Bouaké (Ivory Coast) (AFP)

"A phew of relief!" for patients with heart disease in Côte d'Ivoire: the development of telemedicine, which makes it possible to remotely diagnose and prescribe treatments, changes the situation by simplifying the management of patients.

"Between transport, food and accommodation", which is added to the cost of the consultation (3 to 5,000 CFA francs, or 4.50 to 7.50 euros), come regularly to the hospital to have his 19-year-old cardiac son is paying high fees for Catherine Coulibaly, while the family has only modest incomes.

The lives of several thousand patients like the Coulibaly family have changed with the setting up of a pioneering telemedicine service at the University Hospital Center of Bouaké, spreading to all of northern Côte d'Ivoire.

Telemedicine, "it is a sigh of relief for the population of Bouaké, Boundiali, Korhogo, everyone," says Auguste Dosso, president of the association "P'tit coeur", which helps the families of little heart.

At the origin of the project, Dr. Florent Diby, cardiologist at the University Hospital of Bouaké, created an NGO, "Wake Up Africa", to promote in his country the technology of telemedicine, already widely used in the world but very little in West Africa.

Improving cardiac care has indeed become a public health issue in this region.

- Explosion of cardiovascular diseases -

"In our daily practice there is an emergence of cardiovascular disease, which is thought to be due to changes in lifestyle: urbanization makes the population more sedentary, the rise in tobacco consumption, changes in the diet, stress ... There is an explosion of diseases like hypertension or diabetes, "formerly diseases of rich countries, says Dr. Diby.

"A quarter of the Ivorian population is now affected by hypertension, against only 13% in the 1980s," he says. That is a rate comparable to France. But only less than half of the Ivorian patients are treated for lack of sufficient care infrastructure.

"90% of myocardial infarction can be diagnosed by telemedicine, and for us cardiologists it's a revolutionary technology," says Dr. Diby.

Well-equipped cardiology units are rare in Ivory Coast (Abidjan, Yamoussoukro and Bouaké), hence the idea of ​​focusing on distance medicine.

In practice, neither the doctor nor the patient moves more. The cardiac patient conducts an examination, such as an electrocardiogram, with the help of a technician in a local health center, connected by computer to the cardiology department of the University Hospital of Bouaké. The CHU cardiologist can see the results in real time, interpret them, provide a diagnosis and prescribe treatment.

Launched five years ago, the project led by Wake Up Africa has already linked ten health centers. It is now entering a new phase, with the goal of linking a pool of seven cardiologists from Bouaké to 20 health centers and thus covering a large part of northern and western Côte d'Ivoire.

- 'A strategic project' -

The cardiology department of the Bouaké University Hospital last year treated 4,800 patients on its premises, thanks to the telemedicine network. With the extension of the network, it is 14,000 more patients per year that can be supported, says Dr. Diby.

"Telemedicine can solve the problem of medical deserts and lack of medical expertise" in the country. It therefore offers "better access to care for patients", especially for families who have to incur significant costs to come to the hospital, says Dr. Diby.

Some 45% of the Ivorian population lives below the poverty line, according to the World Bank's latest estimate, in 2017. And the minimum monthly wage - not always respected - is only 60,000 FCFA (90 euros), in this country where there is no public health insurance.

Expertise France, the French agency for international technical cooperation, subsidizes the extension of the telecardiology network to the tune of 185,000 euros to pay for the necessary computer equipment (computers, tablets, artificial intelligence software, internet connection).

"This is a strategic project in this region, telemedicine is a solution for the future," said the Ambassador of France in Côte d'Ivoire Gilles Huberson.

At the CHU Bouaké, the cardiology department, which has become too small, will develop thanks to the creation of a 12,000 m2 cardiac institute, which should open its doors within two to three years.

Dr. Diby now advocates an extension of telemedicine to other medical specialties: neurology, ENT, nephrology, psychiatry ... not only in Côte d'Ivoire but throughout West Africa.

© 2019 AFP