Strategies for overcoming challenges for decentralised diagnostics in resource-limited and catastrophe settings

Abstract

Globally, both communicable and non-communicable diseases pose a serious threat to populations in developed as well as developing countries. Access to reliable diagnostic testing along with qualified health practitioners is severely limited in low resource and very remote areas and following natural catastrophes. Areas covered: This paper provides an overview of the challenges involved and suggests strategies to address them. The emergence of more robust, user-friendly, cost-effective and 'sample-to-result' point-of-care (POC) tools, along with the proliferation of mobile technologies, may provide a practical approach in addressing some of the challenges. Expert commentary: The successful implementation of POC testing requires the availability of versatile diagnostic technologies, improved platforms and back-up infrastructure, successful leveraging of human resources through training and, finally, engagement/coordination of associated stakeholders, including public health agencies, diagnostics companies, healthcare practitioners and local rural authorities.

Toward Improving Accessibility of Point-of-Care Diagnostic Services for Maternal and Child Health in Low- and Middle-Income Countries

“…Availability of adequately trained human resources is further required for successful POC diagnostic services. 97,130 Because physicians and nurses in many LMICs are not traditionally trained to perform tasks meant for laboratory staff, it is important to train a new cadre of nonlaboratory health professionals so that they possess the skills and use them to carry out POCT especially at lower levels of health care. 101 Competent health professionals may improve access to health care including POCT services in LMICs.…”

On-Chip Electrochemical Detection of Cholera Using a Polypyrrole-Functionalized Dendritic Gold Sensor

“…Foremost, the optical ELISA, while sensitive and specific, lacks portability, requiring laboratory infrastructure and trained personnel. Given the often reduced access to healthcare facilities in resource-limited regions, the use of conventional optical ELISA is not suitable for deployment in such resource-limited communities . By contrast, the small size and electrical readout of the dendritic sensor represents an important step toward portability and user-friendliness.…”

Improving the Accessibility and Efficiency of Point-of-Care Diagnostics Services in Low- and Middle-Income Countries: Lean and Agile Supply Chain Management

“…This review demonstrates the impacts of POC testing services such as enabling rapid diagnosis and informing prompt clinical decisions [ 4 , 6 , 11 , 12 , 14 , 16 , 17 , 20 , 21 , 25 , 26 , 27 , 77 , 78 , 79 ]. It also reveals that successful implementation of POC diagnostics services requires appropriate healthcare infrastructure, efficient supply chain management, quality systems management, enabling a policy framework and as well as geographical consideration during implementation [ 38 , 40 , 56 , 64 ]. Despite the significant impact and increase in development of POC diagnostics in recent times [ 4 , 6 ], the literature demonstrates that access to POC testing remains a challenge requiring urgent attention.…”

“…Successful implementation of POC testing further requires the availability of adaptable diagnostic technologies, improved platforms and back-up infrastructure, trained human resource and key stakeholders engagement, including public health representatives, developers, suppliers, healthcare professionals, local health authorities, and the community [ 56 , 64 ]. Competent healthcare workers are essential for the delivery of health interventions including POC testing services [ 31 , 56 , 65 ].…”