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Detection of Potential Arbovirus Infections and Pregnancy Complications in Pregnant Women in Jamaica Using a Smartphone App (ZIKApp): Pilot Evaluation Study

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Title: Detection of Potential Arbovirus Infections and Pregnancy Complications in Pregnant Women in Jamaica Using a Smartphone App (ZIKApp): Pilot Evaluation Study
Authors: Elisa Ruiz-Burga, Patricia Bruijning-Verhagen, Paulette Palmer, Annalisa Sandcroft, Georgina Fernandes, Marieke de Hoog, Lenroy Bryan, Russell Pierre, Heather Bailey, Carlo Giaquinto, Claire Thorne, Celia D C Christie
Source: JMIR Formative Research, Vol 6, Iss 7, p e34423 (2022)
Publisher Information: JMIR Publications, 2022.
Publication Year: 2022
Collection: LCC:Medicine
Subject Terms: Medicine
More Details: BackgroundThere is growing evidence of the benefits of mobile health technology, which include symptom tracking apps for research, surveillance, and prevention. No study has yet addressed arbovirus symptom tracking in pregnancy. ObjectiveThis study aimed to evaluate the use of a smartphone app (ZIKApp) to self-report arbovirus symptoms and pregnancy complications and to assess compliance with daily symptom diaries during pregnancy in a cohort of women in an arbovirus-endemic, subtropical, middle-income country (Jamaica). MethodsPregnant women aged ≥16 years, having a smartphone, and planning on giving birth at the recruiting center were enrolled between February 2020 and July 2020. ZIKApp comprised a daily symptom diary based on algorithms to identify potential episodes of arbovirus infection and pregnancy complications. Sociodemographic, epidemiological, and obstetric information was collected at enrollment, with additional review of medical records, and users’ perception was collected through an exit survey. Descriptive analyses and logistic regression analysis of possible factors associated with diary adherence were performed. ResultsOf the 173 women enrolled, 157 (90.8%) used ZIKApp for a median duration of 155 (IQR 127-173) days until pregnancy end, 6 (3.5%) used the app for 34 years versus those aged 25 to 29 years (adjusted odds ratio 3.14, 95% CI 1.10-8.98) and 2-fold higher odds for women with tertiary versus secondary education (adjusted odds ratio 2.26, 95% CI 1.06-4.83). Of the 161 women who ever made a diary entry, 5454 individual symptom reports were made (median 17 per woman; IQR 4-42; range 0-278); 9 (5.6%) women reported symptom combinations triggering a potential arbovirus episode (none had an adverse pregnancy outcome) and 55 (34.2%) reported painful uterine contractions or vaginal bleeding, mainly in the month before delivery. Overall, 51.8% (71/137) of the women rated the app as an excellent experience and were less likely to be poor diary adherers (P=.04) and 99.3% (138/139) reported that the app was easy to understand and use. ConclusionsThis pilot found a high adherence to ZIKApp. It demonstrated the feasibility and usability of the app in an arbovirus-endemic region, supporting its future development to contribute to surveillance and diagnosis of arbovirus infections in pregnancy and to optimize maternal care.
Document Type: article
File Description: electronic resource
Language: English
ISSN: 2561-326X
Relation: https://formative.jmir.org/2022/7/e34423; https://doaj.org/toc/2561-326X
DOI: 10.2196/34423
Access URL: https://doaj.org/article/185f7a6faea147c08d50aa336f5105f5
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  Data: Detection of Potential Arbovirus Infections and Pregnancy Complications in Pregnant Women in Jamaica Using a Smartphone App (ZIKApp): Pilot Evaluation Study
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  Data: <searchLink fieldCode="AR" term="%22Elisa+Ruiz-Burga%22">Elisa Ruiz-Burga</searchLink><br /><searchLink fieldCode="AR" term="%22Patricia+Bruijning-Verhagen%22">Patricia Bruijning-Verhagen</searchLink><br /><searchLink fieldCode="AR" term="%22Paulette+Palmer%22">Paulette Palmer</searchLink><br /><searchLink fieldCode="AR" term="%22Annalisa+Sandcroft%22">Annalisa Sandcroft</searchLink><br /><searchLink fieldCode="AR" term="%22Georgina+Fernandes%22">Georgina Fernandes</searchLink><br /><searchLink fieldCode="AR" term="%22Marieke+de+Hoog%22">Marieke de Hoog</searchLink><br /><searchLink fieldCode="AR" term="%22Lenroy+Bryan%22">Lenroy Bryan</searchLink><br /><searchLink fieldCode="AR" term="%22Russell+Pierre%22">Russell Pierre</searchLink><br /><searchLink fieldCode="AR" term="%22Heather+Bailey%22">Heather Bailey</searchLink><br /><searchLink fieldCode="AR" term="%22Carlo+Giaquinto%22">Carlo Giaquinto</searchLink><br /><searchLink fieldCode="AR" term="%22Claire+Thorne%22">Claire Thorne</searchLink><br /><searchLink fieldCode="AR" term="%22Celia+D+C+Christie%22">Celia D C Christie</searchLink>
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  Data: JMIR Formative Research, Vol 6, Iss 7, p e34423 (2022)
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  Data: BackgroundThere is growing evidence of the benefits of mobile health technology, which include symptom tracking apps for research, surveillance, and prevention. No study has yet addressed arbovirus symptom tracking in pregnancy. ObjectiveThis study aimed to evaluate the use of a smartphone app (ZIKApp) to self-report arbovirus symptoms and pregnancy complications and to assess compliance with daily symptom diaries during pregnancy in a cohort of women in an arbovirus-endemic, subtropical, middle-income country (Jamaica). MethodsPregnant women aged ≥16 years, having a smartphone, and planning on giving birth at the recruiting center were enrolled between February 2020 and July 2020. ZIKApp comprised a daily symptom diary based on algorithms to identify potential episodes of arbovirus infection and pregnancy complications. Sociodemographic, epidemiological, and obstetric information was collected at enrollment, with additional review of medical records, and users’ perception was collected through an exit survey. Descriptive analyses and logistic regression analysis of possible factors associated with diary adherence were performed. ResultsOf the 173 women enrolled, 157 (90.8%) used ZIKApp for a median duration of 155 (IQR 127-173) days until pregnancy end, 6 (3.5%) used the app for 34 years versus those aged 25 to 29 years (adjusted odds ratio 3.14, 95% CI 1.10-8.98) and 2-fold higher odds for women with tertiary versus secondary education (adjusted odds ratio 2.26, 95% CI 1.06-4.83). Of the 161 women who ever made a diary entry, 5454 individual symptom reports were made (median 17 per woman; IQR 4-42; range 0-278); 9 (5.6%) women reported symptom combinations triggering a potential arbovirus episode (none had an adverse pregnancy outcome) and 55 (34.2%) reported painful uterine contractions or vaginal bleeding, mainly in the month before delivery. Overall, 51.8% (71/137) of the women rated the app as an excellent experience and were less likely to be poor diary adherers (P=.04) and 99.3% (138/139) reported that the app was easy to understand and use. ConclusionsThis pilot found a high adherence to ZIKApp. It demonstrated the feasibility and usability of the app in an arbovirus-endemic region, supporting its future development to contribute to surveillance and diagnosis of arbovirus infections in pregnancy and to optimize maternal care.
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