Use of Telemedicine to Diagnose Tinea in Kenyan Schoolchildren

Abstract

Objective: Internet-based telemedicine has the potential to alleviate the problem of limited access to healthcare in developing countries. The Mashavu project aims to deploy kiosks that transmit health data and pictures from patients in underdeveloped countries who have no immediate access to healthcare to clinics for analysis by trained personnel. To test this principle, we investigated whether dermatophytic fungal infections (tinea) could be diagnosed by Kenyan clinicians solely from pictures of the lesions. Subjects and Methods: Six physicians, five physician assistants, and five nurses from Nyeri Provincial Hospital took a test consisting of 15 pictures of potassium hydroxide (KOH) prep–confirmed tinea lesions and 15 pictures of KOH prep–negative lesions obtained from local children. Results: The mean (standard deviation) sensitivity and specificity for the whole group were 73% (19%) and 83% (11%), respectively. The physicians had the highest sensitivity and specificity, although only sensitivity reached statistical significance when compared with physician assistants. Conclusions: These results suggest that telemedicine can be used to diagnose simple skin conditions in a low resource setting with reasonable sensitivity and specificity.