Assessment of Point of Care Testing devices for infectious disease surveillance, prevention and control

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What is the issue?

As we have learned during the COVID-19 pandemic, diagnosis of infectious diseases is a time-sensitive matter due to their ability to spread and the rapid course of infection. Delays in diagnosis can be fatal or result in patients being treated with non-specific antimicrobials, which in turn contributes to the overall problem of antimicrobial resistance (AMR).

While newer and more rapid technologies, such as point of care testing (POCT) devices, provide faster access to results and allow for more rapid clinical decision making, these have generally not been available in rural settings.

How did we help?

In 2019, RAND Europe was commissioned by the European Centre for Disease Prevention and Control (ECDC) to provide an overview of available POCT devices and their use regarding 56 communicable diseases and related health issues then under EU surveillance (prior to the outbreak of the COVID-19 pandemic).

To do this, we conducted:

A scoping review to obtain an overview of the availability and use of POCT covering the 56 communicable diseases and related health issues under EU surveillance.
A mapping exercise to assess the status and trends in the use of POCT in EU/EEA countries.

What did we find?

We collated and analysed a total of 350 articles and 54 survey responses from 26 EU/EEA countries as part of this study. We found that, across the EU/EEA, POCT is available for a range of infectious diseases, particularly influenza, HIV/AIDS, Legionnaires’ disease and malaria.

While POCT for infectious diseases is often used to support and improve clinical care, such as faster diagnosis for patients and more appropriate use of antimicrobials, there seems to be little use of POCT for wider public health functions, such as surveillance and reporting of infectious diseases.

What can be done?

POCT allows for faster diagnosis of infectious diseases and is particularly useful for patients living in remote or resource-limited settings. However, the full potential of using POCT to support broader public health functions is yet to be realised.

The COVID-19 pandemic has highlighted the benefit of rapid, near-patient testing in infection control and managing outbreaks. As the data collection for this study was primarily designed and conducted before the pandemic, it would be valuable to explore whether these findings also apply to COVID-19, and whether POCT for COVID-19 is used for these wider public health functions.