Chapter 7
Barriers to Point of Care Testing in India
and South Africa
Nora Engel, Vijayashree Yellappa, Malika Davids, Keertan Dheda,
Nitika Pant Pai and Madhukar Pai
7.1 Introduction
Point of care (POC) testing in communities, home settings, and primary healthcare
centers is widely believed by the global health community to have tremendous potential in reducing delays in diagnosing and initiating treatment for diseases such as HIV,
tuberculosis, syphilis, and malaria. The idea is that testing nearer to the patient, at the
point of care, allows for quick diagnosis and further management decisions (referral,
follow-up testing or treatment) completed in the same clinical encounter or at least
the same day, while the patient waits. In this way, the POC continuum is ensured
(Pant Pai et al. 2012). POC testing promises to overcome long turnaround times and
delays associated with conventional laboratory-based testing. These problems can
result in the loss of patients from testing and treatment pathways with detrimental
consequences for the development of advanced disease stages and drug resistance.
N. Engel (B)
Maastricht University, Maastricht, Netherlands
e-mail: n.engel@maastrichtuniversity.nl
V. Yellappa
Institute of Public Health, Bangalore, India
e-mail: vijayashree@iphindia.org
M. Davids · K. Dheda
University of Cape Town, Cape Town, South Africa
e-mail: malika.davids@uct.ac.za
K. Dheda
e-mail: keertan.dheda@uct.ac.za
N. P. Pai · M. Pai
McGill University, Montreal, Canada
e-mail: nitika.pai@mcgill.ca
M. Pai
e-mail: madhukar.pai@mcgill.ca
© The Author(s) 2018
S. Hostettler et al. (eds.), Technologies for Development,
https://doi.org/10.1007/978-3-319-91068-0_7
75
Barriers to Point of Care Testing in India
and South Africa
Nora Engel, Vijayashree Yellappa, Malika Davids, Keertan Dheda,
Nitika Pant Pai and Madhukar Pai
7.1 Introduction
Point of care (POC) testing in communities, home settings, and primary healthcare
centers is widely believed by the global health community to have tremendous potential in reducing delays in diagnosing and initiating treatment for diseases such as HIV,
tuberculosis, syphilis, and malaria. The idea is that testing nearer to the patient, at the
point of care, allows for quick diagnosis and further management decisions (referral,
follow-up testing or treatment) completed in the same clinical encounter or at least
the same day, while the patient waits. In this way, the POC continuum is ensured
(Pant Pai et al. 2012). POC testing promises to overcome long turnaround times and
delays associated with conventional laboratory-based testing. These problems can
result in the loss of patients from testing and treatment pathways with detrimental
consequences for the development of advanced disease stages and drug resistance.
N. Engel (B)
Maastricht University, Maastricht, Netherlands
e-mail: n.engel@maastrichtuniversity.nl
V. Yellappa
Institute of Public Health, Bangalore, India
e-mail: vijayashree@iphindia.org
M. Davids · K. Dheda
University of Cape Town, Cape Town, South Africa
e-mail: malika.davids@uct.ac.za
K. Dheda
e-mail: keertan.dheda@uct.ac.za
N. P. Pai · M. Pai
McGill University, Montreal, Canada
e-mail: nitika.pai@mcgill.ca
M. Pai
e-mail: madhukar.pai@mcgill.ca
© The Author(s) 2018
S. Hostettler et al. (eds.), Technologies for Development,
https://doi.org/10.1007/978-3-319-91068-0_7
75