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Diagnostics
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Point-of-Care Diagnostics (POCD) in Resource-Limited Settings
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Point-of-Care Diagnostics (POCD) in Resource-Limited Settings

A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Point-of-Care Diagnostics and Devices".

Deadline for manuscript submissions: closed (30 November 2023) | Viewed by 6662

Special Issue Editors

Dr. Desmond Kuupiel

E-Mail Website
Guest Editor
Faculty of Health Sciences, Durban University of Technology, Durban 4001, South Africa
Interests: point-of-care testing; critical care nursing; public health; population and reproductive health; general nursing; implementation science
Dr. Paul K. Drain

E-Mail Website
Co-Guest Editor
Departments of Global Health, Medicine (Infectious Diseases), and Epidemiology, University of Washington, 325 Ninth Ave, UW Box 359927, Seattle, WA 98104, USA
Interests: HIV/AIDS; tuberculosis; point-of-care diagnostics; point-of-care testing; implementation science; global health; resource-limited settings
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Point-of-care diagnostics are crucial in healthcare, but proper use and implementation differ between settings. Emerging high-tech solutions are often either unaffordable or unfit for resource-constrained settings. Low-cost, portable, and user-friendly diagnostics are needed that can withstand high heat, humidity, and dust and are not dependent on a constant power supply. In addition, the diseases to be diagnosed can differ substantially from those in high-resource settings. Adapting existing equipment is often unfeasible or unsuccessful. A prerequisite for developing diagnostics suitable for low-resource settings is proper knowledge of the challenges and needs, which is often lacking in the technology industry. This Special Issue on “Point-of-Care Diagnostics (POCD) in Resource-Limited Settings” invites manuscripts on processes for designing and developing, evaluating, and implementing tailormade or adapted diagnostics in these demanding settings.

Dr. Desmond Kuupiel
Dr. Paul K. Drain
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Diagnostics is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Published Papers (6 papers)

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Research

11 pages, 288 KiB  
Article
Comparison of Two Strategies for Hypercholesterolemia Detection through Point-of-Care Testing
by Héctor Eliud Arriaga-Cázares, David Vega-Morales, Carlos Alberto Moreno-Treviño, Juana Lorena Juarez-Juarez, Carlos Azael Pérez-Arizmendi and Alexandro J. Martagón-Rosado
Diagnostics 2024, 14(2), 143; https://doi.org/10.3390/diagnostics14020143 - 08 Jan 2024
Viewed by 669
Abstract
Background: Childhood dyslipidemia is a common condition that can lead to atherosclerotic cardiovascular disease in adulthood. It is usually multifactorial. Screening for cholesterol disorders in children varies based on risk factors, with some guidelines recommending cascade screening for children with a clear family [...] Read more.
Background: Childhood dyslipidemia is a common condition that can lead to atherosclerotic cardiovascular disease in adulthood. It is usually multifactorial. Screening for cholesterol disorders in children varies based on risk factors, with some guidelines recommending cascade screening for children with a clear family history of familial hypercholesterolemia, targeted screening for those with specific risk factors, and universal screening. Point-of-care testing (POCT) cholesterol tests offer potential advantages, including ease of use, portability, increased patient access, low cost, fewer medical or laboratory visits, and instant results. This study aimed to evaluate the effect of POCT cholesterol screening on the diagnosis of hypercholesterolemia in children in a family practice setting. Methods: We used a POCT cholesterol analyzer to perform two different (universal and targeted) screening approaches for dyslipidemia in children. We used the NCEP guidelines for the classification of the results. Results: We screened 183 children, 105 in the universal screening group and 78 in the targeted screening group. Eight patients in the targeted screening group had elevated cholesterol levels (p = 0.02). Conclusions: All participants received instant feedback and recommendations. Using a targeted screening approach, POCT could be a practical and effective tool for identifying at-risk children with hypercholesterolemia. Full article
(This article belongs to the Special Issue Point-of-Care Diagnostics (POCD) in Resource-Limited Settings)
10 pages, 1119 KiB  
Article
Performance Evaluation of Microscanner Plus, an Automated Image-Based Cell Counter, for Counting CD4+ T Lymphocytes in HIV Patients
by Woong Sik Jang, Junmin Lee, Seoyeon Park, Chae Seung Lim and Jeeyong Kim
Diagnostics 2024, 14(1), 73; https://doi.org/10.3390/diagnostics14010073 - 28 Dec 2023
Viewed by 615
Abstract
Counting CD4+ T lymphocytes using flow cytometry is a standard method for monitoring patients with HIV infections. Simpler and cheaper alternatives to flow cytometry are in high demand because getting access to flow cytometers is difficult or impossible in resource-limited settings. We evaluated [...] Read more.
Counting CD4+ T lymphocytes using flow cytometry is a standard method for monitoring patients with HIV infections. Simpler and cheaper alternatives to flow cytometry are in high demand because getting access to flow cytometers is difficult or impossible in resource-limited settings. We evaluated the performance of the Microscanner Plus, a simple and automated image-based cell counter, in determining CD4 counts against a flow cytometer. CD4 count results of the Microscanner Plus and flow cytometer were compared using samples from 47 HIV-infected patients and 87 healthy individuals. All CV% for precision and reproducibility tests were less than 10%. The Microscanner Plus’s lowest detectable CD4 count was determined to be 15.27 cells/µL of whole blood samples. The correlation coefficient (R) between Microscanner Plus and flow cytometry for CD4 counting in 134 clinical samples was very high, at 0.9906 (p < 0.0001). The automated Microscanner Plus showed acceptable analytical performance for counting CD4+ T lymphocytes and may be particularly useful for monitoring HIV patients in resource-limited settings. Full article
(This article belongs to the Special Issue Point-of-Care Diagnostics (POCD) in Resource-Limited Settings)
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13 pages, 2504 KiB  
Article
“It Soothes Your Heart”: A Multimethod Study Exploring Acceptability of Point-of-Care Viral Load Testing among Ugandan Pregnant and Postpartum Women Living with HIV
by Agnes Nakyanzi, Faith Naddunga, Michelle A. Bulterys, Andrew Mujugira, Monique A. Wyatt, Brenda Kamusiime, Alisaati Nalumansi, Vicent Kasiita, Sue Peacock, Connie L. Celum and Norma C. Ware
Diagnostics 2024, 14(1), 72; https://doi.org/10.3390/diagnostics14010072 - 28 Dec 2023
Viewed by 652
Abstract
Background: High adherence to antiretroviral therapy (ART) is critical for achieving viral suppression and preventing onward HIV transmission. ART continuation can be challenging for pregnant women living with HIV (PWLHIV), which has critical implications for risk of vertical HIV transmission. Point-of-care viral load [...] Read more.
Background: High adherence to antiretroviral therapy (ART) is critical for achieving viral suppression and preventing onward HIV transmission. ART continuation can be challenging for pregnant women living with HIV (PWLHIV), which has critical implications for risk of vertical HIV transmission. Point-of-care viral load (POC VL) testing has been associated with improved treatment and retention outcomes. We sought to explore acceptability of POC VL testing among Ugandan PWLHIV during pregnancy and postpartum. Methods: This multimethod analysis drew on quantitative and qualitative data collected between February and December 2021. Quantitatively, we used an intent-to-treat analysis to assess whether randomization to clinic-based POC VL testing during pregnancy and infant testing at delivery was associated with improved viral suppression (≤50 copies/mL) by 3 months postpartum compared to standard-of-care (SOC) VL testing through a central laboratory, adjusting for factorial randomization for the male partner testing strategy. Additionally, a subset of 22 PWLHIV in the POC VL arm participated in in-depth qualitative interviews. We inductively analyzed transcripts to develop categories representing concepts that characterized women’s perceptions of POC VL testing during pregnancy and at delivery and ways that POC VL testing may have impacted their ART adherence and viral suppression. Key themes around women’s perceptions of POC VL testing were then organized into main categories. Results: Overall, 151 PWLHIV were enrolled into the study, 77 (51%) of whom were randomized to receive POC VL testing during pregnancy and at delivery. Women reported in qualitative interviews that POC VL testing had (1) motivated their ART adherence during pregnancy and postpartum and that they felt this testing method had (2) helped them protect their infants from acquiring HIV and (3) improved their emotional wellbeing. Conclusions: POC VL testing was highly acceptable among Ugandan PWLHIV and was viewed as an important tool that women believed improved their ART adherence, gave them information necessary to protect their infants from vertical HIV acquisition, and improved their emotional wellbeing. These findings support the global scale-up of POC VL testing in settings with high HIV burden, especially for PWLHIV who may be at risk of treatment disruptions or loss to follow-up. Full article
(This article belongs to the Special Issue Point-of-Care Diagnostics (POCD) in Resource-Limited Settings)
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13 pages, 858 KiB  
Article
A Scoring Method to Prioritize Fecal Occult Blood Testing as a First Step in Colorectal Cancer Screening in Resource-Limited Settings
by Linda-Nicoleta Bărbulescu, Virginia-Maria Rădulescu, Stelian-Ștefăniță Mogoantă, Lucian-Florentin Bărbulescu, Constantin Kamal, Mirela Radu and Liana Cismaru
Diagnostics 2023, 13(15), 2556; https://doi.org/10.3390/diagnostics13152556 - 01 Aug 2023
Viewed by 834
Abstract
This study aims to develop a scoring method that can be used by primary care physicians from remote areas or resource-limited settings to estimate the need for fecal occult blood testing (FOBT) as a first step in colorectal cancer screening. This method relies [...] Read more.
This study aims to develop a scoring method that can be used by primary care physicians from remote areas or resource-limited settings to estimate the need for fecal occult blood testing (FOBT) as a first step in colorectal cancer screening. This method relies on several modifiable risk factors that can influence a positive FOBT, an indication of the presence of colorectal polyps, or even colorectal cancer. The scoring method considers, besides the age and gender of the patient, the body mass index (BMI), smoking status, and the diagnoses of diabetes mellitus (type 2 diabetes), dyslipidemia, and hypertension. It does not need any paraclinical exams, which is an advantage when access or material resources are limited. The retrospective study was spread over forty-three months, respectively, from October 2019 to April 2023, and included 112 patients. The score that we designed is a numerical value between 0 and 7. The values between 0 and 3 represent a smaller risk of a positive FOBT (9.68%), values 4 and 5 represent a medium risk (14.75%), while values 6 and 7 represent a greater risk (40%). Using this score, a physician can determine if a patient has a greater risk and recommend it to prioritize taking a FOB test. Full article
(This article belongs to the Special Issue Point-of-Care Diagnostics (POCD) in Resource-Limited Settings)
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13 pages, 4250 KiB  
Article
Preparing of Point-of-Care Reagents for Risk Assessment in the Elderly at Home by a Home-Visit Nurse and Verification of Their Analytical Accuracy
by Shoji Takenaka, Hiroshi Moro, Utako Shimizu, Takeshi Koizumi, Kei Nagano, Naoki Edanami, Naoto Ohkura, Hisanori Domon, Yutaka Terao and Yuichiro Noiri
Diagnostics 2023, 13(14), 2407; https://doi.org/10.3390/diagnostics13142407 - 19 Jul 2023
Viewed by 1178
Abstract
With the rising number of older adults residing at home, there is a growing need for risk assessment and patient management in home nursing. This study aims to develop point-of-care test (POCT) reagents that can aid in risk assessment and home care, especially [...] Read more.
With the rising number of older adults residing at home, there is a growing need for risk assessment and patient management in home nursing. This study aims to develop point-of-care test (POCT) reagents that can aid in risk assessment and home care, especially in settings with limited resources. Our focus was on creating a C-reactive protein (CRP) POCT, which can accurately diagnose clinically significant judgment values in home nursing. Additionally, we assessed the utility of the HemoCue WBC DIFF system in providing differential counts of white blood cells (WBC). These performances were compared with a laboratory test using blood samples from patients with pneumonia. The CRP POCT showed a comparable result to that of a laboratory method, with an average kappa index of 0.883. The leukocyte count showed good agreement with the reference method. While the correlation coefficients for both neutrophil and lymphocyte counts were deemed acceptable, it was observed that the measured values tended to be smaller in cases where the cell count was higher. This proportional error indicates a weak correlation with the neutrophil-to-lymphocyte ratio. CRP POCT and WBC counts provided reliable and accurate judgments. These tools may benefit risk management for older adults at home, patients with dementia who cannot communicate, and those living in depopulated areas. Full article
(This article belongs to the Special Issue Point-of-Care Diagnostics (POCD) in Resource-Limited Settings)
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11 pages, 1891 KiB  
Article
Application of Hybridization Chain Reaction/CRISPR-Cas12a for the Detection of SARS-CoV-2 Infection
by Kate Obaayaa Sagoe, Mutinda Cleophas Kyama, Naomi Maina, Moses Kamita, Muturi Njokah, Kelvin Thiong’o, Bernard N. Kanoi, Ernest Apondi Wandera, Davies Ndegwa, Dickson Mwenda Kinyua and Jesse Gitaka
Diagnostics 2023, 13(9), 1644; https://doi.org/10.3390/diagnostics13091644 - 07 May 2023
Cited by 1 | Viewed by 2160
Abstract
Globally, the emergence of the coronavirus disease (COVID-19) has had a significant impact on life. The need for ongoing SARS-CoV-2 screening employing inexpensive and quick diagnostic approaches is undeniable, given the ongoing pandemic and variations in vaccine administration in resource-constrained regions. This study [...] Read more.
Globally, the emergence of the coronavirus disease (COVID-19) has had a significant impact on life. The need for ongoing SARS-CoV-2 screening employing inexpensive and quick diagnostic approaches is undeniable, given the ongoing pandemic and variations in vaccine administration in resource-constrained regions. This study presents results as proof of concept to use hybridization chain reaction (HCR) and clustered regularly interspaced short palindromic repeats (CRISPR)/Cas12a complex for detecting SARS-CoV-2. HCR hairpin probes were designed using the NUPACK web-based program and further used to amplify the SARS-CoV-2 N gene in archived nasopharyngeal samples. The results were visualized using agarose gels and CRISPR Cas12a-based lateral flow strips. The assay was evaluated using the gold standard, real-time polymerase chain reaction (RT-PCR), as recommended by the World Health Organization (WHO). The results show the comparative efficiency of HCR to RT-PCR. This study shows that HCR and CRISPR are viable alternatives for diagnosing SARS-CoV-2 in samples. Full article
(This article belongs to the Special Issue Point-of-Care Diagnostics (POCD) in Resource-Limited Settings)
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