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      Point-of-Care Diagnostic Services as an Integral Part of Health Services during the Novel Coronavirus 2019 Era

      editorial
      Author(s): 1 , * , 2 , 3 , 4 , 5
      Publication date (Electronic):
      Journal: Diagnostics
      Publisher: MDPI
      Keywords: point-of-care diagnostics, healthcare services, COVID-19 era

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          Abstract

          Point-of-care (POC) diagnostic services are commonly associated with pathology laboratory services. This issue presents a holistic approach to POC diagnostics services from a variety of disciplines including pathology, radiological and information technology as well as mobile technology and artificial intelligence. This highlights the need for transdisciplinary collaboration to ensure the efficient development and implementation of point-of-care diagnostics. The advent of the novel coronavirus 2019 (COVID-19) pandemic has prompted rapid advances in the development of new POC diagnostics. Global private and public sector agencies have significantly increased their investment in the development of POC diagnostics. There is no longer a question about the availability and accessibility of POC diagnostics. The question is “how can POC diagnostic services be integrated into health services in way that is useful and acceptable in the COVID-19 era?”.

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          Blockchain and Artificial Intelligence Technology for Novel Coronavirus Disease 2019 Self-Testing

          Tivani Mashamba-Thompson, Ellen Crayton (2020)
          The novel coronavirus disease 2019 (COVID-19) is rapidly spreading with a rising death toll and transmission rate reported in high income countries rather than in low income countries. The overburdened healthcare systems and poor disease surveillance systems in resource-limited settings may struggle to cope with this COVID-19 outbreak and this calls for a tailored strategic response for these settings. Here, we recommend a low cost blockchain and artificial intelligence-coupled self-testing and tracking systems for COVID-19 and other emerging infectious diseases. Prompt deployment and appropriate implementation of the proposed system have the potential to curb the transmissions of COVID-19 and the related mortalities, particularly in settings with poor access to laboratory infrastructure.
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            Implementation of Point-of-Care Diagnostics in Rural Primary Healthcare Clinics in South Africa: Perspectives of Key Stakeholders

            Tivani Mashamba-Thompson, Ngcwalisa A. Jama, Benn Sartorius … (2017)
            Introduction: Key stakeholders’ involvement is crucial to the sustainability of quality point-of-care (POC) diagnostics services in low-and-middle income countries. The aim of this study was to explore key stakeholder perceptions on the implementation of POC diagnostics in rural primary healthcare (PHC) clinics in South Africa. Method: We conducted a qualitative study encompassing in-depth interviews with multiple key stakeholders of POC diagnostic services for rural and resource-limited PHC clinics. Interviews were digitally recorded and transcribed verbatim prior to thematic content analysis. Thematic content analysis was conducted using themes guided by the World Health Organisation (WHO) quality-ASSURED (Affordable, Sensitive, Specific, User friendly, Rapid and to enable treatment at first visit and Robust, Equipment free and Delivered to those who need it) criteria for POC diagnostic services in resource-limited settings. Results: 11 key stakeholders participated in the study. All stakeholders perceived the main advantage of POC diagnostics as enabling access to healthcare for rural patients. Stakeholders perceived the current POC diagnostic services to have an ability to meet patients’ needs, but recommended further improvement of the following areas: research on cost-effectiveness; improved quality management systems; development of affordable POC diagnostic and clinic-based monitoring and evaluation. Conclusions: Key stakeholders of POC diagnostics in rural PHC clinics in South Africa highlighted the need to assess affordability and ensure quality assurance of current services before adopting new POC diagnostics and scaling up current POC diagnostics.
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              Key Stakeholders’ Perspectives on Implementation and Scale up of HIV Self-Testing in Rwanda

              Tafadzwa Dzinamarira, Collins Kamanzi, Tivani Mashamba-Thompson (2020)
              Introduction: The World Health Organisation recommends HIV self-testing as an alternative testing method to help reach underserved populations, such as men in sub-Saharan Africa. Successful implementation and scale-up of HIV self-testing (HIVST) in Rwanda relies heavily on relevant stakeholders’ involvement. We sought to explore HIVST key stakeholders’ perceptions of the implementation and scale-up of HIVST in Rwanda. Method: We conducted in-depth interviews with personnel involved in HIV response projects in Rwanda between September and November 2019. We purposively sampled and interviewed 13 national-level key stakeholders from the Ministry of Health, Rwanda Biomedical Center, non-governmental organizations and HIV clinics at tertiary health facilities in Kigali. We used a thematic approach to analysis with a coding framework guided by Consolidated Framework for Implementation Research (intervention characteristics, inner setting, outer setting, characteristics of individuals involved in the implementation and the implementation process). Results: Key stakeholders perceived HIVST as a potentially effective initiative, which can be used in order to ensure that there is an improvement in uptake of testing services, especially for underserved populations in Rwanda. The following challenges for implementation and scale-up of HIVST were revealed: lack of awareness of the kits, high cost of the self-test kits, and concerns on results interpretation. Key stakeholders identified the following as prerequisites to the successful implementation and scale-up of HIVST in Rwanda; creation of awareness, training those involved in the implementation process, regulation of the selling of the self-test kits, reduction of the costs of acquiring the self-test kits through the provision of subsidies, and ensuring consistent availability of the self-test kits. Conclusions: Key stakeholders expressed confidence in HIVST’s ability to improve the uptake of HIV testing services. However, they reported challenges, which need to be addressed to ensure successful implementation and scale-up of the HIVST. There is a need for further research incorporating lower level stakeholders to fully understand HIVST implementation and scale-up challenges and strategies to inform policy.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Diagnostics (Basel)
                Journal ID (iso-abbrev): Diagnostics (Basel)
                Journal ID (publisher-id): diagnostics
                Title: Diagnostics
                Publisher: MDPI
                ISSN (Electronic): 2075-4418
                Publication date (Electronic): 03 July 2020
                Publication date Collection: July 2020
                Volume: 10
                Issue: 7
                Electronic Location Identifier: 449
                Affiliations
                [1 ]Department of Public Health, University of Limpopo, Polokwane, Limpopo Province 0727, South Africa
                [2 ]International Clinical Research Center, Department of Global Health, University of Washington, Seattle, WA 98195-7965, USA; pkdrain@ 123456uw.edu
                [3 ]Division of Infectious Diseases, Department of Medicine, University of Washington, Seattle, WA 98195-7965, USA
                [4 ]Department of Epidemiology, University of Washington, Seattle, WA 98195-7965, USA
                [5 ]Department of Surgery, Harvard University, Massachusetts General Hospital, Boston, MA 02114, USA
                Author notes
                Article
                Publisher ID: diagnostics-10-00449
                DOI: 10.3390/diagnostics10070449
                PMC ID: 7400507
                PubMed ID: 32635234
                SO-VID: 263c4631-f76a-4a2a-9be2-761a4995693b
                Copyright © © 2020 by the authors.
                License:

                Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( http://creativecommons.org/licenses/by/4.0/).

                History
                Date received : 02 July 2020
                Date accepted : 02 July 2020
                Categories
                Subject: Editorial

                Keywords: point-of-care diagnostics,healthcare services,covid-19 era
                Data availability:
                Keywords: point-of-care diagnostics, healthcare services, covid-19 era

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