{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T03:53:25Z","timestamp":1790740405353,"version":"4.1.0"},"reference-count":43,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2022,1,7]],"date-time":"2022-01-07T00:00:00Z","timestamp":1641513600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Unitaid"},{"DOI":"10.13039\/100000865","name":"Bill and Melinda Gates Foundation","doi-asserted-by":"publisher","award":["OPP1214435"],"award-info":[{"award-number":["OPP1214435"]}],"id":[{"id":"10.13039\/100000865","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,9,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Testing programs for severe acute respiratory syndrome coronavirus 2 have relied on high-throughput polymerase chain reaction laboratory tests and rapid antigen assays to meet diagnostic needs. Both technologies are essential; however, issues of cost, accessibility, manufacturing delays, and performance have limited their use in low-resource settings and contributed to the global inequity in coronavirus disease 2019 testing. Emerging low-cost, multidisease point-of-care nucleic acid tests may address these limitations and strengthen pandemic preparedness, especially within primary healthcare where most cases of disease first present. Widespread deployment of these novel technologies will also help close long-standing test access gaps for other diseases, including tuberculosis, human immunodeficiency virus, cervical cancer, viral hepatitis, and sexually transmitted infections. We propose a more optimized testing framework based on greater use of point-of-care nucleic acid tests together with rapid immunologic assays and high-throughput laboratory molecular tests to improve the diagnosis of priority endemic and epidemic diseases, as well as strengthen the overall delivery of primary healthcare services.<\/jats:p>","DOI":"10.1093\/cid\/ciac013","type":"journal-article","created":{"date-parts":[[2022,1,5]],"date-time":"2022-01-05T20:14:31Z","timestamp":1641413671000},"page":"723-728","source":"Crossref","is-referenced-by-count":43,"title":["Nucleic Acid Point-of-Care Testing to Improve Diagnostic Preparedness"],"prefix":"10.1093","volume":"75","author":[{"given":"Ilesh V","family":"Jani","sequence":"first","affiliation":[{"name":"Instituto Nacional da Sa\u00fade , Marracuene , Mozambique"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Trevor F","family":"Peter","sequence":"additional","affiliation":[{"name":"Clinton Health Access Initiative , Boston, Massachusetts , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2022,1,7]]},"reference":[{"key":"2022091018192666200_CIT0001","author":"Hannay","year":"2021"},{"key":"2022091018192666200_CIT0002","doi-asserted-by":"crossref","first-page":"345","DOI":"10.1038\/s41597-020-00688-8","article-title":"A cross-country database of COVID-19 testing","volume":"7","author":"Hasell","year":"2020","journal-title":"Sci Data"},{"key":"2022091018192666200_CIT0003","author":"World Health Organization"},{"key":"2022091018192666200_CIT0004","doi-asserted-by":"crossref","first-page":"565","DOI":"10.1038\/d41586-020-01265-0","article-title":"Let Africa into the market for COVID-19 diagnostics.","volume":"580","author":"Nkengasong","year":"2020","journal-title":"Nature"},{"key":"2022091018192666200_CIT0005","doi-asserted-by":"crossref","first-page":"e103","DOI":"10.1016\/S2666-5247(20)30068-9","article-title":"COVID-19 testing in Africa: lessons learnt.","volume":"1","author":"Ondoa","year":"2020","journal-title":"Lancet Microbe"},{"key":"2022091018192666200_CIT0006","doi-asserted-by":"crossref","first-page":"380","DOI":"10.1186\/s12913-018-3207-6","article-title":"Operational assessment of point-of-care diagnostics in primary healthcare clinics of KwaZulu-Natal, South Africa: a cross-sectional survey.","volume":"18","author":"Mashamba-Thompson","year":"2018","journal-title":"BMC Health Serv Res"},{"key":"2022091018192666200_CIT0007","volume-title":"Official hCoV-19 Reference Sequence","author":"GISAID."},{"key":"2022091018192666200_CIT0008","doi-asserted-by":"crossref","first-page":"811","DOI":"10.1097\/EDE.0000000000001400","article-title":"Antigen-based rapid testing or alternatives for diagnosis of symptomatic COVID-19: a simulation based net benefit analysis.","volume":"32","author":"Kendall","year":"2021","journal-title":"Epidemiology"},{"key":"2022091018192666200_CIT0009","doi-asserted-by":"crossref","first-page":"1534","DOI":"10.1093\/cid\/ciab683","article-title":"Improvements in severe acute respiratory syndrome coronavirus 2 testing cascade in the United States: data from serial cross-sectional assessments","volume":"74","author":"Clipman","year":"2022","journal-title":"Clin Infect Dis"},{"key":"2022091018192666200_CIT0010","doi-asserted-by":"crossref","first-page":"71","DOI":"10.4314\/gmj.v54i4s.11","article-title":"Diagnostics for COVID-19: a case for field- deployable, rapid molecular tests for community surveillance.","volume":"54","author":"Frimpong","year":"2020","journal-title":"Ghana Med J"},{"key":"2022091018192666200_CIT0011","doi-asserted-by":"crossref","first-page":"e78609","DOI":"10.1371\/journal.pone.0078609","article-title":"Uganda\u2019s new national laboratory sample transport system: a successful model for improving access to diagnostic services for early infant HIV diagnosis and other programs.","volume":"8","author":"Kiyaga","year":"2013","journal-title":"PLoS One"},{"key":"2022091018192666200_CIT0012","doi-asserted-by":"crossref","first-page":"1453","DOI":"10.1097\/QAD.0000000000001846","article-title":"Effect of point-of-care early infant diagnosis on antiretroviral therapy initiation and retention of patients.","volume":"32","author":"Jani","year":"2018","journal-title":"AIDS"},{"key":"2022091018192666200_CIT0013","doi-asserted-by":"crossref","first-page":"e0155256","DOI":"10.1371\/journal.pone.0155256","article-title":"POC CD4 testing improves linkage to HIV care and timeliness of ART initiation in a public health approach: a systematic review and meta-analysis.","volume":"11","author":"Vojnov","year":"2016","journal-title":"PLoS One"},{"key":"2022091018192666200_CIT0014","author":"World Health Organization"},{"key":"2022091018192666200_CIT0015","author":"World Health Organization"},{"key":"2022091018192666200_CIT0016","author":"World Health Organization","year":"2021"},{"key":"2022091018192666200_CIT0017","author":"World Health Organization"},{"key":"2022091018192666200_CIT0018","first-page":"CD013705","article-title":"Rapid, point-of-care antigen and molecular-based tests for diagnosis of SARS-CoV-2 infection.","volume":"3","author":"Dinnes","year":"2021","journal-title":"Cochrane Database Syst Rev"},{"key":"2022091018192666200_CIT0019","author":"CHAI Analysis","year":"2021"},{"key":"2022091018192666200_CIT0020","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1016\/j.plabm.2015.12.002","article-title":"Practical challenges related to point of care testing.","volume":"4","author":"Shaw","year":"2015","journal-title":"Pract Lab Med"},{"key":"2022091018192666200_CIT0021","doi-asserted-by":"crossref","first-page":"e00097","DOI":"10.1128\/CMR.00097-18","article-title":"Point-of-care HIV viral load testing: an essential tool for a sustainable global HIV\/AIDS response.","volume":"32","author":"Drain","year":"2019","journal-title":"Clin Microbiol Rev"},{"key":"2022091018192666200_CIT0022","doi-asserted-by":"crossref","first-page":"e0223669","DOI":"10.1371\/journal.pone.0223669","article-title":"Comparative cost analysis of point-of-care versus laboratory-based testing to initiate and monitor HIV treatment in South Africa.","volume":"14","author":"Simeon","year":"2019","journal-title":"PLoS One"},{"key":"2022091018192666200_CIT0023","doi-asserted-by":"crossref","first-page":"175","DOI":"10.1097\/COH.0000000000000351","article-title":"Point-of-care diagnostics: extending the laboratory network to reach the last mile.","volume":"12","author":"Drain","year":"2017","journal-title":"Curr Opin HIV AIDS"},{"key":"2022091018192666200_CIT0024","doi-asserted-by":"crossref","first-page":"e0211498","DOI":"10.1371\/journal.pone.0211498","article-title":"Poor supply chain management and stock-outs of point-of-care diagnostic tests in Upper East Region\u2019s primary healthcare clinics, Ghana.","volume":"14","author":"Kuupiel","year":"2019","journal-title":"PLoS One"},{"key":"2022091018192666200_CIT0025","author":"World Health Organization ACT-Accelerator"},{"key":"2022091018192666200_CIT0026","author":"National Institutes of Health"},{"key":"2022091018192666200_CIT0027","first-page":"S1286","article-title":"Availability of essential diagnostics at primary care public clinics in Peru.","author":"S\u00e1nchez-S\u00e1nchez","year":"2020","journal-title":"Microbes Infect"},{"key":"2022091018192666200_CIT0028","doi-asserted-by":"crossref","first-page":"e191","DOI":"10.1016\/S2214-109X(18)30458-3","article-title":"Effect of Xpert MTB\/RIF on clinical outcomes in routine care settings: individual patient data meta-analysis.","volume":"7","author":"Di Tanna","year":"2019","journal-title":"Lancet Glob Health"},{"key":"2022091018192666200_CIT0029","volume-title":"Updated recommendations on HIV prevention, infant diagnosis, antiretroviral initiation and monitoring: March 2021","author":"World Health Organization","year":"2021"},{"key":"2022091018192666200_CIT0030","author":"Joint United Nations Programme on HIV\/AIDS"},{"key":"2022091018192666200_CIT0031","author":"CHAI Analysis","year":"2021"},{"key":"2022091018192666200_CIT0032","author":"World Health Organization","year":"2018"},{"key":"2022091018192666200_CIT0033","author":"World Health Organization","year":"2020"},{"key":"2022091018192666200_CIT0034","doi-asserted-by":"crossref","first-page":"e132","DOI":"10.1371\/journal.pmed.0050132","article-title":"Coverage of cervical cancer screening in 57 countries: low average levels and large inequalities.","volume":"5","author":"Gakidou","year":"2008","journal-title":"PLoS Med"},{"key":"2022091018192666200_CIT0035","author":"World Health Organization","year":"2020"},{"key":"2022091018192666200_CIT0036","doi-asserted-by":"crossref","first-page":"e0193577","DOI":"10.1371\/journal.pone.0193577","article-title":"Multidisease testing for HIV and TB using the GeneXpert platform: a feasibility study in rural Zimbabwe.","volume":"13","author":"Ndlovu","year":"2018","journal-title":"PLoS One"},{"key":"2022091018192666200_CIT0037","volume-title":"The potential impact of Covid-19 on tuberculosis in high burden countries: a modeling analysis","author":"Stop TB Partnership","year":"2020"},{"key":"2022091018192666200_CIT0038","doi-asserted-by":"crossref","first-page":"e25008","DOI":"10.1002\/jia2.25008","article-title":"Scaling up HIV viral load\u2014lessons from the large-scale implementation of HIV early infant diagnosis and CD4 testing.","volume":"20","author":"Peter","year":"2017","journal-title":"J Int AIDS Soc"},{"key":"2022091018192666200_CIT0039","doi-asserted-by":"crossref","first-page":"S119","DOI":"10.1093\/cid\/civ552","article-title":"Implementation of HIV and tuberculosis diagnostics: the importance of context.","volume":"61","author":"Dominique","year":"2015","journal-title":"Clin Infect Dis"},{"key":"2022091018192666200_CIT0040","author":"CHAI Analysis","year":"2021"},{"key":"2022091018192666200_CIT0041","author":"DHIS2","year":"2021"},{"key":"2022091018192666200_CIT0042","doi-asserted-by":"crossref","first-page":"233","DOI":"10.1186\/s12911-021-01600-z","article-title":"Connected diagnostics to improve accurate diagnosis, treatment, and conditional payment of malaria services in Kenya.","volume":"21","author":"van Duijn","year":"2021","journal-title":"BMC Med Inform Decis Mak"},{"key":"2022091018192666200_CIT0043","doi-asserted-by":"crossref","first-page":"320","DOI":"10.1186\/s12879-020-4932-0","article-title":"Continuous quality monitoring in the field: an evaluation of the performance of the Fio Deki Reader for rapid HIV testing in South Africa.","volume":"20","author":"Noble","year":"2020","journal-title":"BMC Infect Dis"}],"container-title":["Clinical Infectious Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/cid\/advance-article-pdf\/doi\/10.1093\/cid\/ciac013\/42494508\/ciac013.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/cid\/article-pdf\/75\/4\/723\/45787139\/ciac013.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/cid\/article-pdf\/75\/4\/723\/45787139\/ciac013.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,9,10]],"date-time":"2022-09-10T18:21:22Z","timestamp":1662834082000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/cid\/article\/75\/4\/723\/6500010"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,1,7]]},"references-count":43,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2022,1,7]]},"published-print":{"date-parts":[[2022,9,10]]}},"URL":"https:\/\/doi.org\/10.1093\/cid\/ciac013","relation":{},"ISSN":["1058-4838","1537-6591"],"issn-type":[{"value":"1058-4838","type":"print"},{"value":"1537-6591","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2022,8,15]]},"published":{"date-parts":[[2022,1,7]]}}}