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The Condition Of Diagnostic Tests For Infectious Diseases In Developing Countries
Diagnostic tests play an important role in the detection of infectious agents, the finding of a new agent, direct an appropriate therapy, observing the response to treatment, estimating prognosis, and disease analysis. The inadequate diagnostic services against infectious diseases is a serious problem in developing countries and one of the major issue that a nation must face at the start of this century. Diagnostic and screening of an infectious disease are mandatory for monitoring the identification of etiology of the disease and for effective treatment as well. A large number of people infected from communicable diseases for which patients are not getting treatment in spite of the presence of treatments. For example, the majority of patients for HIV infection are living in such countries where they are not able to approach for any treatment or therapy (1).
Diagnostic centers in developing countries are often less, and access is limited due to their location or economic factors. In addition, due to the high cost, some specific diagnostic tests are not available to the majority population. Furthermore, many clinical laboratories lack sufficient resources and facilities such as electricity supply and water management may be irregular. Unavailability of skilled technical staff is also a big issue in some nations, mainly in rural regions. For certain tropical neglected diseases, suitable testing has not yet been developed. In the developing states, investment in diagnostic tests is often a negligible fraction of healthcare expenditure and some manufacturers have little interest for investing in the production of diagnostic products, because of uncertainty that profit on their investment will likely to be low. Disease patterns in developing countries often variate from those of wealthiest countries and when developing a new test, manufacturers must take into consideration the regional epidemiology at the point of intended use(2).
Technological advancements and the production of innovative devices that can be utilized outside of the diagnostic lab and have the ability to reduce some of the hurdles faced by healthcare personnel in developing countries. Quick tests for practice at the point-of-care (POC) provide novel solutions for recognizing transmissible diseases. In past, there have been less funding for POC tests for infections that are frequent in developing countries, but the trend is now changing. The absence of regulation of diagnostic services in many countries has resulted in the extensive use of sub-optimal POC tests, particularly for malaria. Recently technological advancement and understanding of the significance of definitive diagnostics has followed rapid progress of POC tests that require no special apparatus and training(3). Point-of-care testing is commercially accessible low-income countries for numerous infectious diseases including AIDS/HIV, malaria, syphilis, tuberculosis, human African trypanosomiasis, and Visceral leishmaniasis. In 2003 the term ASSURED test was coined by WHO/TDR (Special Programme for Research and Training in Tropical Diseases), to explain the ideal attributes of a diagnostic test (3).
Even when a diagnostic test with suitable results is available, there are many hindrances in initiating new test in the developing world. The introduction of new tests mainly depends upon the healthcare system and many other conditions such as supply chain management to prevent the stock out of diagnostic tests and drugs. Another major challenge is the alternation in the biology and pathological processes of infectious disease necessitate the direct identification of the infectious agent particularly during the early stage to minimize the further transmission of the disease (2).
In conclusion, prevention of infectious disease in low-income countries is challenged by the low standard provision of diagnostic facilities and a string action is required to remedy the condition. Diagnostic centers are often unreachable, under-resourced and the shortage of basic services and new tests are necessary that can be utilized for people living in remote areas. POC tests against infectious diseases can rescue many lives and enhance public health.
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