overcoming geography with technology: medical drones project

Conditions: Sexually Transmitted Infections (Not HIV or Hepatitis); HIV Infections; COVID-19

Summary: in this study, the investigators shall evaluate the use unmanned air vehicles (medical drones) to deliver art to adult patients eligible/enrolled in community dsd models in bufumira islands, kalangala district. the geography of the islands is ideal for this project because of the flat landscape and water coverage. the investigators hypothesize that the use of drones would be acceptable to patients and stakeholders, reduce facility drug stock outs, increase retention in care by 10% in intervention (at 12 months) compared to the control health centres and be cost neutral (to the patients and health sector perspectives). the investigators will also undertake evaluation of an efficient sample delivery system using medical drones especially for expansive rural areas like moyo and adjumani.

stage one will be a cross-sectional observational study with baseline data collection on art accessibility, adherence, challenges as well as perceptions and attitudes towards possible medical drones. stage two will be a non-randomized observational pilot of medical drones at 3 landing sites in kalangala district, comparing to 3 landing sites without drones, and at five health facilities in moyo and adjumani districts. the investigators shall use qualitative and quantitative methods and a process evaluation to assess the feasibility of using drones for art delivery and determine the impact on patient outcomes. the covid pandemic has taken hold in uganda since this protocol was first approved in june 2020, and having received approval from the ministry of health, the investigators will extend this pilot to moyo and adjumani districts. the investigators shall use qualitative and quantitative methods and a process evaluation to assess the feasibility of using drones for covid sample delivery and determine the impact on result turnaround times. stage two includes a sub-study on validity and quality of transport of biological samples including hiv, sti, tb and covid diagnostic and monitoring samples.

Eligibility criteria:
inclusion criteria: * adult (\>18 years) or emancipated minor (15-17 years) who is hiv-infected and receiving antiretroviral therapy in bufumira sub-county or non plhiv adult who has attended a government health facility in bufumira sub-county * resident in kalangala district for at least the preceding 12 months with an intent to stay for a minimum next 12 months (resident is defined as those who spend more than 9 out of 12 months per year in kalangala district, even if they move within the district) * evidence of a personally signed and dated informed consent document indicating that the subject (or a legal representative) has been informed of all pertinent aspects of the study. * willingness to comply with survey procedures exclusion criteria: * patients with mental illness or any other medical condition that compromises decision making process. * any other clinical condition that, in the opinion of the site investigator, would make the participant unsuitable for the study or unable to comply with joining a dsd group.

Keywords: sample transport anti-retroviral therapy supply chain unmanned ariel vehicles