Presumptive Diagnosis and Awareness for STDs via SMS for Young Cambodian in Rural Areas

From Mobile Health care application

Abstract

Cambodia is a developing country in South-East Asia whose health care system is facing considerable challenges, especially in rural areas, due to limitations in resources (e.g., lack of medical equipments, medical professional staff and limited use of IT). The problem is also compounded by a high illiteracy rate and unawareness of sanitation and access to care. Sexually transmitted diseases (STD) are currently one of the biggest issues that the Cambodian government is trying to overcome. These diseases touch lots of young Cambodians, the force that is supposed to drive Cambodian economy. Media are supporting campaigns of prevention against HIV/AIDS amongst teenagers. Moreover, according to the Reproduction Health association of Cambodia (RHAC http://rhac.org.kh), in 2007, 40% of its patients were affected with other common STDs such as Chlamydia and Gonorrhea. But less attention is being paid to the prevention of these types of STDs. In the meantime, mobile subscribers are growing rapidly in Cambodia due to phone and subscription affordability and improvements of network coverage. We conducted a survey targeting medical staff of all the health centers in a remote area of the Kandal province in the Angk Snuol district. 99% of the medical staff and 70% of young people own a mobile phone. Their motivation is very high concerning the use of mobile handsets as a means of communications for healthcare services. Due to social and cultural obstacles, young people with STD symptoms are afraid and ashamed to consult professional doctors. They are particularly concerned with the judgment of people close to them. Social and cultural pressures are even stronger in rural areas. It is widely known that they often turn to traditional doctors and non professional staff for consultation and treatment. Consequently, they end up in more severe conditions and risk their lives. Therefore, a more secure, trustful and undisclosed means of communication has to be established between young Cambodians and doctors. To achieve this, we propose to build an SMS-based communication system available in the Khmer language. An application will be developed and installed on mobile phones. It will allow users to select any suspicious symptoms they are developing. The symptoms will then be sent anonymously to a server that will identify possible STDs. A message will be sent back to the users with a possible diagnosis, advice and directions to follow to consult a doctor. It will also list the contact numbers of professional doctors in their community for consultation. The privacy of the information will be kept under the professionalism of the involved doctors and medical staff. It is expected that by using the proposed system young Cambodians will be more willing to seek for information about any STDs they may be affected with. This will increase STDs awareness and decreasing STDs transmissions and diseases. This will finally help to promote STD healthcare services in rural areas of Cambodia.

1 Abstract
2 Introduction
3 Research Theme
4 Research Staffs
5 Project Milestone
6 Project Poster
7 Photos and Videos
8 Supported by

Introduction

Cambodia has a population of around 14 million people. Because of the civil war lasting several decades, 35% of the Cambodian population is living below the poverty line and 81% is living in rural areas. Also, nation‐wide infrastructure has almost been destroyed. After the civil war vanished, Cambodian government is making full effort to restore country in all fields including the infrastructure of the country, human resource development as well as welfare of Cambodian people. However, healthcare service cannot be fully provided to Cambodian people, namely, there is a gap of healthcare service between people in the capital and people in rural areas due to some factors. Seeing these challenges, the research, notably, makes contribution not only to enhancing healthcare service, but also to training Computer Science students who are future software developers of Cambodia to apply their knowledge and practice to develop mobile phone application from software engineering, technology, and healthcare perspectives.

Therefore, this research is carried out to apply advanced technology of ICT (Information Communication Technology) to, to some extent, improve the healthcare in Cambodia, especially in rural area. The main objective of the research is to develop mobile phone application to support healthcare in rural areas of Cambodia. An application will be developed in the framework of mobile phone technology and telecommunication technology to fulfill some needs of the doctors, health workers, pharmacists, and patients in rural areas.

Research Theme

Literature Review

A brief overview of m-Health e-Emergency Systems

Abstract

Rapid advances in wireless communications and networking technologies, linked with advances in computing and medical technologies facilitate the development and offering of emerging mobile systems and services in the healthcare sector. The objective of this paper is to provide an overview of the current status and challenges of mobile health systems (m-health) in emergency healthcare systems and services (e-emergency).

Conference:	6th International Special Topic Conference on ITAB,
Date:	2007
Place:	Tokyo

A mobile teletrauma system using 3G networks

Abstract

This paper introduces a cost-effective portable teletrauma system that assists health-care centers in providing prehospital trauma care. Simultaneous transmission of a patient's video, medical images, and electrocardiogram signals, which is required throughout the prehospital procedure, is demonstrated over commercially available 3G wireless cellular data service. Moreover, the physician can remotely control the information sent from the patient side. Such a technology will allow a trauma specialist to be virtually present at the remote location and participate in prehospital care, which improves the quality of trauma care and can potentially reduce mortality and morbidity. To alleviate the limited and fluctuant bandwidth barriers of the wireless cellular link, the system adapts to network conditions through media transformations, data prioritization, and application-level congestion control methods. Experimental evaluation of the system prototype over real network conditions, transmitting different media types between the trauma patient and hospital unit, is encouraging. The teletrauma system reported in this paper is the first of its kind and it provides a basis for future enhancements

Journal:	Information Technology in Biomedicine, IEEE Transactions
Publication Date:	Dec. 2004
Volume:	8
Issue:	4

A Mobile Tele-trauma System for Rural Trauma Care

Abstract

This paper introduces a cost-effective, portable tele-trauma system that assists the health care centers in providing pre-hospital trauma care to rural population. Simultaneous transmission of a patient’s video, medical images, and ECG signals, which is required throughout the pre-hospital procedure, is demonstrated over commercially available, low-bandwidth, wireless cellular data service using transmission technologies such as CDMA. Moreover, the physician can remotely control the information sent from the patient side. Such a technology will allow a trauma specialist to be virtually present at the remote location and participate in pre-hospital care, which improves the quality of trauma care and can potentially reduce mortality and morbidity

Proceedings of the 26th Annual International Conference of the IEEE EMBS
Date:	September 1-5, 2004
Place:	San Francisco, CA, USA

SMS Tools

RapidSMS is an open-source framework for data collection, logistics coordination and communication allowing any mobile phone to interact with the web via SMS text messages. Mashing diverse functionality like remote health diagnostics and monitoring with emergency supply chain tracking, this framework supports the creation of limitless personalized interdependent platforms for diverse use-cases. Because one size does not fit all, this highly flexible system was designed to be customized for the specialized needs and constraints of governments, multilateral and non-government organizations, and development practitioners. [1]
Kannel is an open source WAP gateway. It attempts to provide this essential part of the WAP infrastructure freely to everyone so that the market potential for WAP services, both from wireless operators and specialized service providers, will be realized as efficiently as possible. Kannel also works as an SMS gateway for GSM networks. Almost all GSM phones can send and receive SMS messages, so this is a way to serve many more clients than just those using a new WAP phone. [2]

FrontlineSMS is award-winning free, open source software that turns a laptop and a mobile phone into a central communications hub. Once installed, the program enables users to send and receive text messages with groups of people through mobile phones. What you communicate is up to you, making FrontlineSMS useful in many different ways. [3]
- It does not require an Internet connection.
- It works with your existing plan on all GSM phones, modems and networks.
- Attach a phone and SIM card, and pay your local operator per SMS as usual.
- It is laptop-based so it can be used on the road or during power outages.
- It stores all phone numbers and records all incoming and outgoing messages.
- All data lives on a local computer, not on servers controlled by someone else.
- It is scalable. Messages can be sent to individuals or large groups.
- It enables two-way communication, useful for fieldwork or during surveys.
- It is easy to install and requires little or no training to use.
- Developers can freely take the source code and add their own features.
- It can be used anywhere in the world simply by switching the SIM card.

iDART is a software solution designed to support the dispensing of ARV drugs in the public health care sector. It supports pharmacists in their important role of dispensing accurately to an increasing number of patients whilst still being able to engage and assist the patient. [4]

The intelligent Dispensing of ART software is used by the pharmacist to manage the supplies of ARV stocks, print reports and manage collection of drugs by patients. The software is also designed to address the reporting requirements of Government, international funders (such as PEPFAR) and internal clinical data such as identifying patients who are have not collected their medication for an extended period of time.

Why does it exist?
- to increase capacity of pharmacies in public health clinics by providing a software that is focused on the specific needs of ARV dispensing.
- to facilitate dispensing in remote public health clinics
- to support the so-called "down - referral process"
- to support clinic information management by providing information on the status quo of patients.

Who uses it?
- iDART is being used by accredited ARV sites throughout South Africa. Currently most of our sites are in rural South Africa where clinics often only have one pharmacist or pharmacy assistant.

[1] http://www.rapidsms.org/

[2] http://www.kannel.org/

[3] http://www.frontlinesms.com/

[4] http://www.cell-life.org/idart

Methodology

Data Collection

Method

System design/Framework

Result

Conclusion

Research Staffs

NAME	QUALIFICATION	ROLE
Prof. Dr. John TRAXLER	Professor of Mobile Learning Director, Learning Lab	Mentor
Phal Des	Director of IT Center	Project Investigator
Scharff Christelle	Associate professor of Computer Science	Co Project Investigator
Khim Chamroeun	MS in Management Information System, bachelor in Computer Sciences	Assistant to PI
Kong Marry	PhD in Global Information and Telecommunication Studies	Research staff
Kim Meng	MS in Computer Science	Research staff
Smae Menglim	Bachelor in Computer Science	Research staff
Kor Sokchea	Bachelor in Computer Science	Research staff
Bou Vanaren	Bachelor in Computer Science	Research staff
Sok Sikieng	Bachelor in Computer Science	Research assistant
Seng Molika	Bachelor in Computer Science	Research assistant
Say Sotheara	Bachelor in Computer Science	Research assistant
Heng Sokha	Bachelor in Computer Science	Research assistant
Var Puthnith	Bachelor in Computer Science	Research assistant