The potential of digital molecular diagnostics for infectious diseases in sub-Saharan Africa.
The potential of digital molecular diagnostics for infectious diseases in sub-Saharan Africa.
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DOI：
10.1371/journal.pdig.0000064
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发表时间：
2022-06
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撒哈拉以南非洲 (SSA) 大部分地区的诊断需求和诊断获取之间存在巨大差距，特别是对于造成重大发病率和死亡率负担的传染病。准确的诊断对于个人的正确治疗至关重要，并为疾病监测、预防和控制策略提供重要信息。数字分子诊断将分子检测的高灵敏度和特异性与现场护理格式和移动连接结合起来。这些技术的最新发展为诊断生态系统的彻底变革创造了机会。非洲国家有潜力开创围绕数字诊断设计的新医疗模式，而不是试图在资源丰富的环境中模仿诊断实验室模式。本文描述了对新诊断方法的需求，重点介绍了数字分子诊断技术的进展，并概述了它们在解决 SSA 传染病方面的潜力。然后，它阐述了数字分子诊断的开发和实施所需的步骤。尽管 SSA 的重点是传染病，但许多原则也适用于其他资源有限的环境和非传染性疾病。诊断测试是现代医学实践的基础，是正确诊断和治疗的基础。全球在获得诊断检测方面存在差异，撒哈拉以南非洲 (SSA) 的许多人口无法获得基本检测。因此，关于撒哈拉以南非洲地区许多疾病的真实负担的数据也很有限。诊断实验室的建设、运行和维护成本高昂且复杂，因此增加实验室数量可能不是最佳解决方案。我们已经确定新的数字诊断技术作为一种替代方法，有可能将实验室带到患者身边，无论患者身在何处。这些技术可以改变 SSA 的医疗保健，特别是传染病方面的医疗保健。在手持设备中（通常是在微芯片表面）进行诊断测试，可以提供大型实验室中测试的准确性，但以快速、廉价和便携式的方式进行。通过传输实时数据，数字诊断还有可能改变传染病的监测。这将使预防和控制措施能够针对最需要的地方。
There is a large gap between diagnostic needs and diagnostic access across much of sub-Saharan Africa (SSA), particularly for infectious diseases that inflict a substantial burden of morbidity and mortality. Accurate diagnostics are essential for the correct treatment of individuals and provide vital information underpinning disease surveillance, prevention, and control strategies. Digital molecular diagnostics combine the high sensitivity and specificity of molecular detection with point-of-care format and mobile connectivity. Recent developments in these technologies create an opportunity for a radical transformation of the diagnostic ecosystem. Rather than trying to emulate diagnostic laboratory models in resource-rich settings, African countries have the potential to pioneer new models of healthcare designed around digital diagnostics. This article describes the need for new diagnostic approaches, highlights advances in digital molecular diagnostic technology, and outlines their potential for tackling infectious diseases in SSA. It then addresses the steps that will be necessary for the development and implementation of digital molecular diagnostics. Although the focus is on infectious diseases in SSA, many of the principles apply to other resource-limited settings and to noncommunicable diseases. Diagnostic tests are fundamental to the practice of modern medicine, underpinning correct diagnosis and treatment. There is a global disparity in access to diagnostic tests, and much of the population of sub-Saharan Africa (SSA) does not have access to essential tests. Consequently, there is also limited data on the true burden of many diseases in SSA. Diagnostic laboratories are expensive and complex to build, run and maintain, and so increasing the number of laboratories may not be the best solution. We have identified new digital diagnostic technologies as an alternative approach with potential to bring the laboratory to the patient, wherever they may be. These technologies could transform healthcare in SSA, particularly for infectious diseases. Conducting diagnostic tests in a handheld device, often on the surface of a microchip, then may provide the accuracy of tests in a large laboratory, but in a rapid, cheap, and portable format. By transmitting real-time data, digital diagnostics also have the potential to transform surveillance of infectious diseases. This will allow prevention and control measures to be targeted where they are most needed.