Point-of-care diagnostics to improve maternal and neonatal health in low-resource settings

Majors, Catherine E.; Smith, Chelsey; Natoli, Mary E.; Kundrod, Kathryn; Richards‐Kortum, Rebecca

doi:10.1039/c7lc00374a

Cited by 42 publications

(31 citation statements)

References 313 publications

(384 reference statements)

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“…Diagnostics are an essential component to advance universal health coverage, address health emergencies, and promote healthier populations [1]. However, several primary healthcare (PHC) facilities lack sophisticated laboratory infrastructure and do not have the resources to transport clinical specimens to central laboratories, where available, and point-of-care (POC) diagnostics can provide a solution to this challenge [2–4]. The World Health Organization (WHO) has pre-qualified some POC diagnostic technologies for use in resource-limited settings to facilitate POC testing, disease management and prevention [1].…”

Section: Introductionmentioning

confidence: 99%

Poor supply chain management and stock-outs of point-of-care diagnostic tests in Upper East Region’s primary healthcare clinics, Ghana

et al. 2019

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Introduction Several supply chain components are important to sustain point-of-care (POC) testing services in rural settings. To evaluate the availability of POC diagnostic tests in rural Ghana’s primary healthcare (PHC) clinics, we conducted an audit of the supply chain management for POC diagnostic services in rural Upper East Region’s (UER) PHC clinics, Ghana to determine the reasons/causes of POC tests deficiencies. Material and methods We conducted a review of accessible POC diagnostics in 100 PHC clinics in UER, Ghana from February to March 2018. We used a monitoring audit tool adopted from the World Health Organization and Management Science for Health guidelines for supply chain management of diagnostics for compliance. We determined a clinic’s compliance with the stipulated guidelines, and a composite compliant score was defined as a percentage rating of 90 to 100%. We used univariate logistic regression analysis in Stata 14 to determine the level of association between supply chain management and the audit variables. Results Overall, the composite compliant score of supply chain management for existing POC tests was at 81% (95%CI: 79%–82%). The mean compliance with distribution guidelines was at 93.8% (95%CI: 91.9%–95.6%) the highest score, whilst inventory management scored the lowest, at 53.5% (95%CI: 49.5%–57.5%) compliance. Of the 13 districts in the region, the results showed complete stock-out of blood glucose test in all selected PHC clinics in seven (53.8%) districts, haemoglobin and hepatitis B virus test in three (23.1%), and urine protein test in two (15.4%) districts. Based on our univariate logistics regression models, stock-out of tests at the Regional Medical and District Health Directorates stores in the region, high clinic attendance, lack of documentation of expiry date/expired tests, poor documentation of inventory level, poor monitoring of monthly consumption level, and failure to document unexplained losses of the various POC tests were significant predictors of complete test stock-out in most of the clinics in the Upper East Region. Discussion There is poor supply chain management of POC diagnostic tests in UER’s PHC clinics. Improvement in inventory management and human resource capacity for POC testing is critical to ensure accessibility and sustainability of POC diagnostic services in resource-limited settings PHC clinics.

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Section: Introductionmentioning

confidence: 99%

Poor supply chain management and stock-outs of point-of-care diagnostic tests in Upper East Region’s primary healthcare clinics, Ghana

et al. 2019

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“…The proposed scoping review will aim to map evidence on free maternal healthcare financing and quality of care in SSA. Improving the quality of care during pregnancy has many benefits such as improved utilisation of antenatal services [23, 24], early detection of infection and prompt linkage to care [25], and reduction of maternal morbidities and mortalities [7], among others. It is anticipated that the results of the proposed study will inform future research and reveal evidence-based information to address the potential quality of care issues that may arise because of free maternal healthcare policy implementation in some SSA countries.…”

Section: Discussionmentioning

confidence: 99%

Mapping evidence of free maternal healthcare financing and quality of care in sub-Saharan Africa: a systematic scoping review protocol

Ansu-Mensah

Mohammed

Udoh

et al. 2019

Health Res Policy Sys

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BackgroundIdentifying and addressing research gaps on the implementation of free maternal healthcare financing policies and the quality of service delivery in sub-Saharan Africa (SSA) is essential in ensuring continuous patronage of the services by clients and sustainability of the policies to meet the intended goals. The proposed scoping review is aimed at mapping evidence on free maternal healthcare financing and quality of care in SSA.MethodsArksey and O’Malley’s framework, Levac and colleagues’ recommendations, and the Joanna Briggs Institute guidelines will be used to guide the proposed study. A complete keyword search for relevant studies presenting evidence on free maternal healthcare financing and perceived quality of care among women in SSA will be performed in EBSCOhost, PubMed, Web of Science, Google Scholar and SCOPUS. Relevant grey literature from university repositories and international organisations such as WHO and government websites, and the reference lists of included studies will be additionally searched. The Preferred Reporting Items for Systematic Reviews and Meta-analysis: Extension for Scoping Review (PRISMA-ScR) will be used to present the results of the proposed scoping review. NVivo version 11 software package will be employed to extract the relevant outcomes from the included studies using content thematic analysis. Quality appraisal of the included studies for this proposed study will be performed utilising the latest mixed methods appraisal tool.DiscussionIt is anticipated that the results of the proposed study will inform future research and reveal evidence-based information to address potential quality of care issues that may arise because of free maternal healthcare policy implementation in some SSA countries. The proposed study will also be useful to other SSA countries planning to implement free maternal health policy, as they will be able to draw useful lessons to guide them through the process.

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“…Consequently, there has been growing recognition of the importance of point-of-care tests (POCTs) for detecting the most critical neonatal illnesses to reduce the mortality rate in newborns. When coupled with effective treatment strategies, low-cost POC diagnostics that can be administered in low-resource settings have the potential to reduce neonatal mortality 5 . However, to date, robust, affordable and technically simple methods to measure critical neonatal illness remain unavailable.…”

Section: Introductionmentioning

confidence: 99%

A rapid smartphone-based lactate dehydrogenase test for neonatal diagnostics at the point of care

Halvorsen

Olson

Araújo³

et al. 2019

Sci Rep

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There is a growing recognition of the importance of point-of-care tests (POCTs) for detecting critical neonatal illnesses to reduce the mortality rate in newborns, especially in low-income countries, which account for 98 percent of reported neonatal deaths. Lactate dehydrogenase (LDH) is a marker of cellular damage as a result of hypoxia-ischemia in affected organs. Here, we describe and test a POC LDH test direct from whole blood to provide early indication of serious illness in the neonate. The sample-in-result-out POC platform is specifically designed to meet the needs at resource-limited settings. Plasma is separated from whole blood on filter paper with dried-down reagents for colorimetric reaction, combined with software for analysis using a smartphone. The method was clinically tested in newborns in two different settings. In a clinical cohort of newborns of Stockholm (n = 62) and Hanoi (n = 26), the value of R using Pearson’s correlation test was 0.91 (p < 0.01) and the R 2 = 0.83 between the two methods. The mean LDH (±SD) for the reference method vs. the POC-LDH was 551 (±280) U/L and 552 (±249) U/L respectively, indicating the clinical value of LDH values measured in minutes with the POC was comparable with standardized laboratory analyses.

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Point-of-care diagnostics to improve maternal and neonatal health in low-resource settings

Cited by 42 publications

References 313 publications

Poor supply chain management and stock-outs of point-of-care diagnostic tests in Upper East Region’s primary healthcare clinics, Ghana

Poor supply chain management and stock-outs of point-of-care diagnostic tests in Upper East Region’s primary healthcare clinics, Ghana

Mapping evidence of free maternal healthcare financing and quality of care in sub-Saharan Africa: a systematic scoping review protocol

A rapid smartphone-based lactate dehydrogenase test for neonatal diagnostics at the point of care

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