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Revolutionizing Tropical Medicine

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

Atkinson, Kerry / Mabey, David (Herausgeber)

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1. Auflage August 2019
768 Seiten, Hardcover
Praktikerbuch

ISBN: 978-1-119-28264-8
John Wiley & Sons

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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.

Part I The Health of Low- and Middle-Income Countries Today 1

1 The Burden of Communicable Diseases in Low- and Middle-Income Countries 3
Kerry Atkinson and David Mabey

1.1 Introduction 4

1.2 Definition of a Communicable Disease 4

1.3 Definition of Low- to Middle-Income Countries 4

1.4 Definition of Burden of Disease 5

1.5 Definition of Disease Elimination 7

1.6 Definition of Disease Eradication 7

1.7 Definition of the Primary Point-of-Care 7

1.8 The 2000 Millennium Development Goals (MDGs) and Their Outcomes 7

1.9 Major Individual Diseases in the LMICs: The Big Three - Malaria, HIV/AIDS and Tuberculosis 9

1.10 Other Important Communicable Diseases in the LMICs 17

1.11 Neglected Tropical Disease (NTDs) Prioritized by the World Health Organisation 29

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

1.13 Conclusions 32

Bibliography 32

Webliography 35

2 The Burden of Non-communicable Diseases in Low- and Middle-Income Countries 37
Heiner Grosskurth

2.1 Introduction 38

2.2 Common Non-communicable Diseases in Low- and Middle-Income Countries 38

2.3 NCD Epidemiology 38

2.4 Prevention of Non-communicable Diseases 44

2.5 The Relationship Between Communicable and Non-communicable Diseases 44

2.6 The Health System Burden of NCDs 46

2.7 The Economic Impact of NCDs 47

2.8 The Response to the NCD Epidemic in LMICs 48

2.9 The Readiness of Primary Healthcare Services in LMICs to Cope with the NCD Burden 50

2.10 Introducing Effective NCD Control at Primary Care Services: A Practical Approach 52

2.11 The Role of Primary Healthcare Services in Cancer Prevention and Care 67

2.12 Evaluating Programmes to Strengthen NCD Services at Primary Care Level 70

2.13 Conclusions 70

Bibliography 70

Webliography 78

Part II How to improve healthcare in low- and middle-income countries by primary point-of-care rapid diagnostic testing 81

3 The Optimal Features of a Rapid Point-of-Care Diagnostic Test 83
David Mabey and Rosanna Peeling

3.1 Introduction 83

3.2 Accuracy Versus Accessibility 83

3.3 Quality Assurance 84

3.4 The Importance of Connectivity 85

3.5 Environmental Friendliness 86

References 86

Webliography 87

4 Revolutionizing HIV Healthcare Delivery Through Rapid and Point-of-Care Testing 88
Catherine J. Wedderburn, Debrah I. Boeras, and Rosanna W. Peeling

4.1 Synopsis 88

4.2 Introduction 89

4.3 Diagnostic Tests in Resource-Limited Settings 89

4.4 Challenges of Using Rapid and Point-of-Care Testing Within the Context of the Healthcare System 92

4.5 Recent Advances in HIV Diagnosis and Monitoring and Their Impact 93

4.6 WHO Recommendations: POC Diagnostics for Achieving the 90-90-90 Goals 98

4.7 Remaining Challenges - Human Resources, Quality Assurance, and Test Selection and Placement 98

4.8 Moving Forward 99

4.9 Conclusions 100

Bibliography 101

Webliography 103

5 Rapid Point-of-Care Diagnostic Tests for Tuberculosis 105
Richard Lessells

5.1 Introduction 105

5.2 The Need for Rapid Point-of-Care TB Diagnostic Tests 106

5.3 Weaknesses in the TB Diagnostic Cascade 106

5.4 Potential Impact of Rapid Point-of-Care Diagnostic Tests 107

5.5 Defining the Diagnostic Needs 107

5.6 Smear Microscopy 107

5.7 Molecular Diagnostic Tests 109

5.8 Loop-Mediated Isothermal Amplification (LAMP) 112

5.9 Line Probe Assays 113

5.10 Other Molecular Tests 113

5.11 Antigen Tests 114

5.12 Combination Diagnostic Packages 115

5.13 Next Generation Sequencing 117

5.14 Diagnostic Imaging 117

5.15 Other Diagnostics 118

5.16 Conclusions 118

References 119

6 Rapid Diagnostic Tests for Syphilis 126
David Mabey, Michael Marks, and Rosanna W. Peeling

6.1 Introduction 126

6.2 The Diagnosis of Syphilis 129

6.3 The Impact of POC Testing for Syphilis 131

6.4 Challenges in the Implementation of POC Testing 133

6.5 The Future 134

References 134

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
Heidi Hopkins, and Jane Cunningham

7.1 Introduction 137

7.2 Diagnosis of Malaria 138

7.3 Light Microscopy of Blood Smears 139

7.4 Rapid Diagnostic Tests for Malaria (mRDTs) 140

7.5 Nucleic Acid Amplification-Based Tests (NAATs) for Malaria 142

7.6 Impact of Point-of-Care Testing for Malaria 143

7.7 Challenges in Implementation of POC Testing for Malaria 144

7.8 The Future 146

Biblography 146

Webliography 156

8 Rapid Diagnostic Tests for Human African Trypanosomiasis 159
Veerle Lejon, Epco Hasker, and Philippe Büscher

8.1 Introduction 159

8.2 The Early Introduction of Immunodiagnostic Tests in the Diagnosis of HAT 160

8.3 CATT/T.b. gambiense: A Breakthrough in the Immunodiagnosis of Gambiense-HAT 161

8.4 The Changing Epidemiology of Gambiense-HAT: The Need for Improved Rapid Diagnostic Tests 163

8.5 Second Generation RDTs for HAT 165

8.6 Future Perspectives and Challenges 165

References 166

Webliography 169

9 Rapid Diagnostic Tests for Visceral Leishmaniasis 170
Marleen Boelaert, Suman Rijal, and François Chappuis

9.1 Introduction 170

9.2 Parasitology, a Reference Standard? 171

9.3 Serological Assays 172

9.4 The First Serological Test for Field Use: The Direct Agglutination Assay 173

9.5 The Early Development an Immunochromatographic Test Using the Recombinant Leishmania Antigen rK39 174

9.6 Impact of the VL RDT 174

9.7 Challenges 175

9.8 Other Tests 175

9.9 Discussion 176

9.10 Conclusions 177

References 177

10 A Rapid Diagnostic Test for Dengue 181
Claire Mullender, and James Whitehorn

10.1 Introduction 181

10.2 Clinical Features of Dengue 182

10.3 The Importance of Making a Rapid Diagnosis 183

10.4 The Host Response to Infection 184

10.5 Existing Diagnostic Strategies 184

10.6 Review of Existing Rapid Diagnostic Tests 186

10.7 Future Directions 188

10.8 Conclusions 188

References 188

11 Rapid Diagnostic Tests for Influenza 191
A.C. Hurt, and I.G. Barr

11.1 Introduction 191

11.2 Overview of RIDTs 192

11.3 Antigen Detection-based RIDTs 195

11.4 Nucleic Acid Detection-based RIDTs 197

11.5 Factors that Alter RIDTs Performance 198

11.6 The Use of RIDTs in LMICs 198

11.7 Conclusions 199

Acknowledgment 199

References 200

12 A Rapid Diagnostic Test for Ebola Virus Disease 202
Catherine Houlihan and Colin Brown

12.1 Case Report 202

12.2 Introduction 203

12.3 Diagnostic Methods to Detect Ebola Virus Disease 203

12.4 Rapid Diagnostic Tests for Ebola Virus Disease for Use in a Point-of-Care Facility 206

12.5 Conclusions 209

Bibliography 210

Webliography 212

13 Rapid Diagnostic Tests for Yaws 213
Michael Marks

13.1 Introduction 213

13.2 Epidemiology 214

13.3 Clinical Features 215

13.4 Diagnostic Quandaries 217

13.5 Diagnostic Tests for Yaws 217

13.6 Rapid Diagnostic Tests for Yaws 218

13.7 Molecular Assays 219

References 221

14 Rapid Diagnostic Tests for the Detection of Sickling Hemoglobin 224
Amina Nardo-Marino and Tom N. Williams

14.1 Sickle Cell Disease 224

14.2 Diagnosing Sickle Cell Disease 225

14.3 Conclusions 229

Bibliography 229

15 Progress Toward the Development of Rapid Diagnostic Tests for Lymphatic Filariasis and Onchocerciasis 231
Roger B. Peck, Dunia Faulx, and Tala de los Santos

15.1 Introduction 231

15.2 The Development of Rapid Diagnostic Tests 234

15.3 Rapid Diagnostic Tests for Lymphatic Filariasis 234

15.4 Rapid Diagnostic Tests for Onchocerciasis 236

15.5 Next tests and Steps 240

Bibliography 240

Webliography 242

Part III Other tests that can be performed rapidly at the primary-point-of-care 245

16 Point-of-Care Testing for Blood Counts, HbA1c, Renal Function, Electrolytes, Acid-Base Balance and Hepatitis 247
Mark Shephard, Lara Motta, Brooke Spaeth, Heather Halls, and Lauren Duckworth

16.1 Introduction 248

16.2 Point-of-Care Testing for Blood Counts 248

16.3 Point-of-Care Testing for HbA1c 252

16.4 Point-of-Care Testing for Renal Function 254

16.5 Point-of-Care Testing for Electrolytes and Acid-Base Balance 257

16.6 Point-of-Care Testing for Hepatitis 261

16.7 Conclusions 265

Bibliography 266

Webliography 268

17 Microscopy Skills: Cell Counts, Gram Stains, Ziehl-Neelsen Staining (ZN) and Blood Films 270
Michael Harrison

17.1 Introduction 270

17.2 Microscopy 271

17.3 Microscopy in a POC Testing Laboratory 273

17.4 Gram Staining 274

17.5 Ziehl-Neelsen Stain (ZN) for Mycobacterium tuberculosis 275

17.6 Blood Film Preparation, Staining and Reporting 276

17.7 Conclusions 278

Bibliography 280

Webliography 280

18 India Ink Stain and Cryptococcal Antigen Test for Cryptococcal Infection 281
Hannah K. Mitchell, Joseph N. Jarvis, and Mark W. Tenforde

18.1 Introduction 281

18.2 Diagnosis of Cryptococcal Meningitis 282

18.3 Cryptococcal Antigen Testing (CrAg) 283

18.4 India Ink Stain 285

18.5 CrAg Testing for the Prevention of Cryptococcal Meningitis 286

18.6 Logistical Challenges of CrAg Screening 288

18.7 Non-Meningeal Cryptococcal Disease 289

18.8 Conclusions 289

References 290

19 Mid Upper Arm Circumference Tapes for Assessment of Severe Acute Malnutrition 294
Jane Crawley, Martha Mwangome, James Berkley, and André Briend

19.1 Introduction 294

19.2 Mid Upper Arm Circumference (MUAC) 296

19.3 Comparison of MUAC with other Anthropometric Indices 296

19.4 MUAC: A Brief Historical Perspective 296

19.5 Technique for Measuring MUAC 297

19.6 MUAC, Mortality Risk, and Definitions of Severe Acute Malnutrition 298

19.7 Conclusions: Use of MUAC in Different Settings 301

References 302

Webliography 304

20 Spirometry for Chronic Obstructive Pulmonary Disease Due to Inhalation of Smoke from Indoor Fires Used for Cooking and Heating 306
Janet G. Shaw, Annalicia Vaughan, Emma Smith, Cai Fong, Svetlana Stevanovic, and Ian A. Yang

20.1 Introduction 306

20.2 Indoor Air Pollution from Burning Biomass 307

20.3 Mechanisms of Lung Damage from Exposure to Biomass Smoke 309

20.4 Biomass Smoke-Related Chronic Obstructive Pulmonary Disease (COPD) 311

20.5 Detecting Airflow Obstruction in Biomass Smoke-Related COPD 314

20.6 Lessons Learnt from Clinical Guidelines for the Detection of Cigarette Smoking-Related COPD 317

20.7 Conclusions 319

Acknowledgments 320

Bibliography 320

Webliography 326

21 Point-of-Care Pulse Oximetry for Children in Low-Resource Settings 327
Carina King, Hamish Graham, and Eric D. McCollum

21.1 Introduction 327

21.2 Hypoxemia 328

21.3 Pulse Oximetry 330

21.4 Current Situation in Low-Resource Settings 332

21.5 Current Challenges and Future Opportunities 333

21.6 Conclusions 339

Acknowledgments 339

Bibliography 340

Webliography 343

22 The Use of Near-Infrared Spectroscopy to Monitor Tissue Oxygenation, Metabolism and Injury in Low Resource Settings 344
Gemma Bale, and Ilias Tachtsidis

22.1 Introduction 344

22.2 Near-Infrared Spectroscopy 346

22.3 Clinical Applications 349

22.4 Research Applications 350

22.5 The Use of NIRS in Low Resource Settings 350

22.6 Conclusions 355

Bibliography 356

Webliography 357

Part IV Cheap imaging technologies 361

23 The Use of Point-of-Care Ultrasound in the Resource-Limited Setting 363
Tom Heller, Michaëla A.M. Huson, Sabine Bélard, Dan Kaminstein, and Elizabeth Joekes

23.1 Introduction to Point-of-Care Ultrasound (POCUS) 365

23.2 Physics and Technical Aspects of Ultrasound 366

23.3 Most Relevant POCUS Applications in the Resource-Limited Setting 369

23.4 Considerations for Teaching and Implementation 402

23.5 Conclusions 403

Bibliography 403

Webliography 405

24 The Use of Obstetric Ultrasound in Low Resource Settings 406
Helen Allott

24.1 Introduction 406

24.2 Pregnancy-Related Problems for Which Portable Ultrasound may be Useful 406

24.3 Problems with the Use of Ultrasound Scanning in Limited Resource Settings 407

24.4 Provision of Trained Sonographers 409

24.5 The Perspective of the Pregnant Woman to Antenatal Ultrasound Scanning 410

24.6 Abuse of Ultrasound Scanning in Pregnancy 410

24.7 Advances in Ultrasound Technology (and See Chapter 23) 411

24.8 Targeted Ultrasound Scanning 412

24.9 Conclusions 412

References 413

25 Examining the Optic Fundus and Assessing Visual Acuity and Visual Fields Using Mobile Technology 414
Nigel M. Bolster, and Andrew Bastawrous

25.1 Introduction: The Ascent of Mobile Technology 414

25.2 Visual Acuity 418

25.3 Visual Fields 424

25.4 Smartphone Ophthalmoscopy 427

25.5 Discussion 432

25.6 Conclusions 434

Part V Telemedicine 439

26 Telemedicine for Clinical Management of Adults in Remote and Rural Areas 441
Farhad Fatehi, Monica Taylor, Liam J. Caffery, and Anthony C. Smith

26.1 Introduction 442

26.2 Definitions 443

26.3 Types of Service 444

26.4 Purposes of Telemedicine 444

26.5 Telemedicine for Improving Access to Care 445

26.6 Establishing a Sustainable Telehealth Network: A Case Study from Brazil 445

26.7 Swinfen Telemedicine: A Case Study of Intercontinental Telemedicine 446

26.8 Telemedicine in Natural Disaster Responses 446

26.9 Telemedicine for Remote Training of Healthcare Professionals 447

26.10 Telemedicine for Mental Health (and see Chapter 29) 449

26.11 The Rise of Mobile Health (mHealth) 451

26.12 Social Networking for Clinical Purposes 452

26.13 The World Health Organization and Telemedicine 456

26.14 Challenges and Barriers to Implementation 457

26.15 Conclusions 459

Bibliography 460

Webliography 461

27 Telemedicine for the Delivery of Specialist Pediatric Services 462
Anthony C. Smith, Monica Taylor, Farhad Fatehi, and Liam J. Caffery

27.1 Introduction 463

27.2 Technical Consideration for Telemedicine in LMICs 464

27.3 Models of Care in Telepediatrics 469

27.4 Swinfen Charitable Trust Telemedicine Service 469

27.5 Selected Examples of SCT Referrals 470

27.6 National and International Telemedicine Services 474

27.7 mHealth Applications for LMICs 475

27.8 Telemedicine Screening Services 476

27.9 Telemedicine Support during Disaster Situations 476

27.10 Challenges Associated with Telemedicine Adoption in LMICs 477

27.11 Telepediatric Case Studies in LMICs 478

27.12 Pathology Services 480

27.13 Radiographic (Imaging) Services 480

27.14 Maternal Health Services 481

27.15 Conclusions 481

27.16 Acknowledgements 481

27.17 Useful Websites 481

Bibliography 482

Webliography 486

28 Telemedicine in the Diagnosis and Management of Skin Diseases 488
Giselle Prado, Odinaka Anyanwu, and Carrie Kovarik

28.1 Introduction 489

28.2 Methods of Delivering Teledermatology: Store and Forward Versus Live Interactive Methods 490

28.3 The History of Teledermatology 490

28.4 Global Teledermatology Programs 490

28.5 Teledermatology in Africa 491

28.6 BUP: The Botswana - University of Pennsylvania Partnership 493

28.7 Teledermatopathology in Botswana 494

28.8 Diagnostic Concordance 495

28.9 Teledermatology in Asia 497

28.10 Teledermatology in Latin America 497

28.11 Barriers 498

28.12 Costs 499

28.13 Education and Training 499

28.14 Equipment and Internet Access 499

28.15 Privacy Concerns 500

28.16 Cultural Hesitancy 500

28.17 Language Barriers 501

28.18 Availability of Treatments 501

28.19 Legal Issues 501

28.20 Follow-up 501

28.21 Ensuring Success of a New Teledermatology Initiative 501

28.22 Conclusions 502

Bibliography 502

29 Digital Technology, Including Telemedicine, in the Management of Mental Illness 505
John A Naslund, Sophia M. Bartels, and Lisa A. Marsch

29.1 Introduction and Background 505

29.2 Why Mental Disorders? 506

29.3 Growing Access to Digital Technology and New Opportunities 508

29.4 Promising Examples from Low- and Middle-Income Countries 509

29.5 Critical Assessment of the Risks and Limitations 517

29.6 Future Directions and Implications 519

29.7 Conclusions 524

Bibliography 525

Webliography 530

30 The Use of Mobile Chest X-Rays for Tuberculosis Telemedicine 531
Meghan L. Jardon, Kelsey L. Pomykala, Ishita Desai, and Kara-Lee Pool

30.1 Background 531

30.2 Lack of Access to Radiology 532

30.3 Implementation 532

30.4 Cost 536

30.5 Sustainability 536

30.6 Chest X-Ray Information Technology (IT) 538

30.7 Mobile Devices 540

30.8 Education to Ensure Sustainability 541

30.9 Conclusions 542

Bibliography 542

Webliography 545

Part VI The future 549

31 An Introduction to Digital Health 551
Kerry Atkinson

31.1 Introduction 552

31.2 The Pillars and Components of Digital Health for Use in the LMICs 552

31.3 Smartphones and Internet Access 554

31.4 Wearables 555

31.5 Personal Digital Assistants and Chatbots 558

31.6 Augmented Reality 558

31.7 Big Data 558

31.8 Artificial Intelligence (AI) 558

31.9 The Game Changer - A Smartphone with AI Access 563

31.10 Conclusions 564

Bibliography 564

Webliography 564

32 Digital Health in Low- and Middle-Income Countries 566
Martin Seneviratne and David Peiris

32.1 Introduction - The Digital Health Revolution 567

32.2 The Current Landscape 569

32.3 HIV/AIDS 569

32.4 Diabetes Mellitus 570

32.5 Maternal Health 570

32.6 Core Functionalities 571

32.7 Patient-facing Functions 571

32.8 Clinician-facing Functions 573

32.9 Electronic Medical Record Management 574

32.10 Point-of-Care Diagnostic Tests 575

32.11 Epidemiology 575

32.12 Inventory Management and Supply Chain 575

32.13 Challenges to Scale 575

32.14 Emerging Trends and Future Vision 578

32.15 Conclusions 580

Bibliography 580

Webliography 583

33 Nucleic Acid Detection of Tuberculosis Via Innovative Point-of-Care Nanotechnologies Targeted for Low Resource Settings 584
Benjamin Y.C. Ng, Eugene J.H. Wee, Nicholas P. West, and Matt Trau

33.1 Introduction 584

33.2 Nucleic Acid Detection of Tuberculosis 585

33.3 The Availability of Rapid Diagnostic Tests at the Peripheral Healthcare Level 585

33.4 Leveraging Innovative Nanotechnologies for Point-of-Care TB Diagnosis 587

33.5 Sample Preparation Workflow 589

33.6 Nanotechnologies for TB DNA Sensing and Readouts 590

33.7 Quantitative DNA Detection Methodologies 592

33.8 Drug-resistant Tuberculosis 594

33.9 Conclusions 595

References 596

34 The Use of Functional Nanoparticles for Water Purification 600
Jing Zhang, Chuanping Feng, and Chengzhong Yu

34.1 Introduction 600

34.2 Disinfection 602

34.3 Adsorption 607

34.4 Electrochemistry 609

34.5 Conclusions and Future Perspectives 609

References 610

35 The Use of Drones in the Delivery of Rural Healthcare 615
Debrah I. Boeras, Blanche C. Collins, and Rosanna W. Peeling

35.1 Challenges in Healthcare Delivery - Opportunities for Innovation 616

35.2 The Need for Disruptive Solutions for Healthcare Delivery in Rural Areas 616

35.3 The Use of Drones for Healthcare Delivery 617

35.4 Further Focus on Uptake of Drone Technology by Different Countries 621

35.5 Models of Potential Public-Private Collaboration 622

35.6 Promises and Challenges of the Use of Drones in Healthcare Delivery 623

35.7 Outlook for the Future 624

35.8 Conclusions 626

Bibliography 626

Webliography 630

36 Implementation of Point-of-Care Tests: Lessons Learnt 633
Rosanna W. Peeling, and Debrah I. Boeras

36.1 Synopsis 633

36.2 Healthcare Needs in Low- and Middle-Income Countries 634

36.3 Rapid Diagnostic Tests for Human Immunodeficiency Virus (HIV) Disease (and See Chapter 4) 636

36.4 Rapid Diagnostic Tests for Syphilis (and See Chapter 6) 637

36.5 Rapid Diagnostic Tests for Tuberculosis (TB) (and See Chapter 5) 638

36.6 Rapid Diagnostic Tests for Malaria (and See Chapter 7) 638

36.7 Lessons Learnt from the Implementation of POC Tests 639

36.8 Lessons Learnt from the Implementation of POC Tests for Three Diseases 640

36.9 The Way Forward 642

36.10 The New Paradigm for Technological Innovation and Implementation 643

36.11 Conclusions 644

Bibliography 644

Webliography 648

37 Useful Electronic Healthcare Resources Available for Those Working in Remote Settings 649
Tyler Evans

37.1 Introduction 649

37.2 General Web-Based Resources 650

37.3 Travel Medicine 651

37.4 The Big Three Communicable Diseases in Low- and Middle-Income Countries (LMICs) 652

37.5 Hepatitis C 656

37.6 Other Infectious Diseases (IDs) 657

37.7 Dermatology 657

37.8 Obstetrics and Gynecology 658

37.9 Pediatrics 658

37.10 Psychiatry 658

37.11 Emergency Medicine (EM) 659

37.12 Preventive Health 659

37.13 Disease Mapping 660

37.14 Pharmaceuticals 660

37.15 Online Courses 661

37.16 Recommended Books 661

37.17 Institutions, Societies and Books 662

Webliography 663

38 The Future - How Do We Get from Here to There? 666
Kerry Atkinson and David Mabey

38.1 Progress to Date 667

38.2 Major Factors Adversely Affecting Global Health 670

38.3 Continue Doing What Works 674

38.4 New Measures for Improving Remote Rural Healthcare 674

38.5 The UN 2015 Sustainable Development Goals for 2016-2030 677

38.6 Conclusions 681

Bibliography 682

Webliography 683

Glossary 684

Index 693
About the Editors

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.