Telemedicine and advances in urban and rural healthcare delivery in Africa

Progress in Cardiovascular Diseases

Volumn 56, Issue 3, 2013, Pages 326-335

  Mars, Maurice ^a  

^a UNIVERSITY OF KWAZULU NATAL   (South Africa)

Author keywords

Africa; History; ICT; Implementation; Telehealth; Telemedicine

Indexed keywords

ARTICLE; HEALTH CARE DELIVERY; HEALTH CARE QUALITY; HEALTH EDUCATION; HEALTH PRACTITIONER; HOME MONITORING; HUMAN; LEGAL ASPECT; MEDICAL ETHICS; MEDICAL SPECIALIST; MEDICATION COMPLIANCE; PATIENT MONITORING; PATIENT TRANSPORT; PERSONNEL SHORTAGE; RURAL AREA; TELECARDIOLOGY; TELEDERMATOLOGY; TELEECHOCARDIOGRAPHY; TELEEDUCATION; TELEELECTROCARDIOGRAM; TELEMEDICINE; TELEPSYCHIATRY; TELERADIOLOGY; TEXT MESSAGING; URBAN AREA;

AFRICA; HISTORY; ICT; IMPLEMENTATION; INFORMATION AND COMMUNICATION TECHNOLOGY; TELEHEALTH; TELEMEDICINE;

AFRICA; DELIVERY OF HEALTH CARE; HUMANS; RURAL HEALTH; TELEMEDICINE; URBAN HEALTH;

EID: 84887948228     PISSN: 00330620     EISSN: 18731740     Source Type: Journal    
DOI: 10.1016/j.pcad.2013.10.006     Document Type: Article

References (138)

1. World Health Organization World health report 2006: working together for health 2006, WHO Press, Geneva.
2. United Nations, Department of Economic and Social Affairs, Population Division World population prospects: the 2012 revision, key findings and advance tables. Working paper no. ESA/P/WP.227 2013, United Nations, New York.
3. World Health Organization World Health Statistics 2013 2013, WHO Press, Geneva.
4. United Nations, Department of Economic and Social Affairs, Population Division World Urbanization Prospects, the 2011 Revision 2012, United Nations, New York.
5. American Telemedicine Association What is telemedicine? Accessed 22 June 2013. http://www.americantelemed.org/learn/what-is-telemedicine.
6. World Health Organisation eHealth Accessed 22 June 2013. http://www.who.int/topics/ehealth/en/.
7. Committee A. World Health Assembly eHealth Resolution (WHA58.28). 2005;A58/62:4-6.
8. World Health Organization Building foundations for eHealth. Report of the WHO Global Observatory for eHealth 2006, WHO Press, Geneva.
9. International Telecommunications Union ICT facts and figures Accessed 22 June 2013. http://www.itu.int/en/ITU-D/Statistics/Pages/facts/default.aspx.
10. International Telecommunications Union Measuring the information society 2012 2012, ITU, Geneva.
11. Collier P. The Bottom Billion 2007, Oxford University Press, Oxford.
12. Laws of Malaysia, Telemedicine Act 1997. Available from: The Commissioner of Law Revision, Malaysia. or http://www.agc.gov.my/index.php?option=com_content&view=article&id=650&Itemid=204&lang=bm Accessed 22 June 2013.
13. Jack C., Mars M. Telemedicine a need for ethical and legal guidelines in South Africa. SA Fam Pract 2008, 50. [60-60d].
14. Chipps J., Ramlall S., Mars M. Practice guidelines for videoconference-based telepsychiatry in South Africa. Afr J Psychiatry 2012, 15:271-282.
15. Kekana M., Noe P., Mkhize B. The practice of telemedicine and challenges to the regulatory authorities. S Afr J Bioethics Law 2010, 3:33-37.
16. Mars M., Jack C. Why is telemedicine a challenge to the regulators. S Afr J Bioethics Law 2010, 3:55-58.
17. Peters-Scheepers B. HPCSA condemns unethical telemedicine practice Accessed 22 June 2013. http://www.hpcsa.co.za/downloads/press_releases/current/hpcsa_condemns_unethical_telemedicine_practice.pdf.
18. Bateman C. Cutting-edge telemedicine venture freezes as official bodies frown. S Afr Med J 2011, 101:368-372.
19. Eikelboom R.H. The telegraph and the beginnings of telemedicine in Australia. Stud Health Technol Inform 2012, 182:67-72.
20. Aronson S.H. The Lancet on the telephone. Med Hist 1977, 21:69-87.
21. Einthoven W. Het Telecardiogram [The telecardiogram]. Ned T Geneesk 1906, 50:1517-1547.
22. Dumanskyy Y.Y., Vladzymyrskyy A.V., Lobas V.M., et al. Atlas of the Telemedicine History 2013, Donetsk, Knowledge.
23. Bashshur R.L., Shannon G.W. History of telemedicine: evolution context and transformation 2009, New Rochelle, NY, Mary Ann Liebert Inc.
24. International Telecommunication Union, Telecommunication Development Bureau Impact of telecommunications in health-care and other social services 2013, ITU, Geneva, 2/155(Rev2)-E.
25. House M., Keough E., Hillman D., et al. Into Africa: the telemedicine links between Canada, Kenya and Uganda. CMAJ 1987, 136:398-400.
26. House M, Keough E. Telemedicine and distance education: the Memorial University of Newfoundland experience. Communications: world prosperity through, communications. 1989;302-305.
27. Crowther J.B., Poropatich R. Telemedicine in the U.S. Army: case reports from Somalia and Croatia. Telemed J E Health 1995, 1:73-80.
28. Scott R., Mars M., Herbert M. How global is 'e-Health' and 'Knowledge Translation'?. Technology Enabled Translation for eHealth 2013, Springer, New York. K. Ho, S. Jarvis-Selinger, H.N. Lausher, J. Cordeiro, R. Scott (Eds.).
29. Grigsby J., Bennett R.E. Alternatives to randomized controlled trials in telemedicine. J Telemed Telecare 2006, (Suppl. 2):S77-S84.
30. Mars M., Scott R. Telemedicine service use: a new metric. J Med Internet Res 2012, 14:e178.
31. Gulube S.M., Wynchank S. The national telemedicine system in South Africa - An overview and progress report. S Afr Med J 2002, 92:513.
32. Mars M. Telemedicine in KwaZulu-Natal: from failure to cautious optimism. J Telemed Telecare 2007, 13:57-59.
33. Shiferaw F., Zolfo M. The role of information communication technology (ICT) towards universal health coverage: the first steps of a telemedicine project in Ethiopia. Glob Health Action 2012, 5:15638.
34. Birati E.Y., Roth A. Telecardiology. Isr Med Assoc J 2011, 498-503.
35. Nikus K., Virtanen N., Sclarovsky S., et al. The role of standard12-lead ECG in a telecardiology consultation service. Telemedicine Techniques and Applications 2011, Rijeka, Intech. G. Grashew (Ed.).
36. Klersy C., De Silvestri A., Gabutti G., et al. A meta-analysis of remote monitoring of heart failure patients. J Am Coll Cardiol 2009, 54:1683-1694.
37. Chaudhry S.I., Mattera J.A., Curtis J.P., et al. Telemonitoring in patients with heart failure. N Engl J Med 2010, 363:2301-2309.
38. Koehler F., Winkler S., Schieber M., et al. Impact of remote telemedical management on mortality and hospitalizations in ambulatory patients with chronic heart failure: the telemedical interventional monitoring in heart failure study. Circulation 2011, 123:1873-1880.
39. Alkmim M.B., Marcolini M.S., Santos E.V., et al. 1,000,000 Electrocardiograms by distance: an outstanding milestone for telehealth in Minas Gerais, Brazil. Glob Telemed eHealth Update Knowl Resour 2013, 6:459-464.
40. Dream, Comunita di Sant'Egidio Telemedicine for Africa. Diagnosis and therapy with one click Accessed 22 June. http://dream.santegidio.org/public/news/x__newsreadpubNS.asp?IdNews=1153&Curlang=EN.
41. Bagayoko C.O., Niang M., Traore S.T., et al. Deploying portable ultrasonography with remote assistance for isolated physicians in Africa: lessons from a pilot study in Mali. Stud Health Technol Inform 2010, 160(Pt 1):554-558.
42. Zuhlke L., Mirabel M., Marijon E. Congenital heart disease and rheumatic heart disease in Africa: recent advances and current priorities. Heart 2013, 1-8. 10.1136/heartjnl-2013-303896.
43. Finley J.P. Paediatric telecardiology in Canada. Paediatr Child Health 2009, 14:156-158.
44. Sable C., Donfrio M., Cross R., et al. 6,000 pediatric tele-echocardiogrpahy transmissions: impact on practice and lessons learned. Telemed J E Health 2008, 14:57-58.
45. Alverson D.C., Swinfen R., Swinfen P., et al. Transforming systems of care for children in the global community. Pediatr Ann 2009, 38:579-585.
46. Lester R.T., Ritvo P., Mills E.J., et al. Effects of a mobile phone short messaging service on antiretroviral treatment adherence in Kenya (WelTel Kenya1): a randomised trial. Lancet 2010, 376:1838-1845.
47. Chindo L. Mobile phone use in Cameroon: an increasingly useful tool for the follow-up of children with Burkitt lymphoma. Pediatr Blood Cancer 2013, 60:524.
48. Broomhead S., Mars M. Retrospective return on investment analysis of an electronic treatment adherence device piloted in the Northern Cape Province. Telemed J E Health 2012, 1:24-31.
49. Corr P. Teleradiology in KwaZulu-Natal. A pilot project. S Afr Med J 1998, 88:48-49.
50. Corr P., Couper I., Beningfield S.J., et al. A simple telemedicine system using a digital camera. J Telemed Telecare 2000, 6:233-236.
51. Gulube S.M., Wynchank S. Telemedicine in South Africa: success or failure?. J Telemed Telecare 2001, 7:47-49.
52. Jithoo R., Govender P.V., Corr P., et al. Telemedicine and neurosurgery: experience of a regional unit based in South Africa. J Telemed Telecare 2003, 9:63-66.
53. Jithoo R., Nathoo N., Corr P. 'Yes!' to telemedicine. S Afr Med J 1999, 89:1126.
54. Dulou R., Dagain A., Delmas J.M., et al. The French mobile neurosurgical unit. Neurosurg Focus 2010, 28.
55. Bagayoko C.O., Anne A., Fieschi M., et al. Can ICTs contribute to the efficiency and provide equitable access to the health care system in Sub-Saharan Africa? The Mali Experience. Yearb Med Inform 2011, 6:33-38.
56. Coulborn R.M., Panunzi I., Spijker S., et al. Feasibility of using teleradiology to improve tuberculosis screening and case management in a district hospital in Malawi. Bull World Health Organ 2012, 90:705-711.
57. Wamala D., Katamba A., Dworak O. Feasibility and diagnostic accuracy of Internet-based dynamic telepathology between Uganda and Germany. J Telemed Telecare 2011, 17:222-225.
58. Tsang M.W., Kovarik C.L. The role of dermatopathology in conjunction with teledermatology in resource-limited settings: lessons from the African Teledermatology Project. Int J Dermatol 2011, 50:150-156.
59. Bellina L., Missoni E. Mobile cell-phones (M-phones) in telemicroscopy: increasing connectivity of isolated laboratories. Diagn Pathol 2009, 4:19. 10.1186/1746-1596-4-19.
60. Brauchli K., Oberli H., Hurwitz N., et al. Diagnostic telepathology: long-term experience of a single institution. Virchows Arch 2004, 444:403-409.
61. Brauchli K., O'Mahony D., Banach L., et al. iPath: a telemedicine platform to support health providers in low resource settings. J Inf Technol Healthc 2005, 3:227-235.
62. Schneider J. Telepathology at Tikur Anbessa Hospital: how telemedicine works. Ethiop Med J 2005, 43:51-53.
63. Sohani A.R., Sohani M.A. Static digital telepathology: a model for diagnostic and educational support to pathologists in the developing world. Anal Cell Pathol (Amst) 2012, 35:25-30.
64. O'Mahony D., Banach L., Mahapa D.H., et al. Teledermatology in a rural family practice. S Afr Fam Pract 2002, 6:4-8.
65. Ayad E., Yagi Y. Virtual microscopy beyond the pyramids, applications of WSI in Cairo University for E-education & telepathology. Anal Cell Pathol (Amst) 2012, 35:93-95.
66. Ayad E. Virtual telepathology in Egypt, applications of WSI in Cairo University. Diagn Pathol 2011, (6 Suppl 1):S1.
67. Pagni F., Bono F., Di B.C., et al. Virtual surgical pathology in underdeveloped countries: the Zambia Project. Arch Pathol Lab Med 2011, 135:215-219.
68. Kumar N., Busarla S.V., Sayed S., et al. Telecytology in East Africa: a feasibility study of forty cases using a static imaging system. J Telemed Telecare 2012, 18:7-12.
69. Schmid-Grendelmeier P., Masenga E.J., Haeffner A., et al. Teledermatology as a new tool in sub-saharan Africa: an experience from Tanzania. J Am Acad Dermatol 2000, 42:833-835.
70. Schmid-Grendelmeier P., Doe P., Pakenham-Walsh N. Teledermatology in sub-Saharan Africa. Curr Probl Dermatol 2003, 32:233-246.
71. Kaddu S., Soyer H.P., Gabler G., et al. The Africa Teledermatology Project: preliminary experience with a sub-Saharan teledermatology and e-learning program. J Am Acad Dermatol 2009, 61:155-157.
72. Weinberg J., Kaddu S., Gabler G., et al. The African Teledermatology Project: providing access to dermatologic care and education in sub-Saharan Africa. Pan Afr Med J 2009, 3:16.
73. Tran K., Ayad M., Weinberg J., et al. Mobile teledermatology in the developing world: implications of a feasibility study on 30 Egyptian patients with common skin diseases. J Am Acad Dermatol 2011, 64:302-309.
74. Mars M. Health capacity development through telemedicine in Africa. Yearb Med Inform 2010, 87-93.
75. Wootton R. Telemedicine support for the developing world. J Telemed Telecare 2008, 14:109-114.
76. Gimbel D.C., Sohani A.R., Prasad Busarla S.V., et al. A static-image telepathology system for dermatopathology consultation in East Africa: the Massachusetts General Hospital Experience. J Am Acad Dermatol 2012, 67:997-1007.
77. Tsang M.W., Kovarik C.L. Global access to dermatopathology services: physician survey of availability and needs in sub-Saharan Africa. J Am Acad Dermatol 2010, 63:346-348.
78. Fischer M.K., Kayembe M.K., Scheer A.J., et al. Establishing telepathology in Africa: lessons from Botswana. J Am Acad Dermatol 2011, 64:986-987.
79. Caumes E., Le Bris V., Couzigou C., et al. Dermatoses associated with travel to Burkina Faso and diagnosed by means of teledermatology. Br J Dermatol 2004, 150:312-316.
80. Colven R., Todd G., Wynchank S., March J., Molefi M. A teledermatology network for underserved areas of South Africa Accessed 22 June 2013. http://www.medetel.lu/download/2005/parallel_sessions/presentation/0407/A_Teledermatology_network.pdf.
81. Colven R., Shim M.H.M., Brock D., et al. Dermatological diagnostic acumen improves with use of a simple telemedicine system for underserved areas of South Africa. Telemed J E Health 2011, 17:363-369.
82. Azfar R.S., Weinberg J.L., Cavric G., et al. HIV-positive patients in Botswana state that mobile teledermatology is an acceptable method for receiving dermatology care. J Telemed Telecare 2011, 17:338-340.
83. Fruhauf J., Hofman-Wellenhof R., Kovarik C., et al. Mobile teledermatology in sub-Saharan Africa: a useful tool in supporting health workers in low-resource centres. Acta Derm Venereol 2013, 93:122-123.
84. Mars M., Dlova N. Teledermatology by videoconference: experience of a pilot project. S Afr Fam Pract 2008, 50. 70-70d.
85. Adambounou K., Farin F., Boucher A., et al. Preliminary experience with tele-sonography and tele-mammography in Togo. Diagn Interv Imaging 2012, 93:639-642.
86. Parham G.P., Mwanahamuntu M.H., Pfaendler K.S., et al. EC3-A modern telecommunications matrix for cervical cancer prevention in Zambia. J Low Genit Tract Dis 2010, 14:167-173.
87. Quinley K.E., Gormley R.H., Ratcliffe S.J., et al. Use of mobile telemedicine for cervical cancer screening. J Telemed Telecare 2011, 17:203-209.
88. Andreatta P., Debpuur D., Danquah A., et al. Using cell phones to collect postpartum hemorrhage outcome data in rural Ghana. Int J Gynaecol Obstet 2011, 113:148-151.
89. Abdi Y.A., Elmi J.Y. Internet based telepsychiatry: a pilot case in Somaliland. Med Confl Surviv 2011, 27:145-150.
90. Ramlall S., Chipps J., Mars M. Impact of the South African Mental Health Care Act No. 17 of 2002 on regional and district hospitals designated for mental health care in KwaZulu-Natal. S Afr Med J 2010, 10:667-670.
91. Chipps J., Mars M. Readiness of health-care institutions in KwaZulu-Natal to implement telepsychiatry. J Telemed Telecare 2012, 18:133-137.
92. Chipps J., Ramlall S., Mars M. A telepsychiatry model to support psychiatric outreach in the public sector in South Africa. Afr J Psychiatry 2012, 15:264-270.
93. Chipps J., Ramlall S., Madigoe T., et al. Developing telepsychiatry services in KwaZulu-Natal - an action research study. Afr J Psychiatry 2012, 15:255-263.
94. Mars M., Ramlall S., Kaliski S. Forensic telepsychiatry: a possible solution for South Africa?. Afr J Psychiatry 2012, 15:244-247.
95. Taylor P., Kennedy C., Murdoch I., et al. Assessment of benefit in tele-ophthalmology using a consensus panel. J Telemed Telecare 2003, 9:140-145.
96. Kennedy C., Van Heerden A., Cook C., et al. Utilization and practical aspects of tele-ophthalmology between South Africa and the UK. J Telemed Telecare 2001, 7:20-22.
97. Kennedy C., Bowman R., Fariza N., et al. Audit of Web-based telemedicine in ophthalmology. J Telemed Telecare 2006, 12:88-91.
98. Jivraj I., Ng M., Rudnisky C.J., et al. Prevalence and severity of diabetic retinopathy in Northwest Cameroon as identified by teleophthalmology. Telemed J E Health 2011, 17:294-298.
99. Bhosai S.J., Amza A., Beido N., et al. Application of smartphone cameras for detecting clinically active trachoma. Br J Ophthalmol 2012, 96:1350-1351.
100. Bertani A., Launay F., Candoni P., et al. Teleconsultation in paediatric orthopaedics in Djibouti: evaluation of response performance. Orthop Traumatol Surg Res 2012, 98:803-807.
101. McMullen E. Use of audiovisual equipment (SKYPE) for the treatment of hand injuries for remote consultations. Hand Ther 2012, 17:42-46.
102. Swanepoel de W., Koekemoer D., Clark J. Intercontinental hearing assessment - a study in tele-audiology. J Telemed Telecare 2010, 16:248-252.
103. Biagio L., Swanepoel d.W., Adeyemo A., et al. Asynchronous video-otoscopy with a telehealth facilitator. Telemed J E Health 2013, 19:252-258.
104. Mahmud N., Rodriguez J., Nesbit J. A text message-based intervention to bridge the healthcare communication gap in the rural developing world. Technol Health Care 2010, 18:137-144.
105. Odigie V.I., Yusufu L.M.D., Dawotola D.A., et al. The mobile phone as a tool in improving cancer care in Nigeria. Psycho-Oncology 2012, 21:332-335.
106. Davey DJ, Hares S, Ponce W, et al. Evaluating SMS reminders in improving ART and PMTCT adherence in Mozambique: challenges in achieving scale. 7th International Conference on Appropriate Healthcare Technologies for Developing Countries. 2012;41.
107. Siedner M.J., Lankowski A., Musinga D., et al. Optimizing Network Connectivity for Mobile Health Technologies in sub-Saharan Africa. PLoS ONE 2012, 7.
108. Scott R.E., Ndumbe P., Wootton R. An e-health needs assessment of medical residents in Cameroon. J Telemed Telecare 2005, 11(Suppl. 2):S78-S80.
109. Chib A., Wilkin H., Ling L.X., et al. You have an important message! Evaluating the effectiveness of a text message HIV/AIDS campaign in Northwest Uganda. J Health Commun 2012, 17(Suppl. 1):146-157.
110. De Tolly K., Skinner D., Nembaware V., et al. Investigation into the use of short message services to expand uptake of human immunodeficiency virus testing, and whether content and dosage have impact. Telem J E Health 2012, 18:18-23.
111. Lemay N.V., Sullivan T., Jumbe B., et al. Reaching remote health workers in Malawi: baseline assessment of a pilot mHealth intervention. J Health Commun 2012, 17(Suppl. 1):105-117.
112. Chang L.W., Kagaayi J., Arem H., et al. Impact of a mHealth intervention for peer health workers on AIDS care in rural Uganda: a mixed methods evaluation of a cluster-randomized trial. AIDS Behav 2011, 15:1776-1784.
113. Mukudu A., Van Belle J.P. A case study of a successful mHealth application: cell-life's EMIT system. Recent progress in DEIT 2012, Vol 2:401-408. Springer-Verlag, Berlin.
114. Gurman T.A., Rubin S.E., Roess A.A. Effectiveness of mHealth behavior change communication interventions in developing countries: a systematic review of the literature. J Health Commun 2012, 17:82-104.
115. Corker J. "Ligne Verte" toll free hotline: using cell phones to increase access to family planning information in the Democratic Republic of Congo. Cases Public Health Commun Market 2010, 4:23-37.
116. Chang A.Y., Ghose S., Littman-Quinn R., et al. Use of mobile learning by resident physicians in Botswana. Telemed J E Health 2012, 18:11-13.
117. Merrell R.C., Merriam N., Doarn C. Information support for the ambulant health worker. Telemed J E Health 2004, 10:432-436.
118. Whittaker L., Van Zyl J., Soicher A.S. What is the point of the point-of-care? A case study of user resistance to an e-Health system. Telemed J E Health 2011, 17:55-61.
119. Chaiyachati K.H., Loveday M., Lorenz S., et al. A pilot study of an mHealth application for healthcare workers: poor uptake despite high reported acceptability at a rural South African community-based MDR-TB treatment program. PLoS ONE 2013, 8:e64662.
120. Ricci M.A., Caputo M.P., Callas P.W., et al. The use of telemedicine for delivering continuing medical education in rural communities. Telemed J E Health 2005, 11:124-129.
121. Moffatt J.J., Eley D.S. The reported benefits of telehealth for rural Australians. Aust Health Rev 2010, 34:276-281.
122. Gagnon M.P., Duplantie J., Fortin J.-P., et al. Implementing telehealth to support medical practice in rural/remote regions: what are the conditions for success?. Implement Sci 2006, 1:18.
123. Bagayoko C.O., Perrin C., Gagnon M.P., et al. Continuing distance education: a capacity-building tool for the de-isolation of care professionals and researchers. J Gen Intern Med 2013, 28(Suppl 3):S666-S670. 10.1007/s11606-013-2522-1.
124. Geissbuhler A., Ly O., Lovis C., et al. Telemedicine in Western Africa: lessons learned from a pilot project in Mali, perspectives and recommendations. AMIA Annu Symp Proc 2003, 249-253.
125. Geissbuhler A., Bagayoko C.O., Ly O. The RAFT network: 5years of distance continuing medical education and tele-consultations over the Internet in French-speaking Africa. Int J Med Inform 2007, 76:351-356.
126. Zolfo M., Lynen L., Dierckx J., et al. Remote consultations and HIV/AIDS continuing education in low-resource settings. Int J Med Inform 2006, 75:633-637.
127. Zolfo M., Iglesias D., Kiyan C., et al. Mobile learning for HIV/AIDS healthcare worker training in resource-limited settings. Aids Res Ther 2010, 7:1-6.
128. Chipps J. The use of synchronous videoconferencing teaching to increase access to specialist nurse education in rural Kwazulu-Natal South Africa. Knowl Management E-Learn 2010, 2:154-168.
129. Chipps J., Ramlall S., Mars M. Videoconference-based education for psychiatry registrars at the University of Kwazulu-Natal South Africa. Afr J Psychiatry 2012, 15:248-254.
130. Mars M. Building the capacity to build capacity in e-health in sub-Saharan Africa: the KwaZulu-Natal experience. Telemed J E Health 2012, 18:32-37.
131. Hadley G.P., Mars M. Postgraduate medical education in paediatric surgery: videoconferencing - a possible solution for Africa?. Pediatr Surg Int 2008, 24:223-226.
132. Hadley G.P., Mars M. E-Education in paediatric surgery: a role for recorded seminars in areas of low bandwidth in sub-Saharan Africa. Pediatr Surg Int 2011, 27:407-410.
133. Ozuah P.O., Reznik M. Medical mission for children: a global telemedicine and teaching network. Telehealth in the developing world 2009, 101-108. Royal Society of Medicine Press Ltd, London. R. Wootton, N.G. Patil, R. Scott, K. Ho (Eds.).
134. Kiviat A.D., Geary M.C., Sunpath H., et al. HIV Online Provider Education (HOPE): the internet as a tool for training in HIV medicine. J Infect Dis 2007, 196:S512-S515.
135. Malami S.A. Use of telemedicine for cytology training in Africa. J Telemed Telecare 2008, 14:105-106.
136. Clevenbergh P., Van der Borght S.F.M., Van Cranenburgh K., et al. Database-supported teleconferencing: an additional clinical mentoring tool to assist a multinational company HIV/AIDS treatment program in Africa. HIV Clin Trials 2006, 7:255-262.
137. The Pan-African eHealth Network Accessed 22 June 2013. http://www.panafricanenetwork.com/Portal/ProjectDetails.jsp?projectidhide=12&projectnamehide=Overview.
138. AMREF Basic and post-basic training Accessed 22 June 2013. http://www.amref.org/what-we-do/capacity-building/basic-and-post--basic-training/.