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现场即时检测和快速诊断在人道主义紧急情况中的应用。

Utility of Point of Care and Rapid Diagnostics in Humanitarian Emergencies.

机构信息

Department of Global Health, School of Public Health, University of Washington, Seattle, WA.

Department of Emergency Medicine, School of Medicine, University of Washington, Seattle, WA.

出版信息

J Appl Lab Med. 2021 Jan 12;6(1):236-246. doi: 10.1093/jalm/jfaa180.

Abstract

BACKGROUND

In 2019, there were 70.8 million forcibly displaced people worldwide. Among the top causes of morbidity and mortality were measles, diarrhea, respiratory illness, and malaria. Availability of accurate diagnostics that are of low complexity, affordable, and produce timely results on site without the need for expensive laboratory equipment, extensive training, or distant transport of samples, are essential tools in the response to humanitarian emergencies (HE). Early detection of infectious diseases with epidemic potential and coordinated outbreak response, can result in significant decrease in morbidity and mortality.

CONTENT

This review explores the utility of point of care and rapid diagnostic tests (POCT/RDTs) in HE and presents a review and analysis of the low complexity, availability, and ease of use of these diagnostic modalities that make them helpful tools in these settings, despite the generally lower test performance metrics associated with them over conventional laboratory-based assays. We review the literature to understand how POCT/RDTs have been used in HE response to produce lifesaving information without the need for a robust system for transporting test samples to more sophisticated laboratories, as this is often prohibitive in areas affected by conflict or natural disasters.

SUMMARY

We propose that POCT/RDTs be considered essential healthcare tools provided to countries following a HE and suggest that UN agencies and vulnerable countries include effective RDTs in their essential diagnostics as part of their national preparedness and response plans.

摘要

背景

2019 年,全球有 7080 万人被迫流离失所。发病率和死亡率最高的疾病包括麻疹、腹泻、呼吸道疾病和疟疾。在应对人道主义紧急情况(HE)时,拥有准确、复杂度低、负担得起且能在现场及时得出结果的诊断方法至关重要,而无需昂贵的实验室设备、广泛的培训或样本的远程运输。早期发现具有流行潜力的传染病,并进行协调的疫情应对,可以显著降低发病率和死亡率。

内容

本综述探讨了即时检测和快速诊断检测(POCT/RDTs)在 HE 中的应用,并对这些诊断方法的低复杂度、可用性和易用性进行了综述和分析,尽管与传统基于实验室的检测相比,它们的检测性能指标通常较低,但这些方法在这些环境中仍是有用的工具。我们回顾了文献,以了解 POCT/RDTs 如何在 HE 应对中被用于提供拯救生命的信息,而无需将测试样本运送到更复杂实验室的强大系统,因为在受冲突或自然灾害影响的地区,这通常是不可行的。

总结

我们提出将 POCT/RDTs 视为 HE 后向国家提供的基本医疗保健工具,并建议联合国机构和弱势国家将有效的 RDT 纳入其基本诊断检测中,作为其国家准备和应对计划的一部分。

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