title: Barriers to pilot mobile teleophthalmology in a rural hospital in Southern Malawi.
abstract: BACKGROUND
  Malawi has one of the highest HIV prevalences in Sub-Saharan Africa. The rate of eligible HIV-infected people being initiated on antiretroviral therapy (ART) and retained in HIV-care is currently far from adequate. Consequently, many people continue present with advanced immunosuppression at public health facilities, often with undiagnosed opportunistic infections (OIs).
  
  
  METHODS
  In this context, mHealth was the innovation chosen to assist Eye Clinical Officers in early diagnosis of HIV-related diseases having eye manifestations in a rural hospital in Thyolo, Southern Malawi.
  
  
  RESULTS
  The mTeleophthalmology program began in October 2013, but was stopped prematurely due to organizational and technological barriers that compromised its feasibility.
  
  
  CONCLUSIONS
  Sharing these barriers might be useful to inform the design of similar innovations in other resource-limited settings with a high HIV prevalence and a dearth of eye specialists with capacity to diagnose HIV-related retinopathies.
authors.affiliation: Southern Africa Medical Unit, Médecins Sans Frontières, Cape Town, Southern Africa.
authors.forename: Guillermo Martínez
authors.initials: GM
authors.lastname: Pérez
authors.affiliation: Department of Mechanics and Mechatronics, University of Stellenbosch, South Africa.
authors.forename: Wayne
authors.initials: W
authors.lastname: Swart
authors.affiliation: Médecins Sans Frontières, Malawi.
authors.forename: Jimmy Kondwani
authors.initials: JK
authors.lastname: Munyenyembe
authors.affiliation: Southern Africa Medical Unit, Médecins Sans Frontières, Cape Town, Southern Africa.
authors.forename: Peter
authors.initials: P
authors.lastname: Saranchuk
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000175:diagnosis* / Q000453:epidemiology; D019380:Anti-HIV Agents / Q000627:therapeutic use; D042241:Early Diagnosis; D005128:Eye Diseases / Q000175:diagnosis* / Q000821:virology; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy / Q000453:epidemiology; D006780:Hospitals, Rural / Q000458:organization & administration; D006801:Humans; D008295:Malawi / Q000453:epidemiology; D010865:Pilot Projects; D017216:Telemedicine / Q000458:organization & administration*
chemical_list: D019380:Anti-HIV Agents
keywords: HIV/AIDS; Malawi; eye diseases; mHealth; mteleophthalmology; opportunistic infections