By: Talent Ngandwe and Eva Tallaksen


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[LUSAKA] Improving people's access to tests for the major diseases of the developing world and making the tests more accurate could save hundreds of thousands of lives, say researchers.

Millions of people in developing countries die each year from illnesses that are preventable or treatable because the diagnostic tests are too expensive, complex or inefficient to use.

In Zambia, the government has not adopted new diagnostic tools — for instance for HIV/ AIDS — because of their high costs says James Simpungwe, head of clinical care and diagnostics at Zambia's health ministry.

Speaking to SciDev.Net, he said that Zambia has had to resort to old diagnostic tools, adding that industrialised countries are better placed to benefit from the latest methods.

A series of papers published in Nature yesterday (7 December) calls on scientists, policymakers, and global health organisations to work towards making these tests appropriate for use in poor countries.

The work is a result of a 2-year study by the Global Health Diagnostics Forum, a team of health and disease experts, technology developers and representatives of the diagnostics industry.

The team formed six working groups to study the impact of better diagnostic tests for acute lower respiratory infections, diarrhoeal diseases, HIV/AIDS, malaria, sexually transmitted infections and tuberculosis (TB) in developing countries.

They found that a test for malaria in children that was more accurate and needed little infrastructure, could avoid more than 100,000 child deaths and some 400 million unnecessary treatments every year.

The standard test for TB, say the researchers, misses half of all cases. An ideal diagnostic test for adults with a persistent cough could reduce deaths from TB by more than a third — saving 625,000 lives.

They say simplifying the current tests, and enhancing training for health workers, would make an impact on the death toll.

The studies take into account available resources and training capacities in poor countries, and examined outcomes across a range of healthcare settings, including those with no infrastructure.

The researchers were then able to predict how many lives could be saved if diagnostics were in place for each of the six diseases.  

They also identified one or two points along the path of disease progression where a diagnostic could have the greatest impact on health.

Ria Grant, head of TB Care Association, a non-governmental organisation dealing with TB detection and prevention in Cape Town, South Africa, enthusiastically welcomed the study. "TB diagnostic tests are terribly important in the entire process of TB control," she told SciDev.Net.

"We need something simple, cost-effective and accurate in detecting the disease," she said, adding that giving TB treatment to healthy people can increase drug resistance.

But equally important is the adequate training of people who collect the samples for testing from suspected patients, she said.

The team was convened by the Bill and Melinda Gates Foundation in partnership with the US-based RAND Corporation and commercial technology experts.