{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T20:33:19Z","timestamp":1779309199487,"version":"3.51.4"},"reference-count":66,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"4","license":[{"start":{"date-parts":[[2023,10,4]],"date-time":"2023-10-04T00:00:00Z","timestamp":1696377600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,10,4]]},"abstract":"<jats:title>ABSTRACT.<\/jats:title>\n<jats:p>Cutaneous leishmaniasis (CL) remains a global health problem. Compelled by the protracted healing process, initial and final outcomes of treatment are determined at 90 and 180\u2009days, respectively, after initiation of treatment. Loss to follow-up during these intervals is substantial. Consequently, the effectiveness of treatment is largely unknown. We conducted an effectiveness-implementation hybrid design study of a community-based mobile health (mHealth) strategy to monitor adherence to anti-leishmanial treatment, adverse drug reactions, and therapeutic response compared with standard of care in two rural communities of Colombia. Three implementation outcomes were evaluated: usability and acceptability by qualitative methods and fidelity using quantitative methods. Fifty-seven patients were prospectively included in the mHealth intervention and 48 in the standard-of-care group. In addition, 24 community health leaders (CHLs), health workers, and patients participated in qualitative evaluations. The intervention significantly increased the proportion of patients having follow-up of therapeutic outcomes 90 and 180\u2009days after initiating treatment from 4.2% (standard of care) to 82.5% (intervention), <jats:italic>P<\/jats:italic> &lt; 0.001. The proportion of patients having records of treatment adherence, adverse drug reactions, and therapeutic response also increased significantly (<jats:italic>P<\/jats:italic> &lt; 0.001). Fidelity to the intervention (recording of treatment adherence, adverse drug reactions, lesion photographs, and evaluation of therapeutic response) was 70\u2013100%. The app was highly accepted by CHLs, health workers, and patients, who perceived that the app improved case identification and follow-up and met a public health need. Although usability was high, low connectivity affected real-time transmission of data. This community-based mHealth strategy facilitated access to health care for CL in rural areas and knowledge of treatment effectiveness.<\/jats:p>","DOI":"10.4269\/ajtmh.22-0805","type":"journal-article","created":{"date-parts":[[2023,8,28]],"date-time":"2023-08-28T19:21:24Z","timestamp":1693250484000},"page":"778-790","source":"Crossref","is-referenced-by-count":7,"title":["mHealth Monitoring of Treatment of Cutaneous Leishmaniasis Patients: A Community-Based Implementation Study"],"prefix":"10.4269","volume":"109","author":[{"given":"Alexandra","family":"Cossio","sequence":"first","affiliation":[{"name":"Centro Internacional de Entrenamiento e Investigaciones M\u00e9dicas, Cali, Colombia;"},{"name":"Universidad Icesi, Cali, Colombia;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martha Milena","family":"Bautista-Gomez","sequence":"additional","affiliation":[{"name":"Centro Internacional de Entrenamiento e Investigaciones M\u00e9dicas, Cali, Colombia;"},{"name":"Universidad Icesi, Cali, Colombia;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Neal","family":"Alexander","sequence":"additional","affiliation":[{"name":"Centro Internacional de Entrenamiento e Investigaciones M\u00e9dicas, Cali, Colombia;"},{"name":"Universidad Icesi, Cali, Colombia;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alejandra Mar\u00eda","family":"del Castillo","sequence":"additional","affiliation":[{"name":"Centro Internacional de Entrenamiento e Investigaciones M\u00e9dicas, Cali, Colombia;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mar\u00eda del Mar","family":"Castro","sequence":"additional","affiliation":[{"name":"Centro Internacional de Entrenamiento e Investigaciones M\u00e9dicas, Cali, Colombia;"},{"name":"Universidad Icesi, Cali, Colombia;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Patricia Yaneth","family":"Casta\u00f1o-Grajales","sequence":"additional","affiliation":[{"name":"Centro Internacional de Entrenamiento e Investigaciones M\u00e9dicas, Cali, Colombia;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yeison Hawer","family":"Guti\u00e9rrez-Poloche","sequence":"additional","affiliation":[{"name":"Centro Internacional de Entrenamiento e Investigaciones M\u00e9dicas, Cali, Colombia;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laura Sof\u00eda","family":"Zuluaga","sequence":"additional","affiliation":[{"name":"Centro Internacional de Entrenamiento e Investigaciones M\u00e9dicas, Cali, Colombia;"},{"name":"Universidad Icesi, Cali, Colombia;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Leonardo","family":"Vargas-Bernal","sequence":"additional","affiliation":[{"name":"Universidad Icesi, Grupo i2t, Cali, Colombia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andr\u00e9s","family":"Navarro","sequence":"additional","affiliation":[{"name":"Universidad Icesi, Grupo i2t, Cali, Colombia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nancy Gore","family":"Saravia","sequence":"additional","affiliation":[{"name":"Centro Internacional de Entrenamiento e Investigaciones M\u00e9dicas, Cali, Colombia;"},{"name":"Universidad Icesi, Cali, Colombia;"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2795","reference":[{"key":"b1","series-title":"Clin Infect Dis","first-page":"323","article-title":"Why funding for neglected tropical diseases should be a global priority","volume":"67","author":"Reed","year":"2018"},{"key":"b2","year":"2021"},{"key":"b3","series-title":"JMIR Mhealth Uhealth","first-page":"1","article-title":"Mobile health strategies to tackle skin neglected tropical diseases with recommendations from innovative experiences: systematic 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