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1.
Expert Rev Mol Diagn ; 15(10): 1245-59, 2015.
Article in English | MEDLINE | ID: mdl-26367243

ABSTRACT

Ultrahigh sensitivity and specificity assays that detect Ebola virus disease or other highly contagious and deadly diseases quickly and successfully upstream in Spatial Care Paths™ can stop outbreaks from escalating into devastating epidemics ravaging communities locally and countries globally. Even had the WHO and CDC responded more quickly and not misjudged the dissemination of Ebola in West Africa and other world regions, mobile rapid diagnostics were, and still are, not readily available for immediate and definitive diagnosis, a stunning strategic flaw that needs correcting worldwide. This article strategizes point-of-care testing for diagnosis, triage, monitoring, recovery and stopping outbreaks in the USA and other countries; reviews Ebola molecular diagnostics, summarizes USA FDA emergency use authorizations and documents why they should not be stop-gaps; and reduces community risk from internal and external infectious disease threats by enabling public health at points of need.


Subject(s)
Disease Outbreaks/prevention & control , Hemorrhagic Fever, Ebola/diagnosis , Point-of-Care Systems , Civil Defense , Hemorrhagic Fever, Ebola/epidemiology , Hemorrhagic Fever, Ebola/prevention & control , Humans , International Cooperation , Knowledge Bases , Molecular Diagnostic Techniques , Sensitivity and Specificity
2.
Am J Disaster Med ; 10(2): 121-43, 2015.
Article in English | MEDLINE | ID: mdl-26312494

ABSTRACT

OBJECTIVES: To present a vision where point-of-care testing (POCT) accelerates an Ebola Spatial Care Path™ (SCP) and future molecular diagnostics enable facilitated-access self-testing (FAST POC); to design an alternate care facility (ACF) for the SCP; to innovate an Ebola diagnostic center (DC); and to propel rapid POCT to the frontline to create resilience that stops future outbreaks. DESIGN: PubMed, literature, and web searches. Centers for Disease Control and Prevention (CDC), Food and Drug Administration (FDA), Medicine Without Frontiers, and World Health Organization (WHO) document analyses. Investigations in China, the Philippines, Thailand, and the United States. Review of SE Asia, US, and West Africa isolation-treatment centers. Innovation of a SCP, ACF, and DC suitable for American and other communities. OUTCOMES: The authors designed an ACF and DC to integrate SCP principles for urgent Ebola care. FDA emergency use authorizations for Ebola molecular diagnostics were discovered, but no portable, handheld, or self-contained molecular POC instruments are yet available, although feasible. The WHO initiated design criteria and an acceptance protocol for testing. Financial investment in POCT will downsize Ebola outbreaks. CONCLUSIONS: POCT is facilitating global health. Now, global health problems are elevating POCT to new levels of importance for accelerating diagnosis and evidence-based decision making during disease outbreaks. Authorities concur that rapid diagnosis has potential to stop disease spread. With embedded POCT, strategic SCPs planned by communities fulfill CDC recommendations. POC devices should consolidate multiplex test clusters supporting patients with Ebola in isolation. The ultimate future solution is FAST POC. New technologies offer minimally significant risks. Diagnostic centers in ACFs and transportable formats also will optimize Ebola SCPs.


Subject(s)
Community Health Centers , Decision Support Systems, Clinical , Disease Outbreaks/prevention & control , Hemorrhagic Fever, Ebola/diagnosis , Hemorrhagic Fever, Ebola/therapy , Point-of-Care Systems , Africa, Western , Critical Pathways , Hemorrhagic Fever, Ebola/prevention & control , Humans , Patient Isolation , Public Health , Resilience, Psychological , United States
3.
Indian J Endocrinol Metab ; 15(2): 115-7, 2011 Apr.
Article in English | MEDLINE | ID: mdl-21731869

ABSTRACT

BACKGROUND: Congenital hypothyroidism and phenylketonuria, the two major problems of several metabolic errors are presently the focus of attention, in Thailand. These two conditions are assigned as diseases to be controlled under the National Public Health Policies of Thailand. MATERIALS AND METHODS: Here, the authors summarize and report the 10-year study on the prevalence of neonatal hypothyroidism and phenylketonuria in Southern Thailand. RESULTS: This report is good representative data from Thailand, a country in Southeast Asia. Another interesting point in this study is the concern of the recalling process. CONCLUSION: It can be seen that there are a considerable number of infants who did not receive the confirmation test due to loss of follow-up after calling for a recheck.

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