Do Mobile Health Interventions Effectively Improve Malaria Management? A Systematic Review and Meta-Analysis of Randomized Controlled Trials
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Abstract
Introduction: Climate change is projected to alter the risk of mosquito-borne diseases, including malaria, by increasing transmission suitability for this disease.1 It is estimated that in 2022, malaria cases will reach 249 million globally, resulting in 608,000 deaths across 85 countries.2 Mobile health (mHealth), as an innovative technology, has become a potential solution for improving the management of malaria.3-11 Their potential utilization in malaria-endemic regions is bolstered by increasing mobile phone usage in this area.12 While mHealth presents a promising strategy for improving malaria management, the statistical evidence remains scarce. Thus, this systematic review and meta-analysis aims to analyze the effectiveness of mobile health in enhancing malaria management.
Method: Employing the PRISMA guideline, this study systematically searches literature from PubMed, ScienceDirect, Wiley, and Cochrane Library databases, focusing on publications from 2014 onward. Bias was assessed using the Risk of Bias 2.0 tool, and data were analyzed using Review Manager 5.4.1. Odds Ratio (OR) was calculated with a 95% confidence interval, given p<0.05 as significant.
Results: This meta-analysis of nine randomized controlled trials involving 22,647 patients in Sub-Saharan African countries revealed that various mHealth interventions, including text reminders, AI tools for diagnosis, telehealth platforms, and mobile-based education, have significantly enhanced malaria management. It is demonstrated by a significant effect of mHealth in malaria management, as indicated by the improvement of pharmacoadherence (OR=1.26; p-value=0.01), reduction in case prevalence (OR=3.65; p-value=0.003), and decrease in antibiotic prescription (OR=0.46; p-value<0.00001). Additionally, mHealth interventions were shown to positively affect the accuracy of malaria management (OR=1.78; p-value=0.40).
Conclusion: mHealth interventions are found to be effective in improving malaria management. Henceforth, further research is essential across diverse geographical and social contexts to comprehensively understand their applicability.
Keywords: climate change, malaria, management, mhealth, vector-borne diseases
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