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Considerations for the design and implementation of point-of-care technology for use in low- and middle-income countries

Nature Reviews Methods Primers volume 3, Article number: 8 (2023) Cite this article

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Designing technology for point-of-care use in low- and middle-income countries requires understanding of the underlying barriers that contribute to recalcitrant global problems. The only way to understand those barriers is to work with local experts, otherwise you may wind up solving the wrong problem.

There is no shortage of new point-of-care (POC) devices being developed for use in low- and middle-income countries (LMICs). More than 3,000 articles have been published in the past 10 years describing such technologies, but many factors determine whether a POC technology can be applied to real-world problems.

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Fig. 1: Falsified amoxicillin dosage forms detected by the PAD.

References

  1. World Health Organization. WHO global surveillance and monitoring system for substandard and falsified medical products (WHO, 2017).

  2. Ozawa, S. et al. Prevalence and estimated economic burden of substandard and falsified medicines in low- and middle-income countries: a systematic review and meta-analysis. JAMA Netw. Open 1, e181662 (2018).

    Article  Google Scholar 

  3. Land, K. J., Boeras, D. I., Chen, X.-S., Ramsay, A. R. & Peeling, R. W. REASSURED diagnostics to inform disease control strategies, strengthen health systems and improve patient outcomes. Nat. Microbiol. 4, 46–54 (2019).

    Article  Google Scholar 

  4. Weaver, A. A. et al. Paper analytical devices for fast field screening of beta lactam antibiotics and antituberculosis pharmaceuticals. Anal. Chem. 85, 6453–6460 (2013).

    Article  Google Scholar 

  5. US Pharmacopeia. USP Technology Review: Paper Analytical Device (PAD). The Technology Review Program (US Pharmacopeia, 2020).

  6. Caillet, C. et al. A comparative field evaluation of six medicine quality screening devices in Laos. PLoS Negl. Trop. Dis. 15, e0009674 (2021).

    Article  Google Scholar 

  7. Banerjee, S., Sweet, J., Sweet, C. & Lieberman, M. Visual recognition of paper analytical device images for detection of falsified pharmaceuticals. Proceedings of the 2016 IEEE Winter Conference on Applications of Computer Vision (WACV) (IEEE, 2016).

  8. Eberle, M. S., Ashenef, A., Gerba, H., Loehrer, P. J. Sr & Lieberman, M. Substandard cisplatin found while screening the quality of anticancer drugs from Addis Ababa, Ethiopia. JCO Glob. Oncol. 6, 407–413 (2020).

    Article  Google Scholar 

Download references

Acknowledgements

Paper analytical device (PAD) development was supported by NSF CMMI-1842369, IRES-1559496 and IIP-2016516; the National Cancer Institute of the National Institutes of Health under Award Number U01CA269195; the Indiana Clinical and Translational Sciences Institute, funded in part by Grant Number UL1TR002529 from the National Institutes of Health; National Center for Advancing Translational Sciences; and the University of Illinois Chicago Center for Clinical and Translational Science award UL1TR002003. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. PAD field testing was supported by the Walther Cancer Foundation WCF 0178.01, the Ministry of Science and Technology of the Federal Democratic Republic of Ethiopia Project entitled ‘Developing, validating and adopting simple mobile technologies in drug quality evaluation and counterfeit detection’ for PAD system implementation in Ethiopia, and by USAID DIV program AID-OAA-F-15-00050, the Bill & Melinda Gates Foundation, Management Science for Health, FHI-360, and the Berthiaume Institute for Precision Health Substance Abuse Fund.

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  1. Department of Chemistry and Biochemistry, University of Notre Dame, Notre Dame, IN, USA

    Kathleen L. Hayes & Marya Lieberman

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  1. Kathleen L. Hayes
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  2. Marya Lieberman
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Correspondence to Marya Lieberman.

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Competing interests

M.L. is an inventor of the PAD (US 9,354,181 B2 issued 31 May 2016) and is the owner of Paper Analytics LLC. K.L.H. declares no competing interests.

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Hayes, K.L., Lieberman, M. Considerations for the design and implementation of point-of-care technology for use in low- and middle-income countries. Nat Rev Methods Primers 3, 8 (2023). https://doi.org/10.1038/s43586-023-00197-z

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  • DOI: https://doi.org/10.1038/s43586-023-00197-z

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