Point of Care Diagnostics in Resource-Limited Settings: A Review of the Present and Future of PoC in Its Most Needed Environment

Abstract

Point of care (PoC) diagnostics are at the focus of government initiatives, NGOs and fundamental research alike. In high-income countries, the hope is to streamline the diagnostic procedure, minimize costs and make healthcare processes more efficient and faster, which, in some cases, can be more a matter of convenience than necessity. However, in resource-limited settings such as low-income countries, PoC-diagnostics might be the only viable route, when the next laboratory is hours away. Therefore, it is especially important to focus research into novel diagnostics for these countries in order to alleviate suffering due to infectious disease. In this review, the current research describing the use of PoC diagnostics in resource-limited settings and the potential bottlenecks along the value chain that prevent their widespread application is summarized. To this end, we will look at literature that investigates different parts of the value chain, such as fundamental research and market economics, as well as actual use at healthcare providers. We aim to create an integrated picture of potential PoC barriers, from the first start of research at universities to patient treatment in the field. Results from the literature will be discussed with the aim to bring all important steps and aspects together in order to illustrate how effectively PoC is being used in low-income countries. In addition, we discuss what is needed to improve the situation further, in order to use this technology to its fullest advantage and avoid “leaks in the pipeline”, when a promising device fails to take the next step of the valorization pathway and is abandoned.

Critical Factors and Economic Methods for Regulatory Impact Assessment in the Medical Device Industry

“… The authors consider cost-effectiveness analysis and costs-saving . Spending, costs, and savings 3 Heidt et al 26 II The article summarises current research describing the use of point-of-care diagnostics in resource-limited settings and potential bottlenecks along the value chain that prevent their widespread application. The authors consider cost-effectiveness analysis .…”

Topographical Vacuum Sealing of 3D-Printed Multiplanar Microfluidic Structures

“…The complete process can be performed without a cleanroom and with minimal training, as an entry-level vacuum former works with only a lever that moves the heated thermoplastic over the substrate and two buttons to turn the heating and vacuum on and off; the vacuum automatically carries out all the alignment of the thermoplastic. The use of an low-cost vacuum former, of course, has downsides due to its fixed heating and vacuum settings and fewer control points compared to more complex machines, like the ones made for microthermoforming [32]; however, the device makes up for it with its lower complexity, ease of use, availability and affordability, which might be especially beneficial for applications in low-income countries, where missing infrastructure can be a large bottleneck to research and the deployment of microfluidic devices, e.g., in point-of-care diagnostics [33]. To add to this, highly expensive devices might simply not be necessary in the first place, given that the aim of the method is to seal the microchannels with a relatively thick layer of thermoplastic.…”

A Strategy to Detect Emerging Non-Delta SARS-CoV-2 Variants with a Monoclonal Antibody Specific for the N501 Spike Residue

“…Immunoassays that detect viral antigens, e.g., antigen-detection rapid diagnostic tests (Ag-RDTs), are technologically well suited to POC testing, as many can be read visually [23]. They can also be used for testing at home [24] and may be ideal in low-resource settings [25]. Ag-RDTs are typically lateral flow assays (LFAs) that can be read within 15 min.…”