The goal of point-of-care testing is to provide fast, convenient, and easy-touse diagnostic assays that shorten the turnaround time of intervention. Several diagnostic tests have already migrated from the centralized laboratory to patients' bedside, physician offices and domestic environments in more developed countries. However, the situation is dramatically different in countries of the developing world where lack of facilities and resources still results in diagnosis to be inferred mostly from the symptoms only. Reliable and rapid diagnosis is urgently needed particularly in case of viral diseases with the concrete risk of outbreaks going undetected in the early stages. In this article we will advocate the necessity to implement robust point-of-care testing for viral diseases to overcome the diagnostic gap of less developed countries.
Keywordsintroducing point-of-care testing Point-of-care testing (POCT) is generally defined as medical testing at or near the site of patient care, but encompasses a large variety of technologies for very different environments, which all have in common a quick turnaround time between specimen collection and diagnosis [1,2]. On one side we find very simple dipstick-based immunochromatographic (ICT) assays for self-testing, such as the rapid HIV test kits that provide a result in less than 30 min from an oral swab [3]. On the other side we find relatively sophisticated and expensive instruments that are used in hospitals for molecular diagnosis that also require trained personnel for their use. Remaining on the HIV topic, confirmatory testing of seroconversion, measurement of viral load and CD4 + T cells' count all require specific complex laboratory instrumentation. The case of HIV infection is of particular interest because, despite a very efficient specific combination antiretroviral therapy, the virus cannot be eradicated [4]. Poor compliance of treatment leads inevitably to a relapse of viremia and the risk of selecting resistant viruses. Hence, regular monitoring of HIV viral loads during combination antiretroviral therapy is highly recommended and would enormously benefit from quick POCT. Between these two extremes there is a wide range of rapid diagnostic tests that can be performed by minimally trained health workers in the community. The global POCT market is expected to grow steadily in the next years [5]. Manufacturers focus on the development of highly sensitive biosensors, less expensive optical systems, and noninvasive methods to be integrated into POCT devices for better performance. Microfluidic systems based on the lab-on-chip (LOC) concept, along with improved biomarkers, may witness a paradigm shift in the clinical diagnostics industry. But POCT has also the potential to overcome the lack of a widely accessible health-care infrastructure in resource-limited settings. As pointed out in a recent report from the American Academy of Microbiology, "in resource-limited For reprint orders, please contact: reprints@futuremedicine.com Future Virol. (2014) 9(6) 596 revie...