24000 Participants Needed

Digital App for Sickle Cell Disease Screening

(SIMCS SCD Trial)

Recruiting at 1 trial location
HN
NK
Overseen ByNelson K Sewankambo, MBChB, MMed
Age: < 18
Sex: Any
Trial Phase: Academic
Sponsor: Makerere University
No Placebo GroupAll trial participants will receive the active study treatment (no placebo)

Trial Summary

What is the purpose of this trial?

Although over 75% of children with sickle cell disease (SCD) are born in sub-Sahara where the disease highly contributes to under-5 mortality and causes life-long debilitation, evidence-based strategies to control SCD are not widely implemented in this region. Early detection of SCD by universal infant screening is a pillar of SCD control. Despite the affordability and move to adopt point-of-care (POC) SCD screening assays in sub-Sahara Africa, the absence of screening information management and communication systems (SIMCS) impedes standardized, systematic, coordinated, nationwide SCD screening programs. The long-term goal of the proposed research is to develop a SCD SIMCS that will enable universal SCD screening in the sub-Sahara African setting. The objective is to test and optimize a custom SCD SIMCS app and digital network to facilitate SCD screening and then evaluate its impact on access to SCD screening and care and on clinical outcomes of children with SCD in Uganda. The central hypothesis is that the SCD SIMCS will facilitate accurate and coordinated POC SCD screening that is accessible at health centers in urban and rural Uganda. The rationale is to build a custom SCD SIMCS on existing nationwide digital and health infrastructure in Uganda to standardize use of affordable POC assays at health centers nationwide. The central hypothesis will be tested by pursuing two specific aims: 1) Develop and evaluate a four-module ≥3G cell phone app for a novel SCD SIMCS (R21 Phase); 2) Evaluate the impact of the SCD SIMCS on access to screening and care and outcomes of children with SCD (R33 Phase). The investigators will pursue these aims using an innovative combination of software design and re-organization of SCD screening workflows. These include assembly of off-the-shelf software that is compatible with iOS and Android operating systems to reliably, accurately, and handily capture, interpret, transmit, and retrieve/playback information for patient's IDs, test results, salient clinical events, and education. The novel screening workflows are expected to dramatically reduce the cost and increase access to SCD screening and care. The proposed research is significant, because it will determine how to use POC SCD screening assays on a large nationwide scale. It will also enable coordination of evidence-based care and continuity of care between primary and specialist providers and longitudinally over the patient's lifetime - a critical aspect in controlling this life-long disease. The SCD SIMCS will also facilitate real time data management for research and policy for SCD control. The expected immediate outcome of this research is a SCD SIMCS that optimally functions on the digital and health infrastructure in Uganda and demonstration of its impact on access to SCD screening and care and on clinical outcomes of children with SCD. The expected long-term outcome is that the SCD SIMCS will be adopted, integrated, and scaled-up in the health systems of Uganda and other sub-Sahara Africa countries, particularly those where the POC assays have already been adopted as the national standard of SCD screening. If effective, the SCD SIMCS will have an important positive impact because it will reduce the cost of SCD screening, take screening services and evidence-based care closer to rural communities where the majority of children in sub-Sahara Africa live, and, ultimately, save millions of children from preventable and disability death.

Will I have to stop taking my current medications?

The trial information does not specify whether participants need to stop taking their current medications.

What data supports the effectiveness of the digital app treatment for sickle cell disease screening?

Research shows that mobile apps can help people with sickle cell disease manage their health better. For example, one study found that using an app improved self-management and communication with healthcare providers, while another study showed that frequent app use was linked to better mood and less pain.12345

Is the digital app for sickle cell disease screening safe for humans?

The studies on mobile health apps for sickle cell disease show that participants found them easy to use and helpful for managing their health, with no safety concerns reported.12367

How does the digital app for sickle cell disease screening differ from other treatments?

The digital app for sickle cell disease screening is unique because it leverages mobile health technology to improve self-management and communication with healthcare providers, unlike traditional treatments that focus solely on medication. This app allows patients to track symptoms, manage pain, and engage in health-promoting behaviors, providing a comprehensive approach to managing the condition.138910

Eligibility Criteria

This trial is for infants in sub-Saharan Africa, specifically Uganda, to improve early detection and management of Sickle Cell Disease (SCD). It aims to integrate a digital app and information system into existing healthcare infrastructure.

Inclusion Criteria

I am enrolling my infant who is under 1 year old.

Exclusion Criteria

I am at least 1 year old.

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Development and Evaluation

Development and evaluation of a four-module ≥3G cell phone app for a novel SCD screening information management and communication system (SIMCS)

Phase 1: Conducted at Mulago National Referral Hospital and piloted in Kampala
Multiple visits for app development and testing

Cluster Randomized Trial

Conduct a Cluster Randomized Trial (CRT) involving health centers in one urban district (Kampala) and three rural districts

Phase 2: Two years
Regular visits for data collection and monitoring

Follow-up

Participants are monitored for safety and effectiveness after the implementation of the SCD SIMCS

Two years

Treatment Details

Interventions

  • Digital app and information system
Trial Overview The trial is testing a custom mobile app designed for managing SCD screening data. The goal is to evaluate how this digital system affects access to screening services, continuity of care, and clinical outcomes for children with SCD.
Participant Groups
2Treatment groups
Experimental Treatment
Active Control
Group I: App/digital systemExperimental Treatment1 Intervention
Experimental Hospital/HCs will be provided with point of care test kits and smart phones loaded with airtime credit and the SCD SIMCS app. The health workers that normally provide pediatric care at the facilities will be trained in using the kits and SCD SIMCS app. Outcome measures to compare the effectiveness of SCD screening with and without the SIMCS will include proportions of accurately interpreted assay results, parents that receive counseling, infants seen for SCD care within 1 month of screening, and infants on penicillin. Variables to compute these outcome measures will be entered into cellphone eCRFs (Controls) or automatically transmitted from the SCD SIMCS App (Experimental) and retrieved from the SCD SIMCS database. Chi-squared test and contingent 95% confidence intervals and p-values will be computed to compare the proportions between SIMCS vs. non-SIMCS hospital/HCs.
Group II: No App/digital systemActive Control1 Intervention
Control Hospital/HCs will be provided with point of care test kits and smart phones loaded with airtime credit BUT no SCD SIMCS app. The health workers that normally provide pediatric care at the facilities will be trained in using the kits. To enable independent verification of the accuracy of interpretation of assay results, health workers will use the smart phones to take and send a photographic caption of every used point of care test strip to a designated central study phone from which they will be downloaded into a computer database. Control infants will be IDed by study number in the SCD SIMCS database.

Find a Clinic Near You

Who Is Running the Clinical Trial?

Makerere University

Lead Sponsor

Trials
297
Recruited
1,862,000+

Ministry of Health, Uganda

Collaborator

Trials
36
Recruited
1,380,000+

Baylor College of Medicine

Collaborator

Trials
1,044
Recruited
6,031,000+

Findings from Research

A study involving 46 adolescents and young adults (AYAs) with sickle cell disease (SCD) found that 69% had daily Internet access, indicating a strong potential for mobile health interventions.
The co-designed mobile app prototype, iManage, was rated as highly feasible and beneficial, suggesting it could effectively engage AYAs in self-management strategies to improve their health outcomes.
Development and evaluation of iManage: A self-management app co-designed by adolescents with sickle cell disease.Crosby, LE., Ware, RE., Goldstein, A., et al.[2022]
A feasibility randomized controlled trial involving 67 adults with sickle cell disease (SCD) showed high recruitment (91%) and retention (75%) rates for a mobile health app designed to improve patient knowledge and potentially reduce hospitalizations.
All participants in the treatment group used the mHealth app, indicating strong adherence to the intervention, which suggests that mobile health tools can be effectively integrated into patient care for SCD.
A feasibility randomized controlled trial of an mHealth app vs booklets for patient-facing guidelines in adults with SCD.Cronin, RM., Quaye, N., Liu, X., et al.[2023]
A study involving 26 adolescents and young adults with sickle cell disease showed that using a mobile health app (iManage for SCD) can improve self-management skills and self-efficacy, especially for those who engage frequently with the app.
Increased app engagement was linked to better mood ratings and lower pain levels, suggesting that mobile health tools can be effective in helping young people manage their condition more effectively.
Mobile health use predicts self-efficacy and self-management in adolescents with sickle cell disease.Hood, AM., Nwankwo, C., Walton, A., et al.[2022]

References

Development and evaluation of iManage: A self-management app co-designed by adolescents with sickle cell disease. [2022]
A feasibility randomized controlled trial of an mHealth app vs booklets for patient-facing guidelines in adults with SCD. [2023]
Patients welcome the Sickle Cell Disease Mobile Application to Record Symptoms via Technology (SMART). [2022]
Designing a Multistakeholder Collaboration to Improve Preventive Care for Children With Sickle Cell Anemia. [2021]
Mobile health use predicts self-efficacy and self-management in adolescents with sickle cell disease. [2022]
Mobile health intervention for youth with sickle cell disease: Impact on adherence, disease knowledge, and quality of life. [2019]
Administrative data identify sickle cell disease: A critical review of approaches in U.S. health services research. [2022]
The Potential of mHealth as a Game Changer for the Management of Sickle Cell Disease in India. [2021]
Usability and Feasibility of an mHealth Intervention for Monitoring and Managing Pain Symptoms in Sickle Cell Disease: The Sickle Cell Disease Mobile Application to Record Symptoms via Technology (SMART). [2022]
Feasibility of an mHealth self-management intervention for children and adolescents with sickle cell disease and their families. [2022]
Unbiased ResultsWe believe in providing patients with all the options.
Your Data Stays Your DataWe only share your information with the clinical trials you're trying to access.
Verified Trials OnlyAll of our trials are run by licensed doctors, researchers, and healthcare companies.
Back to top
Terms of Service·Privacy Policy·Cookies·Security