TY - JOUR
T1 - The feasibility of novel point-of-care diagnostics for febrile illnesses at health centres in Southeast Asia
T2 - a mixed-methods study
AU - Adella, Fidelis Jacklyn
AU - Vanna, Moul
AU - Adhikari, Bipin
AU - Ol, Sam
AU - Tripura, Rupam
AU - Davoeung, Chan
AU - Callery, James J.
AU - Sovann, Yok
AU - Chandna, Arjun
AU - Bunreth, Voeunrung
AU - Asnong, Carina
AU - von Seidlein, Lorenz
AU - Dondorp, Arjen M.
AU - Maude, Richard J.
AU - Lubell, Yoel
AU - Wills, Bridget
AU - Lek, Dysoley
AU - Peto, Thomas J.
N1 - Funding Information: This work was supported by Wellcome Trust [219644] and The Global Fund to Fight AIDS, Tuberculosis and Malaria [QSE-M-UNOPS-MORU-20864-007-42]. This research was funded in whole, or in part, by the Wellcome Trust [220211]. For the purpose of Open Access, the author has applied a CC BY public copyright license to any Author Accepted Manuscript version arising from this submission. Study sponsor: University of Oxford, UK. Publisher Copyright: © The Author(s) 2023. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene.
PY - 2023/11/1
Y1 - 2023/11/1
N2 - BACKGROUND: The decline of malaria in Southeast Asia means other causes of fever are increasingly relevant, but often undiagnosed. The objective of this study was to assess the feasibility of point-of-care tests to diagnose acute febrile illnesses in primary care settings. METHODS: A mixed-methods study was conducted at nine rural health centres in western Cambodia. Workshops introduced health workers to the STANDARD(TM) Q Dengue Duo, STANDARD(TM) Q Malaria/CRP Duo and a multiplex biosensor detecting antibodies and/or antigens of eight pathogens. Sixteen structured observation checklists assessed users' performances and nine focus group discussions explored their opinions. RESULTS: All three point-of-care tests were performed well under assessment, but sample collection was difficult for the dengue test. Respondents expressed that the diagnostics were useful and could be integrated into routine clinical care, but were not as convenient to perform as standard malaria rapid tests. Health workers recommended that the most valued point-of-care tests would directly inform clinical management (e.g. a decision to refer a patient or to provide/withhold antibiotics). CONCLUSIONS: Deployment of new point-of-care tests to health centres could be feasible and acceptable if they are user-friendly, selected for locally circulating pathogens and are accompanied by disease-specific education and simple management algorithms.
AB - BACKGROUND: The decline of malaria in Southeast Asia means other causes of fever are increasingly relevant, but often undiagnosed. The objective of this study was to assess the feasibility of point-of-care tests to diagnose acute febrile illnesses in primary care settings. METHODS: A mixed-methods study was conducted at nine rural health centres in western Cambodia. Workshops introduced health workers to the STANDARD(TM) Q Dengue Duo, STANDARD(TM) Q Malaria/CRP Duo and a multiplex biosensor detecting antibodies and/or antigens of eight pathogens. Sixteen structured observation checklists assessed users' performances and nine focus group discussions explored their opinions. RESULTS: All three point-of-care tests were performed well under assessment, but sample collection was difficult for the dengue test. Respondents expressed that the diagnostics were useful and could be integrated into routine clinical care, but were not as convenient to perform as standard malaria rapid tests. Health workers recommended that the most valued point-of-care tests would directly inform clinical management (e.g. a decision to refer a patient or to provide/withhold antibiotics). CONCLUSIONS: Deployment of new point-of-care tests to health centres could be feasible and acceptable if they are user-friendly, selected for locally circulating pathogens and are accompanied by disease-specific education and simple management algorithms.
KW - feasibility
KW - febrile illnesses
KW - health centres
KW - point-of-care diagnostics
UR - http://www.scopus.com/inward/record.url?scp=85176509333&partnerID=8YFLogxK
U2 - https://doi.org/10.1093/trstmh/trad036
DO - https://doi.org/10.1093/trstmh/trad036
M3 - Article
C2 - 37317948
SN - 0035-9203
VL - 117
SP - 788
EP - 796
JO - Transactions of the Royal Society of Tropical Medicine and Hygiene
JF - Transactions of the Royal Society of Tropical Medicine and Hygiene
IS - 11
ER -