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An essential component of evaluating and improving global health is access to appropriate diagnostic tools. Through this series of papers we hope to further the dissemination of current knowledge on global health diagnostic needs for the conditions that most severely affect those living in the developing world.
Developing a strategy for investment in diagnostic technologies requires an understanding of the need for, and the health impact of, potential new tools, as well as the necessary performance characteristics and user requirements. In this paper, we outline an approach for modelling the health benefits of new diagnostic tools.
Acute lower respiratory infections (ALRIs) are the primary killer of children in developing countries. Many children with ALRIs are not properly diagnosed, and overuse of antibiotics has led to increasing drug resistance. The introduction of simple and widely accessible diagnostic tests could significantly reduce deaths among children with ALRIs and reduce the inappropriate use of antibiotics.
The development of an inexpensive, simple and widely accessible test for diagnosing human immunodeficiency virus (HIV) infection in infants could significantly reduce paediatric acquired immunodeficiency syndrome (AIDS) deaths in sub-Saharan Africa.
Stunting affects ~ 147 million children in developing countries. Studies have pointed to a relationship between stunting and different pathogens that are associated with diarrhoeal illness. New easy-to-use tools for diagnosing these pathogens could help to identify children at risk for growth shortfall, and reduce the prevalence of stunting and the large burden of disease associated with it.
Malaria kills > 1 million children aged < 5 years in sub-Saharan Africa annually. Current control efforts are hampered by increasing drug resistance, unreliable diagnostics, widespread overtreatment and rising drug costs. In this environment, new and widely available malaria diagnostics have the potential to save lives and drastically reduce overtreatment.
We estimated the impact of hypothetical new diagnostic tests for tuberculosis (TB) in patients with persistent cough in developing countries. We found that a variety of new tests could help better identify TB cases and target treatment, thereby reducing the burden of disease.
There is a great need for improved diagnosis of curable bacterial sexually transmitted infections among women in developing countries. We found that wider access to new diagnostic tests has a greater overall impact on health outcomes than improvements in test sensitivity or specificity.
This paper focuses on the technologies required to meet the global health diagnostics needs presented in the previous papers, highlighting how new diagnostic technologies might have the potential to change medical and public-health scenarios in the developing world.
