Stories From the Field:

AFRICA

Putting Technology to Work for Human Health

High-tech devices based on cellular networks are showing promise in supporting care and treatment for HIV/AIDS patients in Africa — and getting them the care they need before it’s too late. The systems, MGH doctors hope, could have vast implications for other diseases and isolated populations across the globe.

While working with doctors at the Mbarara University Teaching Hospital in rural southwestern Uganda, Dr. Jessica Haberer, MD, MS, a MGH internist, saw that poor adherence leads to treatment failure and ultimately death in some patients. In particular, people without social support tend to face the most challenges with adherence, including infected AIDS orphans who are transferred from one caretaker to the other. In addition, some of those patients who successfully stick to their regimen yet experience complications die simply because they have difficulty accessing the clinic. They often wait until it’s too late: bad roads, great distances to medical clinics and poor transportation prevent them from getting to the nearest clinic or hospital fast enough.

“Remote, wireless biosensing presents a paradigm shift in care delivery away from the current model in which most patients get similar care at artificially determined intervals. We hope to identify who needs care at the time they need it and make sure it’s available to them.”
– Dr. Jessica Haberer, MGH Center for Global Health

So Dr. Haberer performed a pilot study in which patients are given a new pill container the size of an eyeglass case that uses cellular phone networks to monitor treatment adherence and inform the nearest medical professionals when help is needed — before it’s too late. The technology, called Wisepill, was created by a company named Wisepill Technologies Adherence Management Solutions in South Africa, and Dr. Haberer and her colleagues worked together with its developer to make improvements on it. If a patient misses planned openings for more than two days in a row, a member of Dr. Haberer’s team contacts the patient to find out why.

“This is an extremely valuable technology for HIV/AIDS patients because if a patient misses just a few doses in a row, he or she may begin to develop drug resistance and within a few weeks could lose treatment efficacy. ‘Second line’ therapy is much more expensive, and if it’s unavailable, the resistant virus can then begin circulating in the population,” says Dr. Haberer.

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