Implementation of the Téléder Togo teledermatology programme

BACKGROUND

The Téléder Togo programme funded by the Fondation Pierre Fabre provides technical and human resources to improve diagnosis and treatment of skin diseases at peripheral health structures through use of new technologies.

Téléder Togo follows the project developed in Mali (Téléder Mali project) presented at the First African Teledermatology Conference held in Bamako in 2017. The Togolese Society of Dermatology and Sexually Transmitted Infections (SOTODERM) responded favourably to the call for proposals the Foundation made at this event, open to health structures wanting to implement teledermatology in their areas.

The programme is based on two complementary priorities:

• Training health workers in the most common skin diseases;
• Supplying technical capacities (image-capture and -transfer tools) to submit more difficult cases to specialists, often based in the country’s larger hospitals.

The option to remotely transmit clinical photographs helps to offset the lack of dermatologists. Togo, like many other sub-Saharan African countries, is seeing an increase in severe and persistent forms of skin disease due to the absence of specialised care.

LOCAL TREATMENT

The objective of the Téléder Togo project is to establish the practice of teledermatology in at least 50 peripheral health structures in four Togo regions (the Savanes, Kara, Centrale and Plateaux Regions). These include community health centres, peripheral treatment units and district hospitals.

The pilot phase ran from June 2019 through October 2020, targeting 20 structures and 52 health workers (eight physicians and 44 paramedical staff). Training in ICT (Information and Communication Technologies) was reinforced by two Malian experts who helped implement the project in their country.

USE OF TELEMEDICINE

For the most complex cases, the health centres are supplied with the equipment needed to seek a specialist’s advice remotely. The local health worker is trained in digitising the clinical profile and entering it on a secure exchange platform.

The Sylvanus Olympio Teaching Hospital of Lomé serves as a referral centre for the project: dermatologists from the Dermatology Department respond to requests for remote assessments from the local health workers at the peripheral health centres.

Some of the project’s measurable benefits seen during the pilot phase are:

• Increased traffic to healthcare structures;
• Patient satisfaction by virtue of rapid treatment, meaning less travel and reduced costs;
• Fewer appointment requests for mild cases at the teaching hospital, particularly advantageous during the Covid-19 pandemic.