The objective of this study was to investigate the feasibility and acceptability of telemedicine as a care strategy for Neglected Tropical Diseases (NTDs) in a public hospital center specialized in infectious diseases in Rio de Janeiro, Brazil. A proof of concept was conducted for the use of synchronous medical video consultations to monitor two NTDs of epidemiological relevance in the country: Cutaneous Leishmaniasis (CL) and Chagas Disease (CD). This is an implementation study supported by the sequential stages of the Design Science Research Methodology. An implementation pilot was designed, developed, and evaluated. Video teleconsultations were conducted via WhatsApp Web on a laptop, and patients completed questionnaires before and after the consultations. The study was approved by the responsible Ethics Committee. Forty-six patients were recruited in person, 50% with confirmed diagnosis of CL and 50% with CD, in different clinical stages. Thirty-eight teleconsultations were conducted over 8 weeks: 22 with CL patients and 16 with CD patients. Of these, 78% of CL patients and 52% of CD patients lived in another municipality, showing that distance and travel to the specialized center for in-person visits are a relevant access barrier. Low educational level was observed among participants in both groups: 21.7% of CL and 26.1% of CD were illiterate, and 39.1% and 56.5%, respectively, had studied only up to the 5th grade of elementary school. Despite this, 82.6% of CL patients and 91.3% of CD patients reported having previously made video calls, and only 36% of all patients reported needing help from a family member or friend to perform teleconsultations. In CL, the mean age in the group that needed help was slightly higher than in the overall group (63.5 years vs. 58.9 years), as was the illiteracy rate (42.2%). Overall satisfaction rates with the teleconsultation were 97.5% in both groups, and most would recommend the virtual visit to other patients. The intervention was effective in promoting synchronous access of patients to their specialized healthcare teams. The results point to the simplicity and good acceptability of telemedicine in the care of CL and CD in the studied context.
Salvador et al. (Sun,) studied this question.