Abstract
Background:Short-term, primary care medical service trips (MSTs) frequently use inexpensive, portable point of care (POC) tests to guide diagnosis and treatment of patients in low-resource settings. However, the degree to which different POC tests are carried by organizations serving remote communities is currently unknown.Objective:The aim of this study was to determine the prevalence of various POC tests used by MST-sending organizations operating in Latin America.Methods:We surveyed 166 organizations operating mobile MSTs in Latin America and the Caribbean on the types of POC tests carried on their brigades.Findings:Forty-eight organizations responded (response rate: 28.9%). The most commonly carried tests were glucometers (40/48; 83.3%), urine dipsticks (31/48; 77.1%), and urine pregnancy tests (32/48; 66.7%). Fewer groups carried hemoglobinometers (16/48; 33.3%), malaria diagnostic tests (18/48; 37.5%), tests for sexually transmitted infection (8/48; 16.7%), or portable ultrasound (19/48; 40.0%).Conclusions:These tests may be useful for field diagnosis, but clinicians should understand the performance limitations of each test compared to its gold standard. When combined with knowledge of local epidemiology, these exploratory results will be useful in resource planning, guidelines development for MSTs, and in establishing minimum recommendations for diagnostic resources that should be available on MSTs.
Highlights
The prevalence of primary care medical service trips (MSTs) operating in low- and middle-income countries (LMICs) abroad has increased dramatically in recent years [1, 2], and Latin America is a common destination
The purpose of this study is to describe the prevalence of common point of care (POC) tests carried by primary care mobile MSTs serving Latin America and the Caribbean (LAC), and possible associations between type of tests carried and the characteristics of the MSTs themselves
The search resulted in 166 MST-sending organizations operating short-term primary care mobile clinics in LAC
Summary
The prevalence of primary care medical service trips (MSTs) operating in low- and middle-income countries (LMICs) abroad has increased dramatically in recent years [1, 2], and Latin America is a common destination. The logistics and cost of transporting diagnostic supplies and equipment between remote clinic sites mean that organizations operating such trips are generally limited to use of inexpensive, portable point of care (POC) tests that provide immediate results to inform treatment decisions [3, 4]. Common examples include urine dipstick testing for the diagnosis of urinary tract infection (UTI), hyperglycemia, or proteinuria; glucometer testing for diabetes; qualitative urine pregnancy tests; and use of a hemoglobinometer for obtaining a hemoglobin. These tests may replace gold standard laboratory methods while practicing in remote settings. Short-term, primary care medical service trips (MSTs) frequently use inexpensive, portable point of care (POC) tests to guide diagnosis and treatment of patients in low-resource settings. When combined with knowledge of local epidemiology, these exploratory results will be useful in resource planning, guidelines development for MSTs, and in establishing minimum recommendations for diagnostic resources that should be available on MSTs
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