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Revolutionizing Tropical Medicine


Revolutionizing Tropical Medicine

Point-of-Care Tests, New Imaging Technologies and Digital Health
1. Aufl.

von: Kerry Atkinson, David Mabey

197,99 €

Verlag: Wiley-Blackwell
Format: PDF
Veröffentl.: 23.05.2019
ISBN/EAN: 9781119282655
Sprache: englisch
Anzahl Seiten: 768

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Beschreibungen

<p><b>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</b><b> </b></p> <p><i>Revolutionizing Tropical Medicine</i> 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.</p> <p>This text:</p> <ul> <li>Describes the current burden of communicable and non-communicable diseases in low- to middle-income countries throughout the world</li> <li>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</li> <li>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</li> <li>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</li> <li>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</li> <li>Describes the use of telemedicine in the clinical management of both children and adults in remote rural settings</li> <li>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</li> <li>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.</li> </ul> <p>Written for physicians, infectious disease specialists, pathologists, radiologists, nurses, pharmacists and other health care workers, as well as government healthcare managers, Revolutionizing<i> Tropical Medicine</i> is a new up-to-date essential and realistic guide to treating and diagnosing patients in low-resource tropical countries based on new technologies.</p>
<p><b>Part I The Health of Low‐ and Middle‐Income Countries Today 1</b></p> <p><b>1 The Burden of Communicable Diseases in Low‐ and Middle‐Income Countries 3<br /></b><i>Kerry Atkinson and David Mabey</i></p> <p>1.1 Introduction 4</p> <p>1.2 Definition of a Communicable Disease 4</p> <p>1.3 Definition of Low‐ to Middle‐Income Countries 4</p> <p>1.4 Definition of Burden of Disease 5</p> <p>1.5 Definition of Disease Elimination 7</p> <p>1.6 Definition of Disease Eradication 7</p> <p>1.7 Definition of the Primary Point‐of‐Care 7</p> <p>1.8 The 2000 Millennium Development Goals (MDGs) and Their Outcomes 7</p> <p>1.9 Major Individual Diseases in the LMICs: The Big Three ‐ Malaria, HIV/AIDS and Tuberculosis 9</p> <p>1.10 Other Important Communicable Diseases in the LMICs 17</p> <p>1.11 Neglected Tropical Disease (NTDs) Prioritized by the World Health Organisation 29</p> <p>1.12 A Comparison of Health Metrics in an LMIC (Papua New Guinea) and a Developed Country (Australia) with a 7 km Distance Between them 31</p> <p>1.13 Conclusions 32</p> <p>Bibliography 32</p> <p>Webliography 35</p> <p><b>2 The Burden of Non‐communicable Diseases in Low‐ and Middle‐Income Countries 37<br /></b><i>Heiner Grosskurth</i></p> <p>2.1 Introduction 38</p> <p>2.2 Common Non‐communicable Diseases in Low- and Middle-Income Countries 38</p> <p>2.3 NCD Epidemiology 38</p> <p>2.4 Prevention of Non‐communicable Diseases 44</p> <p>2.5 The Relationship Between Communicable and Non‐communicable Diseases 44</p> <p>2.6 The Health System Burden of NCDs 46</p> <p>2.7 The Economic Impact of NCDs 47</p> <p>2.8 The Response to the NCD Epidemic in LMICs 48</p> <p>2.9 The Readiness of Primary Healthcare Services in LMICs to Cope with the NCD Burden 50</p> <p>2.10 Introducing Effective NCD Control at Primary Care Services: A Practical Approach 52</p> <p>2.11 The Role of Primary Healthcare Services in Cancer Prevention and Care 67</p> <p>2.12 Evaluating Programmes to Strengthen NCD Services at Primary Care Level 70</p> <p>2.13 Conclusions 70</p> <p>Bibliography 70</p> <p>Webliography 78</p> <p><b>Part II How to improve healthcare in low‐ and middle‐income countries by primary point‐of‐care rapid diagnostic testing 81</b></p> <p><b>3 The Optimal Features of a Rapid Point-of-Care Diagnostic Test 83<br /></b><i>David Mabey and Rosanna Peeling</i></p> <p>3.1 Introduction 83</p> <p>3.2 Accuracy Versus Accessibility 83</p> <p>3.3 Quality Assurance 84</p> <p>3.4 The Importance of Connectivity 85</p> <p>3.5 Environmental Friendliness 86</p> <p>References 86</p> <p>Webliography 87</p> <p><b>4 Revolutionizing HIV Healthcare Delivery Through Rapid and Point‐of‐Care Testing 88<br /></b><i>Catherine J. Wedderburn, Debrah I. Boeras, and Rosanna W. Peeling</i></p> <p>4.1 Synopsis 88</p> <p>4.2 Introduction 89</p> <p>4.3 Diagnostic Tests in Resource‐Limited Settings 89</p> <p>4.4 Challenges of Using Rapid and Point‐of‐Care Testing Within the Context of the Healthcare System 92</p> <p>4.5 Recent Advances in HIV Diagnosis and Monitoring and Their Impact 93</p> <p>4.6 WHO Recommendations: POC Diagnostics for Achieving the 90‐90‐90 Goals 98</p> <p>4.7 Remaining Challenges – Human Resources, Quality Assurance, and Test Selection and Placement 98</p> <p>4.8 Moving Forward 99</p> <p>4.9 Conclusions 100</p> <p>Bibliography 101</p> <p>Webliography 103</p> <p><b>5 Rapid Point‐of‐Care Diagnostic Tests for Tuberculosis 105<br /></b><i>Richard Lessells</i></p> <p>5.1 Introduction 105</p> <p>5.2 The Need for Rapid Point‐of‐Care TB Diagnostic Tests 106</p> <p>5.3 Weaknesses in the TB Diagnostic Cascade 106</p> <p>5.4 Potential Impact of Rapid Point‐of‐Care Diagnostic Tests 107</p> <p>5.5 Defining the Diagnostic Needs 107</p> <p>5.6 Smear Microscopy 107</p> <p>5.7 Molecular Diagnostic Tests 109</p> <p>5.8 Loop‐Mediated Isothermal Amplification (LAMP) 112</p> <p>5.9 Line Probe Assays 113</p> <p>5.10 Other Molecular Tests 113</p> <p>5.11 Antigen Tests 114</p> <p>5.12 Combination Diagnostic Packages 115</p> <p>5.13 Next Generation Sequencing 117</p> <p>5.14 Diagnostic Imaging 117</p> <p>5.15 Other Diagnostics 118</p> <p>5.16 Conclusions 118</p> <p>References 119</p> <p><b>6 Rapid Diagnostic Tests for Syphilis 126<br /></b><i>David Mabey, Michael Marks, and Rosanna W. Peeling</i></p> <p>6.1 Introduction 126</p> <p>6.2 The Diagnosis of Syphilis 129</p> <p>6.3 The Impact of POC Testing for Syphilis 131</p> <p>6.4 Challenges in the Implementation of POC Testing 133</p> <p>6.5 The Future 134</p> <p>References 134</p> <p><b>7 Point‐of‐Care and Near‐Point‐of‐Care Diagnostic Tests for Malaria: Light Microscopy, Rapid Antigen‐Detecting Tests and Nucleic Acid Amplification Assays 137<br /></b><i>Heidi Hopkins, and Jane Cunningham</i></p> <p>7.1 Introduction 137</p> <p>7.2 Diagnosis of Malaria 138</p> <p>7.3 Light Microscopy of Blood Smears 139</p> <p>7.4 Rapid Diagnostic Tests for Malaria (mRDTs) 140</p> <p>7.5 Nucleic Acid Amplification‐Based Tests (NAATs) for Malaria 142</p> <p>7.6 Impact of Point‐of‐Care Testing for Malaria 143</p> <p>7.7 Challenges in Implementation of POC Testing for Malaria 144</p> <p>7.8 The Future 146</p> <p>Biblography 146</p> <p>Webliography 156</p> <p><b>8 Rapid Diagnostic Tests for Human African Trypanosomiasis 159<br /></b><i>Veerle Lejon, Epco Hasker, and Philippe Büscher</i></p> <p>8.1 Introduction 159</p> <p>8.2 The Early Introduction of Immunodiagnostic Tests in the Diagnosis of HAT 160</p> <p>8.3 CATT/T.b. gambiense: A Breakthrough in the Immunodiagnosis of Gambiense‐HAT 161</p> <p>8.4 The Changing Epidemiology of Gambiense‐HAT: The Need for Improved Rapid Diagnostic Tests 163</p> <p>8.5 Second Generation RDTs for HAT 165</p> <p>8.6 Future Perspectives and Challenges 165</p> <p>References 166</p> <p>Webliography 169</p> <p><b>9 Rapid Diagnostic Tests for Visceral Leishmaniasis 170<br /></b><i>Marleen Boelaert, Suman Rijal, and François Chappuis</i></p> <p>9.1 Introduction 170</p> <p>9.2 Parasitology, a Reference Standard? 171</p> <p>9.3 Serological Assays 172</p> <p>9.4 The First Serological Test for Field Use: The Direct Agglutination Assay 173</p> <p>9.5 The Early Development an Immunochromatographic Test Using the Recombinant Leishmania Antigen rK39 174</p> <p>9.6 Impact of the VL RDT 174</p> <p>9.7 Challenges 175</p> <p>9.8 Other Tests 175</p> <p>9.9 Discussion 176</p> <p>9.10 Conclusions 177</p> <p>References 177</p> <p><b>10 A Rapid Diagnostic Test for Dengue 181<br /></b><i>Claire Mullender, and James Whitehorn</i></p> <p>10.1 Introduction 181</p> <p>10.2 Clinical Features of Dengue 182</p> <p>10.3 The Importance of Making a Rapid Diagnosis 183</p> <p>10.4 The Host Response to Infection 184</p> <p>10.5 Existing Diagnostic Strategies 184</p> <p>10.6 Review of Existing Rapid Diagnostic Tests 186</p> <p>10.7 Future Directions 188</p> <p>10.8 Conclusions 188</p> <p>References 188</p> <p><b>11 Rapid Diagnostic Tests for Influenza 191<br /></b><i>A.C. Hurt, and I.G. Barr</i></p> <p>11.1 Introduction 191</p> <p>11.2 Overview of RIDTs 192</p> <p>11.3 Antigen Detection‐based RIDTs 195</p> <p>11.4 Nucleic Acid Detection‐based RIDTs 197</p> <p>11.5 Factors that Alter RIDTs Performance 198</p> <p>11.6 The Use of RIDTs in LMICs 198</p> <p>11.7 Conclusions 199</p> <p>Acknowledgment 199</p> <p>References 200</p> <p><b>12 A Rapid Diagnostic Test for Ebola Virus Disease 202<br /></b><i>Catherine Houlihan and Colin Brown</i></p> <p>12.1 Case Report 202</p> <p>12.2 Introduction 203</p> <p>12.3 Diagnostic Methods to Detect Ebola Virus Disease 203</p> <p>12.4 Rapid Diagnostic Tests for Ebola Virus Disease for Use in a Point‐of‐Care Facility 206</p> <p>12.5 Conclusions 209</p> <p>Bibliography 210</p> <p>Webliography 212</p> <p><b>13 Rapid Diagnostic Tests for Yaws 213<br /></b><i>Michael Marks</i></p> <p>13.1 Introduction 213</p> <p>13.2 Epidemiology 214</p> <p>13.3 Clinical Features 215</p> <p>13.4 Diagnostic Quandaries 217</p> <p>13.5 Diagnostic Tests for Yaws 217</p> <p>13.6 Rapid Diagnostic Tests for Yaws 218</p> <p>13.7 Molecular Assays 219</p> <p>References 221</p> <p><b>14 Rapid Diagnostic Tests for the Detection of Sickling Hemoglobin 224<br /></b><i>Amina Nardo‐Marino and Tom N. Williams</i></p> <p>14.1 Sickle Cell Disease 224</p> <p>14.2 Diagnosing Sickle Cell Disease 225</p> <p>14.3 Conclusions 229</p> <p>Bibliography 229</p> <p><b>15 Progress Toward the Development of Rapid Diagnostic Tests for Lymphatic Filariasis and Onchocerciasis 231<br /></b><i>Roger B. Peck, Dunia Faulx, and Tala de los Santos</i></p> <p>15.1 Introduction 231</p> <p>15.2 The Development of Rapid Diagnostic Tests 234</p> <p>15.3 Rapid Diagnostic Tests for Lymphatic Filariasis 234</p> <p>15.4 Rapid Diagnostic Tests for Onchocerciasis 236</p> <p>15.5 Next tests and Steps 240</p> <p>Bibliography 240</p> <p>Webliography 242</p> <p><b>Part III Other tests that can be performed rapidly at the primary‐point‐of-care 245</b></p> <p><b>16 Point‐of‐Care Testing for Blood Counts, HbA1c, Renal Function, Electrolytes, Acid–Base Balance and Hepatitis 247<br /></b><i>Mark Shephard, Lara Motta, Brooke Spaeth, Heather Halls, and Lauren Duckworth</i></p> <p>16.1 Introduction 248</p> <p>16.2 Point‐of‐Care Testing for Blood Counts 248</p> <p>16.3 Point‐of‐Care Testing for HbA1c 252</p> <p>16.4 Point‐of‐Care Testing for Renal Function 254</p> <p>16.5 Point‐of‐Care Testing for Electrolytes and Acid–Base Balance 257</p> <p>16.6 Point‐of‐Care Testing for Hepatitis 261</p> <p>16.7 Conclusions 265</p> <p>Bibliography 266</p> <p>Webliography 268</p> <p><b>17 Microscopy Skills: Cell Counts, Gram Stains, Ziehl‐Neelsen Staining (ZN) and Blood Films 270<br /></b><i>Michael Harrison</i></p> <p>17.1 Introduction 270</p> <p>17.2 Microscopy 271</p> <p>17.3 Microscopy in a POC Testing Laboratory 273</p> <p>17.4 Gram Staining 274</p> <p>17.5 Ziehl‐Neelsen Stain (ZN) for Mycobacterium tuberculosis 275</p> <p>17.6 Blood Film Preparation, Staining and Reporting 276</p> <p>17.7 Conclusions 278</p> <p>Bibliography 280</p> <p>Webliography 280</p> <p><b>18 India Ink Stain and Cryptococcal Antigen Test for Cryptococcal Infection 281<br /></b><i>Hannah K. Mitchell, Joseph N. Jarvis, and Mark W. Tenforde</i></p> <p>18.1 Introduction 281</p> <p>18.2 Diagnosis of Cryptococcal Meningitis 282</p> <p>18.3 Cryptococcal Antigen Testing (CrAg) 283</p> <p>18.4 India Ink Stain 285</p> <p>18.5 CrAg Testing for the Prevention of Cryptococcal Meningitis 286</p> <p>18.6 Logistical Challenges of CrAg Screening 288</p> <p>18.7 Non‐Meningeal Cryptococcal Disease 289</p> <p>18.8 Conclusions 289</p> <p>References 290</p> <p><b>19 Mid Upper Arm Circumference Tapes for Assessment of Severe Acute Malnutrition 294<br /></b><i>Jane Crawley, Martha Mwangome, James Berkley, and André Briend</i></p> <p>19.1 Introduction 294</p> <p>19.2 Mid Upper Arm Circumference (MUAC) 296</p> <p>19.3 Comparison of MUAC with other Anthropometric Indices 296</p> <p>19.4 MUAC: A Brief Historical Perspective 296</p> <p>19.5 Technique for Measuring MUAC 297</p> <p>19.6 MUAC, Mortality Risk, and Definitions of Severe Acute Malnutrition 298</p> <p>19.7 Conclusions: Use of MUAC in Different Settings 301</p> <p>References 302</p> <p>Webliography 304</p> <p><b>20 Spirometry for Chronic Obstructive Pulmonary Disease Due to Inhalation of Smoke from Indoor Fires Used for Cooking and Heating 306<br /></b><i>Janet G. Shaw, Annalicia Vaughan, Emma Smith, Cai Fong, Svetlana Stevanovic, and Ian A. Yang</i></p> <p>20.1 Introduction 306</p> <p>20.2 Indoor Air Pollution from Burning Biomass 307</p> <p>20.3 Mechanisms of Lung Damage from Exposure to Biomass Smoke 309</p> <p>20.4 Biomass Smoke‐Related Chronic Obstructive Pulmonary Disease (COPD) 311</p> <p>20.5 Detecting Airflow Obstruction in Biomass Smoke‐Related COPD 314</p> <p>20.6 Lessons Learnt from Clinical Guidelines for the Detection of Cigarette Smoking‐Related COPD 317</p> <p>20.7 Conclusions 319</p> <p>Acknowledgments 320</p> <p>Bibliography 320</p> <p>Webliography 326</p> <p><b>21 Point‐of‐Care Pulse Oximetry for Children in Low‐Resource Settings 327<br /></b><i>Carina King, Hamish Graham, and Eric D. McCollum</i></p> <p>21.1 Introduction 327</p> <p>21.2 Hypoxemia 328</p> <p>21.3 Pulse Oximetry 330</p> <p>21.4 Current Situation in Low‐Resource Settings 332</p> <p>21.5 Current Challenges and Future Opportunities 333</p> <p>21.6 Conclusions 339</p> <p>Acknowledgments 339</p> <p>Bibliography 340</p> <p>Webliography 343</p> <p><b>22 The Use of Near‐Infrared Spectroscopy to Monitor Tissue Oxygenation, Metabolism and Injury</b> <b>in Low Resource Settings 344<br /></b><i>Gemma Bale, and Ilias Tachtsidis</i></p> <p>22.1 Introduction 344</p> <p>22.2 Near‐Infrared Spectroscopy 346</p> <p>22.3 Clinical Applications 349</p> <p>22.4 Research Applications 350</p> <p>22.5 The Use of NIRS in Low Resource Settings 350</p> <p>22.6 Conclusions 355</p> <p>Bibliography 356</p> <p>Webliography 357</p> <p><b>Part IV Cheap imaging technologies 361</b></p> <p><b>23 The Use of Point‐of‐Care Ultrasound in the Resource‐Limited Setting 363<br /></b><i>Tom Heller, Michaëla A.M. Huson, Sabine Bélard, Dan Kaminstein, and Elizabeth Joekes</i></p> <p>23.1 Introduction to Point‐of‐Care Ultrasound (POCUS) 365</p> <p>23.2 Physics and Technical Aspects of Ultrasound 366</p> <p>23.3 Most Relevant POCUS Applications in the Resource‐Limited Setting 369</p> <p>23.4 Considerations for Teaching and Implementation 402</p> <p>23.5 Conclusions 403</p> <p>Bibliography 403</p> <p>Webliography 405</p> <p><b>24 The Use of Obstetric Ultrasound in Low Resource Settings 406<br /></b><i>Helen Allott</i></p> <p>24.1 Introduction 406</p> <p>24.2 Pregnancy‐Related Problems for Which Portable Ultrasound may be Useful 406</p> <p>24.3 Problems with the Use of Ultrasound Scanning in Limited Resource Settings 407</p> <p>24.4 Provision of Trained Sonographers 409</p> <p>24.5 The Perspective of the Pregnant Woman to Antenatal Ultrasound Scanning 410</p> <p>24.6 Abuse of Ultrasound Scanning in Pregnancy 410</p> <p>24.7 Advances in Ultrasound Technology (and See Chapter 23) 411</p> <p>24.8 Targeted Ultrasound Scanning 412</p> <p>24.9 Conclusions 412</p> <p>References 413</p> <p><b>25 Examining the Optic Fundus and Assessing Visual Acuity and Visual Fields Using Mobile Technology 414<br /></b><i>Nigel M. Bolster, and Andrew Bastawrous</i></p> <p>25.1 Introduction: The Ascent of Mobile Technology 414</p> <p>25.2 Visual Acuity 418</p> <p>25.3 Visual Fields 424</p> <p>25.4 Smartphone Ophthalmoscopy 427</p> <p>25.5 Discussion 432</p> <p>25.6 Conclusions 434</p> <p><b>Part V Telemedicine 439</b></p> <p><b>26 Telemedicine for Clinical Management of Adults in Remote and Rural Areas 441<br /></b><i>Farhad Fatehi, Monica Taylor, Liam J. Caffery, and Anthony C. Smith</i></p> <p>26.1 Introduction 442</p> <p>26.2 Definitions 443</p> <p>26.3 Types of Service 444</p> <p>26.4 Purposes of Telemedicine 444</p> <p>26.5 Telemedicine for Improving Access to Care 445</p> <p>26.6 Establishing a Sustainable Telehealth Network: A Case Study from Brazil 445</p> <p>26.7 Swinfen Telemedicine: A Case Study of Intercontinental Telemedicine 446</p> <p>26.8 Telemedicine in Natural Disaster Responses 446</p> <p>26.9 Telemedicine for Remote Training of Healthcare Professionals 447</p> <p>26.10 Telemedicine for Mental Health (and see Chapter 29) 449</p> <p>26.11 The Rise of Mobile Health (mHealth) 451</p> <p>26.12 Social Networking for Clinical Purposes 452</p> <p>26.13 The World Health Organization and Telemedicine 456</p> <p>26.14 Challenges and Barriers to Implementation 457</p> <p>26.15 Conclusions 459</p> <p>Bibliography 460</p> <p>Webliography 461</p> <p><b>27 Telemedicine for the Delivery of Specialist Pediatric Services 462<br /></b><i>Anthony C. Smith, Monica Taylor, Farhad Fatehi, and Liam J. Caffery</i></p> <p>27.1 Introduction 463</p> <p>27.2 Technical Consideration for Telemedicine in LMICs 464</p> <p>27.3 Models of Care in Telepediatrics 469</p> <p>27.4 Swinfen Charitable Trust Telemedicine Service 469</p> <p>27.5 Selected Examples of SCT Referrals 470</p> <p>27.6 National and International Telemedicine Services 474</p> <p>27.7 mHealth Applications for LMICs 475</p> <p>27.8 Telemedicine Screening Services 476</p> <p>27.9 Telemedicine Support during Disaster Situations 476</p> <p>27.10 Challenges Associated with Telemedicine Adoption in LMICs 477</p> <p>27.11 Telepediatric Case Studies in LMICs 478</p> <p>27.12 Pathology Services 480</p> <p>27.13 Radiographic (Imaging) Services 480</p> <p>27.14 Maternal Health Services 481</p> <p>27.15 Conclusions 481</p> <p>27.16 Acknowledgements 481</p> <p>27.17 Useful Websites 481</p> <p>Bibliography 482</p> <p>Webliography 486</p> <p><b>28 Telemedicine in the Diagnosis and Management of Skin Diseases 488<br /></b><i>Giselle Prado, Odinaka Anyanwu, and Carrie Kovarik</i></p> <p>28.1 Introduction 489</p> <p>28.2 Methods of Delivering Teledermatology: Store and Forward Versus Live Interactive Methods 490</p> <p>28.3 The History of Teledermatology 490</p> <p>28.4 Global Teledermatology Programs 490</p> <p>28.5 Teledermatology in Africa 491</p> <p>28.6 BUP: The Botswana – University of Pennsylvania Partnership 493</p> <p>28.7 Teledermatopathology in Botswana 494</p> <p>28.8 Diagnostic Concordance 495</p> <p>28.9 Teledermatology in Asia 497</p> <p>28.10 Teledermatology in Latin America 497</p> <p>28.11 Barriers 498</p> <p>28.12 Costs 499</p> <p>28.13 Education and Training 499</p> <p>28.14 Equipment and Internet Access 499</p> <p>28.15 Privacy Concerns 500</p> <p>28.16 Cultural Hesitancy 500</p> <p>28.17 Language Barriers 501</p> <p>28.18 Availability of Treatments 501</p> <p>28.19 Legal Issues 501</p> <p>28.20 Follow‐up 501</p> <p>28.21 Ensuring Success of a New Teledermatology Initiative 501</p> <p>28.22 Conclusions 502</p> <p>Bibliography 502</p> <p><b>29 Digital Technology, Including Telemedicine, in the Management of Mental Illness 505<br /></b><i>John A Naslund, Sophia M. Bartels, and Lisa A. Marsch</i></p> <p>29.1 Introduction and Background 505</p> <p>29.2 Why Mental Disorders? 506</p> <p>29.3 Growing Access to Digital Technology and New Opportunities 508</p> <p>29.4 Promising Examples from Low‐ and Middle‐Income Countries 509</p> <p>29.5 Critical Assessment of the Risks and Limitations 517</p> <p>29.6 Future Directions and Implications 519</p> <p>29.7 Conclusions 524</p> <p>Bibliography 525</p> <p>Webliography 530</p> <p><b>30 The Use of Mobile Chest X‐Rays for Tuberculosis Telemedicine 531<br /></b><i>Meghan L. Jardon, Kelsey L. Pomykala, Ishita Desai, and Kara‐Lee Pool</i></p> <p>30.1 Background 531</p> <p>30.2 Lack of Access to Radiology 532</p> <p>30.3 Implementation 532</p> <p>30.4 Cost 536</p> <p>30.5 Sustainability 536</p> <p>30.6 Chest X‐Ray Information Technology (IT) 538</p> <p>30.7 Mobile Devices 540</p> <p>30.8 Education to Ensure Sustainability 541</p> <p>30.9 Conclusions 542</p> <p>Bibliography 542</p> <p>Webliography 545</p> <p><b>Part VI The future 549</b></p> <p><b>31 An Introduction to Digital Health 551<br /></b><i>Kerry Atkinson</i></p> <p>31.1 Introduction 552</p> <p>31.2 The Pillars and Components of Digital Health for Use in the LMICs 552</p> <p>31.3 Smartphones and Internet Access 554</p> <p>31.4 Wearables 555</p> <p>31.5 Personal Digital Assistants and Chatbots 558</p> <p>31.6 Augmented Reality 558</p> <p>31.7 Big Data 558</p> <p>31.8 Artificial Intelligence (AI) 558</p> <p>31.9 The Game Changer – A Smartphone with AI Access 563</p> <p>31.10 Conclusions 564</p> <p>Bibliography 564</p> <p>Webliography 564</p> <p><b>32 Digital Health in Low- and Middle-Income Countries 566<br /></b><i>Martin Seneviratne and David Peiris</i></p> <p>32.1 Introduction – The Digital Health Revolution 567</p> <p>32.2 The Current Landscape 569</p> <p>32.3 HIV/AIDS 569</p> <p>32.4 Diabetes Mellitus 570</p> <p>32.5 Maternal Health 570</p> <p>32.6 Core Functionalities 571</p> <p>32.7 Patient‐facing Functions 571</p> <p>32.8 Clinician‐facing Functions 573<br /><br /> 32.9 Electronic Medical Record Management 574</p> <p>32.10 Point‐of‐Care Diagnostic Tests 575</p> <p>32.11 Epidemiology 575</p> <p>32.12 Inventory Management and Supply Chain 575</p> <p>32.13 Challenges to Scale 575</p> <p>32.14 Emerging Trends and Future Vision 578</p> <p>32.15 Conclusions 580</p> <p>Bibliography 580</p> <p>Webliography 583</p> <p><b>33 Nucleic Acid Detection of Tuberculosis Via Innovative Point‐of‐Care Nanotechnologies Targeted for Low Resource Settings 584<br /></b><i>Benjamin Y.C. Ng, Eugene J.H. Wee, Nicholas P. West, and Matt Trau</i></p> <p>33.1 Introduction 584</p> <p>33.2 Nucleic Acid Detection of Tuberculosis 585</p> <p>33.3 The Availability of Rapid Diagnostic Tests at the Peripheral Healthcare Level 585</p> <p>33.4 Leveraging Innovative Nanotechnologies for Point‐of‐Care TB Diagnosis 587</p> <p>33.5 Sample Preparation Workflow 589</p> <p>33.6 Nanotechnologies for TB DNA Sensing and Readouts 590</p> <p>33.7 Quantitative DNA Detection Methodologies 592</p> <p>33.8 Drug‐resistant Tuberculosis 594</p> <p>33.9 Conclusions 595</p> <p>References 596</p> <p><b>34 The Use of Functional Nanoparticles for Water Purification 600<br /></b><i>Jing Zhang, Chuanping Feng, and Chengzhong Yu</i></p> <p>34.1 Introduction 600</p> <p>34.2 Disinfection 602</p> <p>34.3 Adsorption 607</p> <p>34.4 Electrochemistry 609</p> <p>34.5 Conclusions and Future Perspectives 609</p> <p>References 610</p> <p><b>35 The Use of Drones in the Delivery of Rural Healthcare 615<br /></b><i>Debrah I. Boeras, Blanche C. Collins, and Rosanna W. Peeling</i></p> <p>35.1 Challenges in Healthcare Delivery – Opportunities for Innovation 616</p> <p>35.2 The Need for Disruptive Solutions for Healthcare Delivery in Rural Areas 616</p> <p>35.3 The Use of Drones for Healthcare Delivery 617</p> <p>35.4 Further Focus on Uptake of Drone Technology by Different Countries 621</p> <p>35.5 Models of Potential Public‐Private Collaboration 622</p> <p>35.6 Promises and Challenges of the Use of Drones in Healthcare Delivery 623</p> <p>35.7 Outlook for the Future 624</p> <p>35.8 Conclusions 626</p> <p>Bibliography 626</p> <p>Webliography 630</p> <p><b>36 Implementation of Point‐of‐Care Tests: Lessons Learnt 633<br /></b><i>Rosanna W. Peeling, and Debrah I. Boeras</i></p> <p>36.1 Synopsis 633</p> <p>36.2 Healthcare Needs in Low‐ and Middle‐Income Countries 634</p> <p>36.3 Rapid Diagnostic Tests for Human Immunodeficiency Virus (HIV) Disease (and See Chapter 4) 636</p> <p>36.4 Rapid Diagnostic Tests for Syphilis (and See Chapter 6) 637</p> <p>36.5 Rapid Diagnostic Tests for Tuberculosis (TB) (and See Chapter 5) 638</p> <p>36.6 Rapid Diagnostic Tests for Malaria (and See Chapter 7) 638</p> <p>36.7 Lessons Learnt from the Implementation of POC Tests 639</p> <p>36.8 Lessons Learnt from the Implementation of POC Tests for Three Diseases 640</p> <p>36.9 The Way Forward 642</p> <p>36.10 The New Paradigm for Technological Innovation and Implementation 643</p> <p>36.11 Conclusions 644</p> <p>Bibliography 644</p> <p>Webliography 648</p> <p><b>37 Useful Electronic Healthcare Resources Available for Those Working in Remote Settings 649<br /></b><i>Tyler Evans</i></p> <p>37.1 Introduction 649</p> <p>37.2 General Web‐Based Resources 650</p> <p>37.3 Travel Medicine 651</p> <p>37.4 The Big Three Communicable Diseases in Low‐ and Middle‐Income Countries (LMICs) 652</p> <p>37.5 Hepatitis C 656</p> <p>37.6 Other Infectious Diseases (IDs) 657</p> <p>37.7 Dermatology 657</p> <p>37.8 Obstetrics and Gynecology 658</p> <p>37.9 Pediatrics 658</p> <p>37.10 Psychiatry 658</p> <p>37.11 Emergency Medicine (EM) 659</p> <p>37.12 Preventive Health 659</p> <p>37.13 Disease Mapping 660</p> <p>37.14 Pharmaceuticals 660</p> <p>37.15 Online Courses 661</p> <p>37.16 Recommended Books 661</p> <p>37.17 Institutions, Societies and Books 662</p> <p>Webliography 663</p> <p><b>38 The Future – How Do We Get from Here to There? 666<br /></b><i>Kerry Atkinson and David Mabey</i></p> <p>38.1 Progress to Date 667</p> <p>38.2 Major Factors Adversely Affecting Global Health 670</p> <p>38.3 Continue Doing What Works 674</p> <p>38.4 New Measures for Improving Remote Rural Healthcare 674</p> <p>38.5 The UN 2015 Sustainable Development Goals for 2016–2030 677</p> <p>38.6 Conclusions 681</p> <p>Bibliography 682</p> <p>Webliography 683</p> <p>Glossary 684</p> <p>Index 693</p>
<p><b>About the Editors</b> <p><b>KERRY ATKINSON</b> 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. <p><b>DAVID MABEY</b> 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.
<p><b>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</b> <p><i>Revolutionizing Tropical Medicine: Point???of???Care Tests, New Imaging Technologies and Digital Health</i> 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. <p>This text: <ul> <li>Describes the current burden of communicable and non-communicable diseases in low- to middle-income countries throughout the world</li> <li>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</li> <li>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</li> <li>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</li> <li>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</li> <li>Describes the use of telemedicine in the clinical management of both children and adults in remote rural settings</li> <li>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</li> <li>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.</li> </ul> <p>Written for physicians, infectious disease specialists, pathologists, radiologists, nurses, pharmacists and other health care workers, as well as government healthcare managers, <i>Revolutionizing</i> <i>Tropical Medicine: Point???of???Care Tests, New Imaging Technologies and Digital Health</i> is a new up-to-date essential and realistic guide to treating and diagnosing patients in low-resource tropical countries based on new technologies.

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