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Report addresses challenges in implementing new diagnostic testswhere they are needed most by airbru airbru





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Report addresses challenges in implementing new diagnostic testswhere they are needed most by
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Report addresses challenges in implementing new diagnostic testswhere they are needed most


 
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Easy-to-use, inexpensive tests to diagnose infectious diseases areurgently needed in resource-limited countries. A new report basedon an American Academy of Microbiology colloquium, "Bringing theLab to the Patient: Developing Point-of-Care Diagnostics forResource Limited Settings," describes the challenges inherent inbringing new medical devices and technologies to the areas of theworld where they are needed most. Point-of-care diagnostics (POCTs)bypass the need for sophisticated laboratory systems by leveragingnew technologies to diagnose infectious diseases and other healthconcerns at the bedside, or "point-of-care". Diagnostics accountfor 2% of the cost of health care, yet can affect 60-70% oftreatment decisions. In resource limited areas where advancedlaboratory services are not available, access to POCTs may be thedifference between making a treatment decision that is informed byan accurate diagnosis versus one that is ineffective or evenharmful.

Despite the urgent need for POCTs, deploying them in resourcelimited settings can be fraught with difficulty. "POCTs aredeveloped by researchers and engineers and implemented by aseparate group of public health professionals at a local level.There are so many variables that can make or break theeffectiveness of any test, and so often the scientists andengineers developing the test are not aware of them." said KeithKlugman, who chaired the colloquium. "POCTs that perform well intesting may not function 'on the ground' in resource limited areas,where there may not be running water, electricity, or trainedpersonnel to administer the test." Recognizing the need to connect the scientists and engineersdeveloping the POCTs with the health care workers implementingthem, the American Academy of Microbiology convened a colloquium inSeptember of 2011 to discuss how to develop POCTs that can beeffectively integrated into resource limited settings. Theparticipants discussed which tests were needed most urgently,features that should be incorporated in the design of the test tomake it more effective in the field, and how collaborations betweencommunities could foster an environment of success for new POCTs. The resulting report makes recommendations in several areas.

Itdetails a list of POCTs that would make the biggest impact, forexample, tests to detect drug resistance, or effectively monitorviral load in HIV patients. The report describes qualities needed in tests to beeffective in resource limited settings such as minimal powerrequirements, simple interfaces, and integrated instructions on useand quality control protocols. Finally, it recommends changes inhow POCTs are regulated, approved, and brought to market to helpfoster a more conducive environment for POCT development. "POCTs can fundamentally change the quality of health care receivedin resource limited settings, but only if scientists, engineers,and health care professionals work together to develop simple,effective POCTs.", said Jeanne Jordan of George WashingtonUniversity, one of the colloquium participants. "Bringing the Labto the Patient: Developing Point-of Care Diagnostics for ResourceLimited Settings" is a step forward in forming productivecollaborations between these groups to bring POCTs to the peoplethat need them the most.

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