Revolutionizing Tropical Medicine

A comprehensive resource describing innovative technologies and digital health tools that can revolutionize the delivery of health care in low- to middle-income countries, particularly in remote rural impoverished communities

Revolutionizing Tropical Medicine offers an up-to-date guide for healthcare and other professionals working in low-resource countries where access to health care facilities for diagnosis and treatment is challenging. Rather than suggesting the expensive solution of building new bricks and mortar clinics and hospitals and increasing the number of doctors and nurses in these deprived areas, the authors propose a complete change of mindset. They outline a number of ideas for improving healthcare including rapid diagnostic testing for infectious and non-infectious diseases at a point-of-care facility, together with low cost portable imaging devices. In addition, the authors recommend a change in the way in which health care is delivered. This approach requires task-shifting within the healthcare provision system so that nurses, laboratory technicians, pharmacists and others are trained in the newly available technologies, thus enabling faster and more appropriate triage for people requiring medical treatment.

This text:

    Describes the current burden of communicable and non-communicable diseases in low- to middle-income countries throughout the world
    Describes the major advances in healthcare outcomes in low-to middle-income countries derived from implementation of the United Nations/World Health Organisation’s 2000 Millennium Development Goals
    Provides a review of inexpensive rapid diagnostic point-of-care tests for infectious diseases in low-resource countries, particularly for people living in remote rural areas
    Provides a review of other rapid point-of-care services for assessing hematological function, biochemical function, renal function, hepatic function and status including hepatitis, acid-base balance, sickle cell disease, severe acute malnutrition and spirometry
    Explores the use of low-cost portable imaging devices for use in remote rural areas including a novel method of examining the optic fundus using a smartphone and the extensive value of portable ultrasound scanning when x-ray facilities are not available
    Describes the use of telemedicine in the clinical management of both children and adults in remote rural settings
    Looks to the future of clinical management in remote impoverished rural settings using nucleic acid identification of pathogens, the use of nanoparticles for water purification, the use of drones, the use of pulse oximetry and the use of near-infrared spectroscopy
    Finally, it assesses the potential for future healthcare improvement in impoverished areas and how the United Nations/World Health Organization 2015 Sustainable Development Goals are approaching this.

Written for physicians, infectious disease specialists, pathologists, radiologists, nurses, pharmacists and other health care workers, as well as government healthcare managers, Revolutionizing Tropical Medicine is a new up-to-date essential and realistic guide to treating and diagnosing patients in low-resource tropical countries based on new technologies.

 Table of contents

Section 1. The health of low- to middle-income countries today

1. The burden of communicable diseases in low- to middle-income countries today
Kerry Atkinson and David Mabey

2. The burden of non-communicable diseases in low- to middle-income countries today
Heiner Grosskurth

Section 2. How to improve health care in low- to middle-income countries by primary point-of-care rapid diagnostic testing

3. The optimal features of a rapid point-of-care diagnostic test
David Mabey and Rosanna Peeling

4. Revolutionizing HIV healthcare delivery through rapid and point-of-care testing
Catherine J. Wedderburn, Debrah I. Boeras and Rosanna W. Peeling

5. Rapid point-of-care diagnostic tests for tuberculosis
Richard Lessells

6. Rapid diagnostic tests for syphilis
David Mabey, Michael Marks and Rosanna Peeling

7. Point-of-care and near-point-of-care diagnostic tests for malaria: light microscopy, rapid antigen-detecting tests and nucleic acid amplification assays
Heidi Hopkins and Jane Cunningham

8. Rapid diagnostic tests for human African trypanosomiasis
Veerle Legon, Epco Hasker and Philippe Büscher

9. Rapid diagnostic tests for visceral leishmaniasis
Marleen Boelaert, Suman Rijal and François Chappuis

10.A rapid diagnostic test for dengue
Claire Mullender and James Whitehorn

11. Rapid diagnostic tests for influenza
A.C. Hurt and I.G. Barr

12. A rapid diagnostic test for Ebola virus disease
Catherine Houlihan and Colin Brown

13. Rapid diagnostic tests for yaws
Michael Marks

14. Rapid diagnostic tests for the detection of sickling hemoglobin
Amina Nardo-Marino and Thomas N. Williams

15. Progress toward the development of rapid diagnostic tests for lymphatic filariasis and onchocerciasis
Roger B. Peck, Dunia Faulx and Tala de los Santos

Section 3. Other tests that can be performed rapidly at the primary-point-of care

16. Point-of-care testing for blood counts, HbA1c, renal function,electrolytes, acid-base balance and hepatitis
Mark Shephard, Lara Motta, Brooke Spaeth, Heather Halls and Lauren Duckworth

17. Microscopy skills: cell counts, Gram stains and blood films
Michael Harrison

18. India ink stain and cryptococcal antigen test for cryptococcal infection
Hannah K. Mitchell, Joseph N. Jarvis and Mark W. Tenforde

19. Mid upper arm circumference tapes for assessment of severe acute malnutrition
Jane Crawley, Martha Mwangome, James Berkley and André Briend

20. Spirometry for chronic obstructive pulmonary disease due to inhalation of smoke from indoor fires used for cooking and heating
Janet G. Shaw1, Annalicia Vaughan1, Emma Smith, Cai Fong, Svetlana Stevanovic and Ian A.Yang

21. Point-of-care pulse oximetry for children in low-resource Settings
Carina King, Hamish Graham and Eric D. McCollum

22. The use of near-infrared spectroscopy to monitor tissue oxygenation, metabolism and injury in low resource settings
Gemma Bale and Ilias Tachtsidis

Section 4. Cheap imaging technologies

23. The use of point-of-care ultrasound in the resource-limited setting
Tom Heller, Michaëla AM Huson, Sabine Bélard, Dan Kaminstein and Elizabeth Joekes

24. The use of obstetric ultrasound in low resource settings
Helen Allott

25. Examining the optic fundus and assessing visual acuity and visual fields using mobile technology
Nigel M Bolster and Andrew Bastawrous

Section 5. Telemedicine

26. Telemedicine for clinical management of adults in remote and rural areas
Farhad Fatehi, Monica Taylor, Liam J. Caffery and Anthony C. Smith

27. Telemedicine for the delivery of specialist pediatric services
Anthony C Smith, Monica Taylor, Farhad Fetehi and Liam J Caffery

28. Telemedicine in the diagnosis and management of skin diseases
Giselle Prado, Odinaka Anyanwu and Carrie Kovarik

29. Digital technology, including telemedicine, in the management of  mental illness
John A Naslund, Sophia M. Bartels and Lisa A.Marsch

30. The use of mobile chest x-rays for tuberculosis telemedicine
Meghan L. Jardon, Kelsey L. Pomykala, Ishita Desai, Kara-Lee Pool

Section 6. The future

31. An introduction to digital health
Kerry Atkinson

32. Digital health in low and middle income countries
Martin Seneviratne

33. Nucleic acid detection of tuberculosis via innovative point-of- care nanotechnologies targeted for low resource settings
Benjamin Y.C.Eugene J.H. Wee, Nicholas P. West and Matt Trau1

34. The use of functional nanoparticles for water purification
Jing Zhang, Chuanping Feng, and Chengzhong Yu

35. The use of drones in the delivery of rural healthcare
Debrah I. Boeras, Blanche C. Collins and Rosanna W. Peeling

36. Implementation of point-of-care tests: lessons learnt
Rosanna W. Peeling and Debrah I. Boeras

37. Useful electronic health care resources available for those working in remote settings
Tyler Evans

38. The future – how do we get from here to there?
Kerry Atkinson and David Mabey

KERRY ATKINSON is an Honorary Professor at the University of Queensland Centre for Clinical Research in Brisbane, Australia, and an Adjunct Professor in the Stem Cell Laboratories, Queensland University of Technology at the Translational Research Institute, Brisbane, Queensland, Australia. DAVID MABEY is Professor of Communicable Diseases at the London School of Hygiene and Tropical Medicine, London, UK. He is a physician specializing in infectious and tropical diseases.