%). For those 358 (44%) completing the full app, AUROC was 0.78 for combined cognitive and informant-reported functional assessment. Conclusions: The pilot dementia screening app had good sensitivity but lacked specificity for dementia when administered by non-specialist rural community workers. This technological approach may be a promising way forward in low-resource settings, specialist onward referral may be prioritized.

scholarly journals Just the Facts: Diagnosis and management of small bowel obstruction

CJEM ◽  
2020 ◽  
Vol 22 (5) ◽  
pp. 648-651
Author(s):  
Brit Long ◽  
Elisha Targonsky ◽  
Alex Koyfman
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Abdominal Pain ◽  
Small Bowel ◽  
Oxygen Saturation ◽  
Respiratory Rate ◽  
Small Bowel Obstruction ◽  
Vital Signs ◽  
Oral Temperature ◽  
Include Blood Pressure

A 63-year-old female patient presents with abdominal pain, vomiting, and abdominal distention. She has previously had a cholecystectomy and hysterectomy. She has had no prior similar episodes, and denies fever, hematemesis, or diarrhea. She takes no medications. Vital signs include blood pressure 123/61 mm Hg, heart rate 97, oral temperature 37.2°C, respiratory rate 18, oxygen saturation 97% on room air. Her abdomen is diffusely tender and distended.

scholarly journals Ethical issues raised by cluster randomised trials conducted in low-resource settings: identifying gaps in the Ottawa Statement through an analysis of the PURE Malawi trial

2019 ◽  
Vol 45 (6) ◽  
pp. 388-393 ◽  
Author(s):  
Tiwonge K Mtande ◽  
Charles Weijer ◽  
Mina C Hosseinipour ◽  
Monica Taljaard ◽  
Mitch Matoga ◽  
...  
Keyword(s):  
Ethical Issues ◽  
Health Workers ◽  
National Standards ◽  
Guidance Document ◽  
Randomised Trials ◽  
Low Resource Settings ◽  
Low Resource ◽  
Cluster Randomised Trials ◽  
Cluster Randomised ◽  
Resource Setting

The increasing use of cluster randomised trials in low-resource settings raises unique ethical issues. The Ottawa Statement on the Ethical Design and Conduct of Cluster Randomised Trials is the first international ethical guidance document specific to cluster trials, but it is unknown if it adequately addresses issues in low-resource settings. In this paper, we seek to identify any gaps in the Ottawa Statement relevant to cluster trials conducted in low-resource settings. Our method is (1) to analyse a prototypical cluster trial conducted in a low-resource setting (PURE Malawi trial) with the Ottawa Statement; (2) to identify ethical issues in the design or conduct of the trial not captured adequately and (3) to make recommendations for issues needing attention in forthcoming revisions to the Ottawa Statement. Our analysis identified six ethical aspects of cluster randomised trials in low-resource settings that require further guidance. The forthcoming revision of the Ottawa Statement should provide additional guidance on these issues: (1) streamlining research ethics committee review for collaborating investigators who are affiliated with other institutions; (2) the classification of lay health workers who deliver study interventions as health providers or research participants; (3) the dilemma experienced by investigators when national standards seem to prohibit waivers of consent; (4) the timing of gatekeeper engagement, particularly when researchers face funding constraints; (5) providing ancillary care in health services or implementation trials when a routine care control arm is known to fall below national standards and (6) defining vulnerable participants needing protection in low-resource settings.

Improving health workers' performance in low-resource settings

The Lancet ◽  
2005 ◽  
Vol 366 (9497) ◽  
pp. 1606 ◽  
Author(s):  
Anthony D Harries ◽  
Felix Salaniponi
Keyword(s):  
Health Workers ◽  
Low Resource Settings ◽  
Low Resource

scholarly journals Comprehensive pregnancy monitoring with a network of wireless, soft, and flexible sensors in high- and low-resource health settings

2021 ◽  
Vol 118 (20) ◽  
pp. e2100466118
Author(s):  
Dennis Ryu ◽  
Dong Hyun Kim ◽  
Joan T. Price ◽  
Jong Yoon Lee ◽  
Ha Uk Chung ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Body Position ◽  
Vital Signs ◽  
Blood Oxygenation ◽  
Morbidity And Mortality ◽  
Low Resource Settings ◽  
Low Resource ◽  
Vital Signs Monitoring ◽  
Wide Range

Vital signs monitoring is a fundamental component of ensuring the health and safety of women and newborns during pregnancy, labor, and childbirth. This monitoring is often the first step in early detection of pregnancy abnormalities, providing an opportunity for prompt, effective intervention to prevent maternal and neonatal morbidity and mortality. Contemporary pregnancy monitoring systems require numerous devices wired to large base units; at least five separate devices with distinct user interfaces are commonly used to detect uterine contractility, maternal blood oxygenation, temperature, heart rate, blood pressure, and fetal heart rate. Current monitoring technologies are expensive and complex with implementation challenges in low-resource settings where maternal morbidity and mortality is the greatest. We present an integrated monitoring platform leveraging advanced flexible electronics, wireless connectivity, and compatibility with a wide range of low-cost mobile devices. Three flexible, soft, and low-profile sensors offer comprehensive vital signs monitoring for both women and fetuses with time-synchronized operation, including advanced parameters such as continuous cuffless blood pressure, electrohysterography-derived uterine monitoring, and automated body position classification. Successful field trials of pregnant women between 25 and 41 wk of gestation in both high-resource settings (n = 91) and low-resource settings (n = 485) demonstrate the system’s performance, usability, and safety.

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