Using electronic readers to monitor progress toward elimination of mother‐to‐child transmission of HIV and syphilis: An opinion piece

Abstract

a b s t r a c t a r t i c l e i n f oKeywords: Connectivity Dual elimination of HIV and syphilis Electronic readers Surveillance Electronic readers and smartphones have the potential to standardize the interpretation of rapid diagnostic tests (RDTs) and provide timely surveillance program data. RDTs are widely used for HIV and are being increasingly used for syphilis screening in pregnant women. Following the WHO initiative for the validation of elimination of mother-to-child transmission of HIV and syphilis, there is a need for more extensive testing and data monitoring. However, access to timely and accurate data can be challenging once testing is decentralized as data quality at remote sites is often difficult to verify. Electronic RDT readers can help to ensure quality and allow automated data transmission, creating an opportunity for real-time surveillance to inform control strategies and assess intervention impact. Furthermore, by linking the data to existing supply chain management software, stockouts can be minimized. The present opinion piece looks at the opportunities and challenges of using these tools within national elimination programs.

Advancing prevention of sexually transmitted infections through point-of-care testing: target product profiles and landscape analysis

“…This recommendation is based on the currently available diagnostic technology, which is primarily lateral flow chromatography, as well as clinical practice with regard to syphilis case management and screening programmes, including in rural and remote areas with limited or no access to laboratory-based diagnostics. It was also agreed by the IEG that the POC diagnostic platform should have connectivity capability as a minimal TPP characteristic in order to support surveillance and monitoring activities within the syphilis control programmes 8. The IEG has also recommended the minimal acceptable target price per test as <US$3 (excluding the cost of a device or reader) and <US$1.5 as the optimal target price per test.…”

Syphilis

“…However, the quality of testing must be assured given these tests are conducted outside the laboratory. Strategies to ensure reliability of POC tests include use of electronic readers 227 and microfluidic assays powered by smart phones 228 for real-time monitoring of progress 229 , and routine provision of proficiency testing panels 121,122 . For example, one study in the Amazon region of Brazil showed that proficiency panels consisting of dried serum tubes that were assessed by each healthcare worked could be used to monitor the performance of healthcare workers in remote settings 123 .…”

REASSURED diagnostics to inform disease control strategies, strengthen health systems and improve patient outcomes

“…Use of a smart phone to power NATs is in development and will play an important role in future POC applications 60,61 . In particular, there has been considerable interest shown in utilizing mobile phones as readers and connectivity for RDTs using RFID (radio frequency identification) to prevent errors in subjective interpretation and transcription [62][63][64][65] . While phone-based diagnostics are attractive as an option, regulatory approval and rapid updates of phone software that can affect test performance are important challenges.…”