End-user perspectives on design and implementation of a novel SkinScan3D (SS3D) device for monitoring Kaposi Sarcoma in East Africa: a qualitative study

Imagine you are a detective trying to solve a mystery, but instead of looking for fingerprints, you are looking for changes in a person's skin. In the world of medicine, there is a condition called Kaposi Sarcoma (KS), which causes purple or red spots to appear on the skin. It is a common and serious problem in parts of Africa, often linked to a virus that weakens the body's defenses. To know if the medicine is working, doctors have to check these spots regularly. For a long time, the only way to do this was to use a ruler and a human eye. But humans make mistakes; one doctor might measure a spot slightly differently than another, and it's hard to remember exactly how big a spot was last month. This is like trying to guess the size of a cloud by looking at it, rather than measuring it with a ruler.

Now, imagine a new tool that acts like a high-tech camera. It doesn't just take a picture; it builds a 3D model of the skin spot, measuring its length, width, and height with the help of a smart computer (artificial intelligence). This tool is called the SkinScan3D (SS3D). It promises to be a super-accurate ruler that never gets tired and never argues with another doctor about the numbers. But before this cool gadget can be used in real hospitals, the people who will actually use it—the doctors, the patients, and the community members—need to give it a test drive. They need to say, "Does this feel right? Is it safe? Will we actually use it?" This is the story of how a team of researchers asked those questions in Kenya and Uganda to make sure the new tool fits perfectly into the real world.

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The Big Test Drive: Getting the Green Light for a Skin Scanner

So, what did the researchers actually do? They didn't just build the machine and hope for the best. Instead, they invited a group of people—doctors, nurses, patients with KS, and community leaders—to a special meeting. They showed them a video of the SkinScan3D in action and let them hold the actual prototype, which looks a bit like a futuristic scanner with a cup-shaped tip. The goal was simple: get their honest opinions before the machine went into a big clinical trial.

The researchers talked to 83 people in total across Kenya and Uganda. They held six group discussions and 28 one-on-one interviews. The people they talked to were a mix of ages and backgrounds, ensuring they got a wide range of voices. After everyone got to play with the device, the researchers listened closely to what they said, looking for patterns in their thoughts.

The Good News: Everyone Was Excited (Mostly)

The big takeaway from this study is that the people were generally very happy with the idea of the SkinScan3D. When they held the device, they thought it was easy to learn. One doctor compared the touchscreen to a smartphone, saying that even people who aren't tech-savvy could figure it out quickly.

The most exciting part for the patients was the idea of "objectivity." Right now, if a doctor measures a spot with a ruler, it's just a guess based on their eyes. With the SS3D, the computer gives a precise number. Patients told the researchers that knowing the exact size of their spot would make them feel less anxious. It's like having a scoreboard that clearly shows if your team is winning or losing, rather than just guessing. Doctors agreed, noting that this would help them decide faster if the medicine was working or if they needed to change the plan.

The "But..." List: Things That Need Fixing

However, just because people liked the idea didn't mean they thought the current version was perfect. The researchers found several specific things that needed to be tweaked before the machine could be used in a busy hospital.

1. The "Germ" Worry
One of the biggest concerns was about cleanliness. The device has a little cup that touches the patient's skin. Doctors asked, "How do you clean this between patients?" If the cup isn't cleaned perfectly, it could spread germs. The researchers noted that the current design didn't have a clear plan for this. The solution? The users suggested using disposable cups (like a new one for every person) or a way to easily wipe the cup down without leaving germs behind.

2. The "Wait Time" Problem
The machine takes a little while to turn on, or "boot up." In a busy clinic where patients are waiting in line, a slow start feels like a waste of time. One doctor said, "At times they look at it as if you are wasting their time. The machine takes time to boot. He would rather use a ruler." The team needs to make the machine start up faster so it doesn't slow down the clinic.

3. The "What Does It Do?" Confusion
Here is a funny but important mix-up: Many people thought the machine was a cure for the disease, not just a tool to measure it. They thought the scanner itself would heal the skin! The researchers realized they need to teach patients better. They need to explain clearly: "This machine is a ruler, not a medicine."

4. Power and Theft
The machine runs on a battery, which is great because it works even when the electricity goes out (which happens often in some areas). But because it is small and portable, people worried it might get stolen. They also suggested adding solar power so it could charge up using the sun in remote villages.

5. Privacy and Security
Since the machine takes high-quality pictures of patients, people were worried about who could see them. They suggested adding password protection, so only the right doctors could log in and see the images.

The Final Verdict: A Work in Progress

The study didn't prove that the SkinScan3D is the perfect solution yet. Instead, it suggested that the device has huge potential but needs some "tuning." The researchers concluded that if they fix the issues with cleaning, speed, and education, the device could become a standard tool in hospitals.

The team came up with a list of specific changes to make the next version better:

• Hardware: Make the probe wireless (no messy cables), use disposable cups, and add solar charging.
• Software: Add password protection, make the screen bigger for clearer pictures, and create a feature that automatically compares today's picture with last month's to show the change.
• Training: Teach all the different types of staff (doctors, nurses, and technicians) how to use it so the machine doesn't stop working if one person is away.

In short, the people in Kenya and Uganda gave the SkinScan3D a thumbs-up for its potential, but they also gave it a list of homework assignments. The researchers are now taking these notes to the engineers to build a better, safer, and faster version before they start the big clinical trial. It's a great example of how listening to the people who will actually use a new invention is the key to making it work in the real world.