Point-of-care diagnostic tools Selection, evaluation and implementation in resource-constrained settings

In recent year’s point-of-care diagnostic tools especially for the three main killer diseases HIV/AIDS, tuberculosis and malaria have been emerging on the market.
This thesis examines the selection, evaluation and implementation of point-of-care diagnostic tools for use in resource-constrained settings (RCS) where often laboratory capacity is lacking and diagnostic testing is of poor quality. There were two main sub-themes to the work. The first examines diagnostic tests for infectious diseases (chapter 3- 9) and the second sub-theme focuses on point-of-care tests for monitoring disease progression, and tools to monitor treatment side-effects (chapter 10-12).
Diagnostics tests for malaria (chapter 3), tuberculosis (chapter 6), HIV (chapter 7) and CD4 counts (chapter 10) have been evaluated and monitored during routine use in RCS. Diagnostic test accuracy evaluations for hepatitis C (chapter 4 and 5), creatinine monitoring (chapter 11) and thyroid stimulating hormone (TSH) (chapter 12) have been carried out under ideal conditions to assess their performance and ease-of-use pre-implementation in RCSs.
Furthermore, modelling of diagnostic algorithms has been performed using data from diagnostic accuracy evaluations on HIV tests (chapter 8) in order to select best performing algorithms in 6 different settings in sub-Saharan Africa (chapter 9).
Finally, chapter 13 and 14 discuss the main findings of this thesis, give recommendations for policy makers and give recommendation for future studies.