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Telemedicine in the clinical care of Chagas disease and American cutaneous leishmaniasis
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Resumo(s)
Background: Neglected tropical diseases (NTDs) remain major public health challenge in low- and middle-income countries (LMICs), especially in rural and underserved regions. Although telemedicine has expanded globally, evidence on its implementation for individual clinical care of NTDs remains scarce. This pilot implementation study aimed to assess the feasibility and acceptability of synchronous telemedicine consultations for patients with Chagas disease (CD) and American Cutaneous Leishmaniasis (ACL) in a national reference hospital in Brazil. Methods: We conducted a mixed-methods implementation study using the Design Science Research Methodology (DSRM). The context analysis involved structured surveys with 31 health professionals and semi-structured interviews with two local managers. Patients diagnosed with CD or ACL were recruited from August to October 2024. Teleconsultations were performed via WhatsApp video calls by four specialists. Patient satisfaction was evaluated using structured questionnaires. Findings: Of the 46 patients recruited, 38 (82.6%) completed teleconsultations. Most were older adults and had no prior telehealth experience. Despite low digital literacy and education levels, 63.2% (24/38) completed the teleconsultation without assistance. High levels of satisfaction were reported: 97.4% (37/38) were satisfied and would attend future virtual visits. Participants reported the reduced travel burden and improved access to care. No major technical issues were observed. Conclusion: Synchronous telemedicine via a low-cost, widely available platform was feasible and well-accepted for clinical follow-up of CD and ACL in a Brazilian public hospital. This approach may help reduce access barriers to specialized care for NTDs. Further research should evaluate clinical outcomes and cost-effectiveness in LMIC settings.
Descrição
Funding Information: The author(s) declare that financial support was received for the research and/or publication of this article. This study was supported by the Foundation for Science and Technology (FCT) under funds to GHTM/IHMT-NOVA (grant numbers GHTM-UID/04413/2020 and DOI 10.54499/UI/BD/151068/2021). This study was financed in part by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior Brasil (CAPES) Finance Code 001. The founders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Publisher Copyright: Copyright © 2025 Salvador, Oliveira, Pimentel, Lyra, Hasslocher-Moreno, Holanda, Varela, Silveira and Valete.
Palavras-chave
Chagas disease cutaneous leishmaniasis digital health neglected tropical diseases telemedicine Public Health, Environmental and Occupational Health SDG 3 - Good Health and Well-being