Emerging Evolutionary Changes From the Traditional Diagnostic Method to Point of Care Technology
POCT or Point of Care Testing is a medical testing that is done by the healthcare professional at or near the site of the patient care. These tests include blood and urine samples. The main aim of the POCT is to collect the specimen and give the result in a short period of time. They are usually performed in hospitals, clinics, general practitioner office or retail clinics. POCT helps in the treatment of the patient if any problem is detected.
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As per the technological advancement, the Point of care testing system has been expanded. Nowadays result can be transmitted wirelessly assisting the patient in visualizing the results more accurately. POC testing is a portable and convenient way to get better and productive results. Example, Glucose meters are used by the diabetic patients to monitor their glucose level. Blood analyzers are used to analyze the pathogens and anti- bodies present in the sample.
Points of care testing devices are selected as per the type of diagnosis that is required to be performed. These are very cost- effective methods for many diseases including diabetes, carpal tunnel syndrome and acute coronary syndrome. POC testing requires few drops of saliva, bloods and urine and results can be interpreted within seconds. They usually use basic dipsticks as with urinalysis, devices like glucose meters or molecular analyzers to detect infectious diseases. Blood glucose monitoring, home pregnancy tests, hemoglobin, fecal occult blood, rapid strep are some of the common point of care tests.
Points of care testing can provide results for several infectious diseases and have various advanced technology and lab equipment which assist in calculating the results within 5minutes. Few of the diseases and developments which took place in recent years include.
- Dengue fever– Dengue fever is a mosquito borne disease that is caused by the dengue virus. Dengue hemorrhagic fever and dengue shock syndrome are the two form of the disease. Symptoms which usually began four to six days after infections are high fever, headache, fatigue, nausea, skin rash, vomiting, joint and muscle pain, mild bleeding and pain behind the eyes. Incidence of dengue has increased in recent years; 40-50% of people are at risk for the disease in tropical, subtropical and temperate areas. With point of caring technology it is very easy to detect the disease and find the suitable treatment for it.
- In January 2015, The Institute of Bioengineering and Nanotechnology (IBN) of A*STAR launched a paper based disposable device which will help the people to detect dengue within 20 minutes. The disease can be detected through the saliva.
- Enteric Disease- This disease is caused by an intestinal infection. These enteric pathogens enter via mouth through water, food or hands. Salmonella, E. coli, Campylobacter, Norovirus, Rotavirus, Giardia, Vibrio, Cyclospora, Listeris are the major pathogens that causes enteric diseases. Every year thousands of deaths and millions of cases of foodborne illness are registered worldwide.
- In July 2014, Trinity Biotech plc, announced the launch of its new Uni- Gold H. pylori Antigen point- of- care test. It is used for the diagnosis of Helicobacter pylori which is a bacterium found in the stomach, duodenum and hepatobiliary tract and causes problems like gastritis and ulcers. Uni- Gold H is a rapid test which will show result in 15 minutes.
- In December 2018, Becton, Dickson and Company announced the launch U.S. Food and Drug administration clearance of its BD MAX enteric viral panel. It will be used for the direct qualitative detection and differentiation of enteric viral pathogens which are responsible for the viral gastroenteritis.
- Giardiasis- Giardiasis is an infection caused in the small intestine which is caused by the small microscopic parasite called Giardia lamblia. It usually spreads when there is any contact with the infected person or by eating or drinking infected food or water. They are the most common cause for the waterborne diseases and its parasites are found in municipal water supplies, swimming pools, whirlpool spas, wells etc.
- In February 2012, Trinity Biotech plc announced that they filled FDA approval for its new point of care Uni- Gold Giardia Test. This device will detect the presence of the giardia cyst in just 15 minutes.
- In June 2011, Abaxis, Inc. announced the launch of their two new diagnostics tests in veterinary market, the VetScan Canine Parvovirus Rapid Test and VetScan Giardia Rapid Test.
- HIV- HIV stands for human immunodeficiency virus, which is the factor that causes AIDS. This virus destroys the white blood cell in the immune system which is called T- helper cell, and then these viruses make copy of them, which will damage and weaken the person’s immune system.
- In June 2018, Abbott announced the launch of its new point- of- care test for easy and accurate human immunodeficiency management called m- PIMA HIV -1/2 VL. This will display the result in just 70 minutes which will help them to find the treatment easily.
- In November 2018, Owen Mumford announced the launch of its rapid diagnostic HIV tests Simplitude Pro HIV with built- in safety lancet, blood collection and strip tests. It will help the patient to detect the problem easily and help them to get treatment on time and also reduces the risk of transmission.
- Epstein Barr Virus (EBV): EBV is also known as Human gammaherpesvirus 4, is the main factor which causes They usually spread through body fluids like saliva and is very common virus.
- In December 2018, Novacyt announced that they have received CE marking for its Genesis BK virus and Epstein – Barr virus diagnostic kits. They are designed for the post- transplantation and for the immunosuppressed patients. This new RT- PCR kit is based on Roche LightCycler 48 instruments and detects the viral DNA in blood plasma and urine.
- In June 2019, bioMerieux announced the launch of their VIDAS EBV for the detection of the Epstein – Barr virus. This testing device will provide the results in just 40 minutes and also helps in the detection of toxoplasmosis and cytomegalovirus infections.
- Malaria: Malaria is usually spread with a bite of Anopheles mosquito which carries plasmodium parasite. Whenever mosquito bites you these parasites are released into the bloodstream. Every year there are approximately 1 million deaths and around 300 million cases registered.
- In January 2019, ERADA announced the launch of their saliva- based diagnostic SMAART, Saliva- based Malaria Asymptomatic and Asexual Rapid Test. It is easy- to- use saliva test which will help in the early detection, treatment and prevention of the disease.
- In April 2017, Alere Inc, announced the launch of its Alere Malaria Ag P.f., which is a high- sensitivity rapid tests versus currently available malaria RDTs. It helps in the identification of individuals with low parasitemia
- Tuberculosis: TB is caused by bacteria called Mycobacterium tuberculosis which usually damage lungs and can also damage other parts of the body. It usually spreads when the person with TB coughs, sneezes or talks.
- In October 2018, Becton, Dickson and Company announced the launch of BD MAX MDR- TB which can be used by the clinicians to detect bacteria that cause tuberculosis.
- In March 2017, EDCTP funded project was launched at Tygerberg campus of Stellenbosch university, PredictTB. It is a combination of microbiological and radiographic marker which will identify TB patient who are cured within 16 weeks of conventional therapy. This study will also develop a point- of care device which could be implemented in resource limited setting.
Thus with all the above studies it can be concluded that Point of Care Test plays a vital role in the decision making process in the field of diagnosis. POCT focuses mainly in providing a laboratory testing outside the main laboratory testing space. So, some of the benefits of POCT includes-
- Efficiency: POCT uses efficient work flow process as it is done beside or close location of the patient care.
- Speed Diagnosis: It gives the result rapidly due to which the treatment can be done in short period.
- Portable Devices: The test can be conducted anywhere as they are easy to carry anywhere.
- Patient Management: They give immediate results which help the doctors to handle more patients in fewer time frames.