African Journals OnLine  
South African Family Practice

Volume 25 Number 6, 2002 
Abstracts

Teledermatology in a Rural Family Practice

BACKGROUND: Telemedicine can provide specialist services at a distance to rural areas where access to such services is limited, especially in developing countries. The objectives of this study are to describe and evaluate a teledermatology service in a rural family practice.

METHODS: Internet-based store-and-forward technology was used. Patients were selected who needed a specialist dermatologist's opinion for diagnosis and management. Pictures of skin conditions were taken with a digital camera and forwarded, together with clinical data, via electronic mail (e-mail) to specialist dermatologists at either of three distant academic centres. Digital pictures of skin biopsies were also forwarded from the regional pathology laboratory. Results were received via e-mail.

RESULTS: Over a twenty-one month period, fifty-two patients had teledermatology consultations. Picture quality was adequate for evaluation in all cases. The family practitioner's provisional diagnosis, compared to the teledermatologists, was correct in 28 (57%) of 49 cases where a definite diagnosis was made. Six patients needed referral to a dermatology clinic. The most common diagnoses (number) were tinea (8), acquired immune-deficiency syndrome associated papulopruritic eruption (3), photosensitive dermatitis (3) scleroderma or morphea (3), ptyriasis rosea (2), psoriasis (2) and systemic lupus erythematosis (2).

CONCLUSION: Most patients with dermatology problems in rural family practice can be managed by means of store-and-forward teledermatology.

Injections and Patient Satisfaction in Zulu-Speaking Patients

Background: There is a belief that Zulu patients who do not receive an injection, as part of the consultation in family practice, will be less satisfied with the consultation than those patients who receive an injection.

Methods: A cross-sectional study of adult Zulu patients attending a family practice in northern KwaZulu/Natal in which a questionnaire was given to those patients receiving injections and those who did not, in order to assess satisfaction with the consultation.

Results: One hundred and eighty Zulu patients receiving injections were compared to 132 Zulu patients who did not receive injections. Those who had not received an injection were more satisfied with their consultation, compared to the group who did receive an injection. This result held after testing for confounding variables.

Conclusions: Adult Zulu patients, especially those who are younger and of higher educational achievement, need not be offered a therapeutic injection in order to obtain patient satisfaction.