The need for universal access to diagnostics in resource-limited urban and rural environments
Click on a question to view the answer.
- Why is there a need for better access to CD4 and CD4% T-cell testing?
Clinicians cannot start antiretroviral therapy (ART) until they have tested CD4/CD4% in an HIV-infected individual. If they cannot do this testing, it is known that ART is likely to be:
- Administered longer than medically necessary, risking drug toxicity
- Started too late risking death from opportunistic infection
- What stops some people from receiving CD4/CD4% testing?
Often, they can’t receive testing because of where they live. People living far from an equipped hospital are not receiving testing. Current estimates suggest that this inequity is felt by two thirds of the world’s population of HIV-infected individuals.
- But if testing is essential, why are people put off by a long walk?
It’s not that simple. Having walked many kilometres for a test, they are told to go home and come back another day for the results. Maybe they don’t have time or money for this. Three trips will be needed if there’s a problem with specimen integrity and they have to be re-tested.
Many people don’t make a journey until they are very sick, most likely suffering from one or more opportunistic infections. This is very bad for their clinical outcome.
- Why aren’t testing facilities located closer to patients?
Most CD4 lymphocyte counting equipment is designed for use in environments with a highly developed infrastructure (stable electricity, temperature control and reagent refrigeration).
Also, these conventional systems require very skilled operators who can chemically prepare blood samples by hand, use complex reagents and laboratory equipment, and then interpret the data. Resource-limited urban and rural environments have a shortage of skilled personnel to perform these tasks and, of course, cannot afford expensive equipment and supplies.
- What is the solution to this problem?
Resource-limited urban and rural areas require completely automated and simple-to-use equipment and supplies that:
- Eliminate the need for a high-level infrastructure
- Eliminate the need for highly skilled operators
This describes the equipment and supplies that we, at PointCare, have invented.
- How will patients benefit from local testing?
- The patient doesn’t have a long walk
- He or she has the ability to receive same-day CD4 testing, counselling and treatment
- The clinician has the ability to make on-the-spot appropriate clinical decisions
- The sooner a patient is correctly started on ART, there is a potential for a better clinical outcome
- Treatment resources are deployed to maximum advantage and cost efficiency
- For HIV-infected patients, this means there is a potential for lives to be saved and for the quality of life to be improved
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