Rapid Point of Diagnostics Testing and Imaging

793 Pages·2019·19.578 MB·English

by  Atkinson, Kerry, Mabey, David

Revolutionizing Tropical Medicine

Revolutionizing Tropical Medicine
Point‐of‐Care Tests, New Imaging Technologies and Digital Health
Edited by
Kerry Atkinson
University of Queensland Centre for Clinical Research,
Brisbane, Australia and the University of Technology/ Institute of Health
and Biomedical Innovation, Brisbane, Australia
David Mabey
London School of Hygiene and Tropical Medicine, London, UK
This edition first published 2019
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“The wounded surgeon plies the steel
That questions the distempered part;
Beneath the bleeding hands we feel
The sharp compassion of the healer’s art
Resolving the enigma of the fever chart.”
Four Quartets. IV. East Coker
T.S. Eliot, Nobel Laureate in Literature, 1948.

vii
Contents
Editor’s Preface xxix
List of Contributors xxxi
Part I The Health of Low‐ and Middle‐Income Countries Today 1
1 The Burden of Communicable Diseases in Low‐ and 
Middle‐Income Countries 3
Kerry Atkinson and David Mabey
1.1 Introduction 4
1.2 Definition of a Communicable Disease 4
1.3 Definition of Low‐ to Middle‐Income Countries 4
1.4 Definition of Burden of Disease 5
1.4.1 Disability‐Adjusted Life Years 5
1.5 Definition of Disease Elimination 7
1.6 Definition of Disease Eradication 7
1.7 Definition of the Primary Point‐of‐Care 7
1.8 The 2000 Millennium Development Goals (MDGs) and Their Outcomes 7
1.9 Major Individual Diseases in the LMICs:
The Big Three ‐ Malaria, HIV/AIDS and Tuberculosis 9
1.9.1 Malaria 9
1.9.2 HIV/AIDS 10
1.9.3 Tuberculosis (TB) 11
1.9.3.1 Multidrug‐Resistant Tuberculosis 15
1.9.3.2 Extensively Drug‐Resistant TB (XDR‐TB) 17
1.9.3.3 The Co‐epidemics of TB and HIV/AIDS 17
1.10 Other Important Communicable Diseases in the LMICs 17
1.10.1 Lower Respiratory Tract Infections 24
1.10.1.1 WHO 24
1.10.1.2 Data Sources and Analysis 24
1.10.1.3 Global Burden of Disease Collaborators, 2016 27
1.10.2 Diarrheal Diseases 28
1.10.3 Meningitis 28
1.10.4 Sexually Transmitted Diseases (Excluding HIV/AIDS) 28
1.10.5 Hepatitis 28
1.10.6 Measles 28
viii Contents
1.10.7 Whooping Cough (Pertussis) 28
1.10.8 Tetanus 29
1.10.9 Yellow Fever 29
1.11 Neglected Tropical Disease (NTDs) Prioritized by the World Health
Organisation 29
1.12 A Comparison of Health Metrics in an LMIC (Papua New Guinea)
and a Developed Country (Australia) with a 7 km Distance Between
them 31
1.13 Conclusions 32
Bibliography 32
Webliography 35
2 The Burden of Non‐communicable Diseases in Low‐ and Middle‐Income
Countries 37
Heiner Grosskurth
2.1 Introduction 38
2.2 Common Non‐communicable Diseases in Low- and Middle-Income
Countries 38
2.3 NCD Epidemiology 38
2.3.1 Arterial Hypertension and Cardiovascular Diseases 39
2.3.2 Diabetes Mellitus 40
2.3.3 The Metabolic Syndrome 41
2.3.4 Chronic Kidney Disease 41
2.3.5 Chronic Obstructive Pulmonary Disease (COPD) 41
2.3.6 Asthma 42
2.3.7 Cancer 43
2.4 Prevention of Non‐communicable Diseases 44
2.5 The Relationship Between Communicable and Non‐communicable
Diseases 44
2.6 The Health System Burden of NCDs 46
2.7 The Economic Impact of NCDs 47
2.7.1 The Patient’s Perspective 47
2.7.2 The Provider’s Perspective 47
2.7.3 Macroeconomic Effects 48
2.8 The Response to the NCD Epidemic in LMICs 48
2.8.1 Response at the International Level 48
2.8.2 Response at the National Level 49
2.8.3 Response by the Private Sector 50
2.9 The Readiness of Primary Healthcare Services in LMICs to Cope
with the NCD Burden 50
2.10 Introducing Effective NCD Control at Primary Care Services:
A Practical Approach 52
2.10.1 Raising NCD Awareness Within the Health Services 52
2.10.2 Training Healthcare Workers 52
2.10.3 Conducting Support Supervision 53
2.10.4 Providing Essential Diagnostic Equipment and Tests 64
2.10.5 Ensuring a Reliable Supply of Essential NCD Drugs 64
2.10.6 Introducing Standardized NCD Case Management Algorithms 65