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A model for point of care testing for non-communicable disease diagnosis in resource-limited countries

Glob Health Epidemiol Genom. 2019 Sep 11:4:e7. doi: 10.1017/gheg.2019.6. eCollection 2019.

Abstract

Non-communicable disease diagnosis frequently relies on biochemical measurements but laboratory infrastructure in low-income settings is often insufficient and distances to clinics may be vast. We present a model for point of care (POC) epidemiology as used in our study of chronic disease in the Haiti Health Study, in rural and urban Haiti. Point of care testing (POCT) of creatinine, cholesterol, and hemoglobin A1c as well as physical measurements of weight, height, and waist circumference allowed for diagnosis of diabetes, chronic kidney disease, dyslipidemias, and obesity. Methods and troubleshooting techniques for the data collection of this study are presented. We discuss our method of community-health worker (CHW) training, community engagement, study design, and field data collection. We also discuss the machines used and our quality control across CHWs and across geographical regions. Pitfalls tended to include equipment malfunction, transportation issues, and cultural differences. May this paper provide information for those attempting to perform similar diagnostic and screening studies using POCT in resource poor settings.

Keywords: Chronic disease; Haiti; global health; non-communicable disease; point of care.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Chronic Disease / epidemiology
  • Chronic Disease / prevention & control
  • Community Health Workers / education
  • Community Health Workers / statistics & numerical data
  • Cost of Illness
  • Diabetes Mellitus / diagnosis*
  • Diabetes Mellitus / epidemiology
  • Dyslipidemias / diagnosis
  • Dyslipidemias / epidemiology
  • Female
  • Haiti / epidemiology
  • Humans
  • Male
  • Middle Aged
  • Noncommunicable Diseases / epidemiology*
  • Noncommunicable Diseases / prevention & control
  • Obesity / diagnosis
  • Obesity / epidemiology
  • Point-of-Care Testing / economics
  • Point-of-Care Testing / standards*
  • Quality Control
  • Renal Insufficiency, Chronic / diagnosis*
  • Renal Insufficiency, Chronic / epidemiology
  • Risk Factors
  • Rural Population / statistics & numerical data