Medical & Bio TechnologyMondialab Pro POCT Kit

Infectious diseases continue to cause huge amoutn of death and disability in developing countries. Increasing access to appropriate treatment and screening for infectious diseases could have a major impact on relieving the burden of such diseases. Some common infections can be managed syndromically without the need for diagnostic tests, but this is not appropriate for many infectious diseases, in which a positive diagnostic test is needed before a treatment can be delivered. Since many people in developing countries do not have access to laboratory services, diagnosis depends on the availability of point of care tests (POCT). Historically there has been little investment in POCT for diseases that are common in developing countries, but that is now changing. Lack of regulation of diagnostic tests in many countries has resulted in the widespread use of sub-standard POCT, especially for malaria, making it difficult for manufacturers of reliable POCT to compete. However, in recent years increased investment, technological advances, and greater awareness about the importance of reliable diagnostic tests has resulted in rapid progress. Rapid, reliable and affordable POCT, requiring no equipment and minimal training, are now available for HIV infection, syphilis and malaria, but POCT for other infections are urgently required. Many countries do not have established criteria for licensing and introducing new diagnostic tests, and many clinicians in developing countries have become disenchanted with diagnostic tests and prefer to rely on clinical judgment. Continuing advocacy and training in the field of POCT are needed, and systems for quality control of POCT need to be developed if they are to achieve their maximum potential.

Infectious diseases continue to be a cause of millions of deaths every year, the great majority of them in developing countries, and a huge burden of disability. Because many of the deaths caused by infection are in young children, the burden of disease attributable to infectious diseases, in terms of healthy life years lost, is high. Strategies for reducing the burden of disease caused by infectious diseases include: vaccination programmes, which are now being expanded to cover Streptocccus pneumoniae and Haemophilus influenzae type b infections, in addition to the traditional vaccine-preventable childhood diseases; health education, to promote breastfeeding, hand-washing, and safe sex; the use of insecticide-impregnated bed-nets in malaria-endemic communities; improved provision of clean water and sanitation; and mass drug administration for certain neglected tropical diseases. However, appropriate clinical management of sick patients presenting to health facilities continues to be of paramount importance, and represents a tremendous challenge in global health.

Most patients in developing countries are treated at health facilities that do not have access to lab tests. Patients in rural areas may have to walk for hours to reach a clinic where laboratory services are available. If they are asked to come back for their results the following day or week, many will fail to do so. The 2004 World Development Report cites lack of accessibility as one of the major reasons why health services fail.

In many cases, patients can be effectively treated by following WHO guidelines for syndromic management. For example, children with fever, cough and rapid breathing are treated for bacterial pneumonia according to guidelines for the Integrated Management of Childhood Illness (IMCI), using an antibiotic that covers the common causes; and patients presenting with symptoms of sexually transmitted infection (STI), such as urethral discharge or genital ulcer, are treated for the common causes of those syndromes. Syndromic management can be highly effective, but inevitably results in overtreatment, resulting in wasted resources and, potentially, increased antimicrobial resistance. In other cases, e.g. where asymptomatic infection is common, clinical features are nonspecific, or treatment is potentially toxic and/or difficult to administer, diagnostic tests are needed. Ideally, the diagnosis should be made at the point of care, so that treatment can be started without delay, and should not depend on the availability of a lab or of highly trained staff. The article below focuses on POCT for infectious diseases that could be used to improve clinical management in resource limited settings.

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ScienceDirect, December 2014