The next phase for point-of-care testing in resource-limited settings noncommunicable disease

In this essay we ask the question, what tests are clinically important in low-resource settings but not widely available in point-of-care (POC) formats? A survey of laboratory test offerings in Kampala, Uganda revealed three tests (and our three wishes) commonly offered in high complexity laboratories but rarely found in point of care laboratories: viral hepatitis immunoassays/liver enzymes, renal function tests, and lipid profiles. The focus of the POC industry on infectious disease in emerging nations was understandable when the burden of disease was primarily infectious, but due to the demographic transition occurring in sub-Saharan Africa and other resource-poor regions, there is a now a co-burden of communicable and noncommunicable disease. An agenda for POC testing of noncommunicable disease in these settings is not yet mature and should be informed by local test utilization patterns.