Why do some Doctors ignore Infection Control issues when experimenting with mHealth on the poor?

National Post Toronto Doctor turns his iPhone into field microscope

As for his iPhone, (Dr. Isaac) Bogoch (an Infectious Disease Specialist at Toronto General Hospital) says it takes seconds to turn it back into phone. He simply removes the ball lens and tape, and gives it a “wipe with alcohol”

This is the second time I’ve noticed such complete abandonment of good practice with regard to infection control by Doctors from leading North American Medical Schools as they experiment with ways to provide care for Patients in poorer regions of the world using their mobile phones.

It’s not a surprise that tech writers at the BBC and CNN haven’t picked up on this but it amazes me that the Editors at the American Journal of Tropical Medicine and Hygiene have let this be published in their Journal even though it doesn’t have a single mention or warnings of infection control issues or details of the cleaning procedures being used.

In case there is any doubt:

The value of documenting intestinal worms in a patients stool in a very poor region of the world is not worth risking lives.

If you are collecting stool samples and conducting fecal smears it is a good idea to be trained, to be doing it in a dedicated laboratory environment with proper waste disposal facilities and to be wearing disposable gloves, face mask, etc. The importance of this should be obvious to an Infectious Disease Specialist at the Toronto General Hospital as there are many viruses (like the Novoviruses that have closed Canadian hospitals) that can be present in fecal material that can even become aerosolized.

Even a thorough cleaning process using Alcohol (in the National Post article Dr Isaac Bogoch is quoted as suggesting that a “wipe with alcohol” will be sufficient) will not kill everything and there are certain bacterial spores, protozoa and noneveloped viruses that won’t be affected.

In regions of the world where it would be too expensive to use proper equipment for analysing stools the alcohol-based hand cleansers that are for sale are often of variable quality.

A Mobile phone that hasn’t been cleaned properly will be a fomite that will be capable of transferring infectious organisms to the next person who comes into contact with it and smooth non-porous surfaces like the glass and metal casing of an iPhone will transmit bacteria and viruses very effectively because unlike porous materials it will not absorb and trap any contagion – thus making it easier for it to be contracted via simple touch.

iPhone being used to read fecal smears

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