scholarly journals Diagnostic Performance and Usability of the Genedrive® HCV ID Kit in Two Decentralized Settings in Cameroon and Georgia

Diagnostics ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. 746
Author(s):  
Francois M. J. Lamoury ◽  
Richard Njouom ◽  
Marie Amougou-Atsama ◽  
Euloge Yiagnigni Mfopou ◽  
Nino Berishvili ◽  
...  
Keyword(s):  
Gold Standard ◽  
Point Of Care ◽  
Real Life ◽  
Linkage To Care ◽  
Hcv Rna ◽  
Middle Income ◽  
Resource Limited ◽  
Point Of Care Diagnostics ◽  
Fresh Plasma ◽  
Chronic Hcv

Point-of-care diagnostics have the potential to increase diagnosis and linkage to care and help reach the WHO targets to eliminate hepatitis C virus (HCV) by 2030. Here, we evaluated the diagnostic accuracy of Genedrive HCV ID assay for the qualitative detection of HCV RNA in decentralized settings in two low- and middle-income countries using fresh plasma specimens from 426 participants. The Abbott RealTime HCV assay was used as the gold standard. Genedrive HCV ID assay was conducted by different users. Users also completed questionnaires to assess the usability of Genedrive. At detection thresholds of 12 IU/mL or 30 IU/mL, 1000 IU/mL, and 2362 IU/mL, the sensitivity was 96.2% (95% CI: 92.7–98.4), 100% (98.2–100), and 100% (98.2–100), respectively; the specificity was 99.5% (95% CI: 97.4–100), 99.5% (97.5–100), and 98.7% (96.1–100), respectively. All genotypes detected using the gold-standard assay were also detected with Genedrive. Users found Genedrive easy to use. Genedrive is a simple and accurate test to confirm chronic HCV infection in decentralized, real-life, resource-limited settings. This novel diagnostic tool could contribute to closing the current gap in HCV diagnosis.

scholarly journals Triboelectric Effect Enabled Self-Powered, Point-of-Care Diagnostics: Opportunities for Developing ASSURED and REASSURED Devices

Micromachines ◽  
2021 ◽  
Vol 12 (3) ◽  
pp. 337
Author(s):  
Navneet Soin ◽  
Sam J. Fishlock ◽  
Colin Kelsey ◽  
Suzanne Smith
Keyword(s):  
High Efficiency ◽  
Resource Constraints ◽  
Point Of Care ◽  
Wearable Sensors ◽  
Middle Income ◽  
Physiological Signal ◽  
Point Of Care Diagnostics ◽  
Self Powered ◽  
Triboelectric Nanogenerators ◽  
Triboelectric Effect

The use of rapid point-of-care (PoC) diagnostics in conjunction with physiological signal monitoring has seen tremendous progress in their availability and uptake, particularly in low- and middle-income countries (LMICs). However, to truly overcome infrastructural and resource constraints, there is an urgent need for self-powered devices which can enable on-demand and/or continuous monitoring of patients. The past decade has seen the rapid rise of triboelectric nanogenerators (TENGs) as the choice for high-efficiency energy harvesting for developing self-powered systems as well as for use as sensors. This review provides an overview of the current state of the art of such wearable sensors and end-to-end solutions for physiological and biomarker monitoring. We further discuss the current constraints and bottlenecks of these devices and systems and provide an outlook on the development of TENG-enabled PoC/monitoring devices that could eventually meet criteria formulated specifically for use in LMICs.

scholarly journals Assessing the Potential Deployment of Biosensors for Point-of-Care Diagnostics in Developing Countries: Technological, Economic and Regulatory Aspects

Biosensors ◽  
2018 ◽  
Vol 8 (4) ◽  
pp. 119 ◽  
Author(s):  
Daniel Migliozzi ◽  
Thomas Guibentif
Keyword(s):  
Developing Countries ◽  
Technological Development ◽  
Point Of Care ◽  
Medical Personnel ◽  
Developed Countries ◽  
Key Factors ◽  
Resource Limited ◽  
Point Of Care Diagnostics ◽  
Successful Case ◽  
The Cost

Infectious diseases and antimicrobial resistance are major burdens in developing countries, where very specific conditions impede the deployment of established medical infrastructures. Since biosensing devices are nowadays very common in developed countries, particularly in the field of diagnostics, they are at a stage of maturity at which other potential outcomes can be explored, especially on their possibilities for multiplexing and automation to reduce the time-to-results. However, the translation is far from being trivial. In order to understand the factors and barriers that can facilitate or hinder the application of biosensors in resource-limited settings, we analyze the context from several angles. First, the technology of the devices themselves has to be rethought to take into account the specific needs and the available means of these countries. For this, we describe the partition of a biosensor into its functional shells, which define the information flow from the analyte to the end-user, and by following this partition we assess the strengths and weaknesses of biosensing devices in view of their specific technological development and challenging deployment in low-resource environments. Then, we discuss the problem of cost reduction by pointing out transversal factors, such as throughput and cost of mistreatment, that need to be re-considered when analyzing the cost-effectiveness of biosensing devices. Beyond the technical landscape, the compliance with regulations is also a major aspect that is described with its link to the validation of the devices and to the acceptance from the local medical personnel. Finally, to learn from a successful case, we analyze a breakthrough inexpensive biosensor that is showing high potential with respect to many of the described aspects. We conclude by mentioning both some transversal benefits of deploying biosensors in developing countries, and the key factors that can drive such applications.

scholarly journals Hepatitis C testing and linkage to care among adults on probation in a large US city

2021 ◽  
Author(s):  
Kevin F Kamis ◽  
David L Wyles ◽  
Matthew S Minturn ◽  
Tracy Scott ◽  
Dean McEwen ◽  
...  
Keyword(s):  
Hepatitis C ◽  
Point Of Care ◽  
Linkage To Care ◽  
Virologic Response ◽  
Patient Navigator ◽  
Hcv Rna ◽  
Study Cohort ◽  
Hcv Treatment ◽  
Hiv Test ◽  
Hcv Testing

Abstract Background Despite constituting the largest segment of the correctional population, individuals on probation remain largely unstudied with respect to hepatitis C virus (HCV) testing and linkage-to-care. We implemented an HCV testing and patient navigation program at an adult probation department. Methods Adults were tested at a local probation department with a rapid point-of-care HCV antibody (Ab) assay followed by a lab-based HCV RNA assay if anti-HCV positive. All individuals received counseling rooted in harm-reduction principles. Individuals testing positive for HCV Ab were immediately linked to a patient navigator in person or via telephone. The patient navigator assisted patients through cure unless lost to follow-up. Study participation involved an optional survey and optional point-of-care HIV test. Results Of 417 individuals tested, 13% were HCV Ab positive and 65% of those tested for HCV RNA (34/52) had detectable HCV RNA. Of the 14 individuals who linked to an HCV treatment provider, 4 completed treatment as measured by pharmacy fill documentation in the electronic medical record, and 1 obtained sustained virologic response. 193 individuals tested for HIV; none tested positive. Conclusions The study cohort had a higher HCV seroprevalence than the general population (13% vs 2%), but linkage-to-care, completion of HCV treatment, and successful test-of-cure rates were all low. This study indicates that HCV disproportionately impacts adults on probation and prioritizing support for testing and linkage-to-care could improve health in this population. Co-localization of HCV treatment within probation programs would reduce the barrier of attending a new institution and could be highly impactful.

scholarly journals Characteristics and Specialist Linkage to Care of Patients Diagnosed With Chronic Hepatitis C Across Different Settings in an Urban Academic Hospital: Implications for Improving Diagnosis and Linkage to Care

2021 ◽  
Vol 12 ◽  
Author(s):  
Dan C. S. Im ◽  
Susheel Reddy ◽  
Claudia Hawkins ◽  
Shannon Galvin
Keyword(s):  
Chronic Hepatitis ◽  
Hepatitis C ◽  
Chronic Hepatitis C ◽  
Acute Care ◽  
Public Health Problem ◽  
Linkage To Care ◽  
Hcv Rna ◽  
Chi Square ◽  
Race And Gender ◽  
Chronic Hcv

IntroductionChronic hepatitis C virus (HCV) infection is a significant public health problem. Strategies to identify more HCV infections and improve linkage to care (LTC) are needed. We compared characteristics, treatment and LTC among chronic HCV patients in different health care settings.MethodsNewly diagnosed HCV antibody positive (anti-HCV+) patients within settings of acute care, inpatient and outpatient in one health system were studied. Proportion of LTC and treatment were analyzed only for HCV RNA positive patients. Chi-square, one-way ANOVA and logistic regression were used to compare the characteristics and outcomes in the three care settings. Patients in acute care settings were excluded from multivariate analyses due to low sample size.ResultsAbout 43, 368, and 1159 anti-HCV+ individuals were identified in acute care, inpatient, and outpatient, respectively. Proportion of RNA positivity in acute, inpatient, and outpatient were 47.8, 60.3 and 29.2%, respectively (p < 0.01). After adjusting for age, insurance type, race, and gender, outpatients had higher odds of LTC and of treatment (OR 4.7 [2.9, 7.6] and 4.5 [2.8, 7.3]).ConclusionsInpatients had lower proportion of LTC and treatment compared to outpatients. Use of LTC coordinators and the provision of integrated service for specialty care may improve outcomes.

Risks of hepatitis C virus reactivation in a real-life population of oncology patients treated in an academic center

2020 ◽  
pp. 107815522096979
Author(s):  
Catherine-Audrey Boutin ◽  
Jean-Philippe Adam ◽  
Dominic Martel ◽  
Stéphane Doucet ◽  
Valérie Martel-Laferrière
Keyword(s):  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Real Life ◽  
Viral Reactivation ◽  
Hcv Rna ◽  
Hepatic Decompensation ◽  
Oncology Patients ◽  
Chronic Hcv ◽  
The Impact ◽  
Hepatic Flare

Background Chemotherapy has been associated with a theoretical risk of hepatitis C virus (HCV) reactivation. However, little is known about the amplitude of viral replication and the incidence of subsequent hepatic exacerbation. Method We aimed to describe the occurrence of hepatitis flare and HCV reactivation at our center. We included, over a period of 5 years, adult patients with chronic HCV receiving intravenous chemotherapy. We excluded patients with undetectable HCV RNA, hepatocellular carcinoma, liver metastases or other etiologies of hepatic disease. The primary objective was to identify hepatic flares (elevation of alanine aminotransferase 3 times above the upper limit of normal). Secondary objectives were to assess viral reactivation (HCVr, HCV-RNA ≥1 log10 IU/mL when compared to baseline value), hepatic decompensation, mortality and the impact on the chemotherapy. Descriptive statistics were used. Results A total of 11 patients with chronic HCV were identified among the 5761 oncology patients. Five patients experienced a hepatic flare with median maximal ALT value of 139 U/L (IQR 133-237). Only 2 patients met criteria for HCVr with a median RNA increase of 1.16 log IU/mL (IQR 1.1-1.2). One patient presented with both HCVr and a hepatic flare. Only one patient required chemotherapy discontinuation following hepatic flare. No hepatic decompensation or related mortality were observed. Conclusion We identified a very small number of HCV cases among our population. We observed HCVr and hepatic flares, but only one consequence on cancer treatment. Nonetheless, HCV screening is encouraged among patients undergoing chemotherapy to allow close follow-up of hepatic function.

scholarly journals Development and Remodeling of Point-of-Care Ultrasound Education for Emergency Medicine Residents in Resource Limited Countries during the COVID-19 Pandemic

Tomography ◽  
2021 ◽  
Vol 7 (4) ◽  
pp. 721-733
Author(s):  
Kamonwon Ienghong ◽  
Lap Woon Cheung ◽  
Somsak Tiamkao ◽  
Vajarabhongsa Bhudhisawasdi ◽  
Korakot Apiratwarakul
Keyword(s):  
Emergency Medicine ◽  
Positive Impact ◽  
Point Of Care ◽  
Handheld Devices ◽  
Ultra Sound ◽  
Point Of Care Ultrasound ◽  
Learning Materials ◽  
Middle Income ◽  
Resource Limited ◽  
Medical Program

The administration of an accurate and effective POCUS course is a crucial tool in improving health education and thus the health care system in low- to middle-income countries. The development of the ultrasound curriculum in these countries during the pandemic era is a major challenge for medical educators. Therefore, this study aims to survey the learner experience after implementing the POCUS curriculum for first-year emergency medicine residents. All learners responded to the survey. Our results demonstrated that the ultrasound rotation and our ultra-sound learning materials were useful tools which showed a positive impact on POCUS knowledge for our learners. However, some obstacles of POCUS learning were identified to assist in closing faculty development gaps, including the availability of handheld devices, as well as the re-modeling of the ultrasound rotation course, which should be managed according to the feedback we received. This study demonstrated a clear need for constant updates in higher education, medical program development, accuracy of local learning materials, and the explosion of virtual and online learning platforms during this decade.

scholarly journals Advances in addressing technical challenges of point-of-care diagnostics in resource-limited settings

2016 ◽  
Vol 16 (4) ◽  
pp. 449-459 ◽  
Author(s):  
ShuQi Wang ◽  
Mark A. Lifson ◽  
Fatih Inci ◽  
Li-Guo Liang ◽  
Ye-Feng Sheng ◽  
...  
Keyword(s):  
Point Of Care ◽  
Resource Limited Settings ◽  
Resource Limited ◽  
Point Of Care Diagnostics ◽  
Technical Challenges

scholarly journals Microfluidic system for screening disease based on physical properties of blood

Bioimpacts ◽  
2019 ◽  
Vol 10 (3) ◽  
pp. 141-150
Author(s):  
Siddharth Singh Yadav ◽  
Basant Singh Sikarwar ◽  
Priya Ranjan ◽  
Rajiv Janardhanan
Keyword(s):  
Physical Properties ◽  
Large Scale ◽  
One Health ◽  
Point Of Care ◽  
Low Cost ◽  
Microfluidic System ◽  
Middle Income ◽  
Blood Samples ◽  
Resource Limited ◽  
Automated Classifier

Introduction: A key feature of the 'One Health' concept pertains to the design of novel point of care systems for largescale screening of health of the population residing in resource-limited areas of low- and middle-income countries with a view to obtaining data at a community level as a rationale to achieve better public health outcomes. The physical properties of blood are different for different samples. Our study involved the development of an innovative system architecture based upon the physical properties of blood using automated classifiers to enable large-scale screening of the health of the population living in resource-limited settings. Methods: The proposed system consisted of a simple, robust and low-cost sensor with capabilities to sense and measure even the minute changes in the physical properties of blood samples. In this system, the viscosity of blood was derived from a power-law model coupled with the Rabinowitsch-Mooney correction for non-Newtonian shear rates developed in a steady laminar Poiseuille flow. Surface tension was measured by solving the Young-Laplace equation for pendant drop shape hanging on a vertical needle. An anticipated outcome of this study would be the development of a novel automated classifier based upon the rheological attributes of blood. This automated classifier would have potential application in evaluating the health status of a population at regional and global levels. Results: The proposed system was used to measure the physical properties of various samples like normal, tuberculous and anemic blood samples. The results showed that the physical properties of these samples were different as compared to normal blood samples. The major advantage of this system was low-cost, as well as its simplicity and portability. Conclusion: In this work, we proposed making a case for the validation of a low-cost version of a microfluidic system capable of scanning large populations for a variety of diseases as per the WHO mandate of "One Health".

scholarly journals Hepatitis C virus screening of high-risk patients in a community hospital emergency department: Retrospective review of patient characteristics and future implications

PLoS ONE ◽  
2021 ◽  
Vol 16 (6) ◽  
pp. e0252976
Author(s):  
Ji Seok Park ◽  
Judy Wong ◽  
Hillary Cohen
Keyword(s):  
Hepatitis C ◽  
Tobacco Use ◽  
Screening Test ◽  
Linkage To Care ◽  
Hcv Infection ◽  
Hcv Rna ◽  
Spontaneous Clearance ◽  
History Of ◽  
Chronic Hcv Infection ◽  
Chronic Hcv

Background Chronic hepatitis C virus infection (HCV) is a common infectious disease that affects more than 2.7 million people in the US. Because the emergency department (ED) can present an ideal opportunity to screen patients who may not otherwise get routine screening, we implemented a risk-based screening program for ED patients and established a system to facilitate linkage to care. Methods and findings A risk-based screening algorithm for HCV was programmed to trigger an alert in Epic electronic medical record system. Patients identified between August 2018 and April 2020 in the ED were tested for HCV antibody reflex to HCV RNA. Patients with a positive screening test were contacted for the confirmatory test result and to establish medical care for HCV treatment. Patient characteristics including age, sex, self-awareness of HCV infection, history of previous HCV treatment, history of opioids use, history of tobacco use, and types of insurance were obtained. A total of 4,525 patients underwent a screening test, of whom 131 patients (2.90%) were HCV antibody positive and 43 patients (0.95%) were HCV RNA positive, indicating that only 33% of patients with positive screening test had chronic HCV infection. The rate of chronic infection was higher in males as compared to females (1.34% vs 0.60%, p = 0.01). Patients with history of opioid use or history of tobacco use were found to have a lower rate of spontaneous clearance than patients without each history (opioids: 48.6% vs 72.0%, p = 0.02; tobacco: 56.6% vs 80.5%, p = 0.01). Among 43 patients who were diagnosed with chronic hepatitis C, 26 were linked to a clinical setting that can address chronic HCV infection, with linkage to care rate of 60.5%. The most common barrier to this was inability to contact patients after discharge from the ED. Conclusions A streamlined EMR system for HCV screening and subsequent linkage to care from the ED can be successfully implemented. A retrospective review suggests that male sex is related to chronic HCV infection, and history of opioid use or history of tobacco use is related to lower HCV spontaneous clearance.

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