Throughout history, physicians relied heavily on their senses to diagnose diseases, examining appearances, sounds, and even odors associated with various conditions. As our understanding of diseases has evolved, so too have our diagnostic methods, leading to the development of sophisticated testing processes that form a crucial line of defense against global health threats.
The swift, accurate identification of infectious diseases is essential for managing outbreaks. Dr. Placide Welo, director of the National Program for the Elimination of Cholera and the Control of Other Diarrheal Diseases (PNECHOL), emphasizes the significance of innovative testing methods that are not only faster and more affordable but also comprehensive in nature. “Testing accelerates progress against both new health threats and those that have devastated mankind for centuries,” Dr. Welo states.
As pathogens continue to evolve, the need for ongoing innovation in diagnostic testing becomes imperative. However, public health responses often encounter obstacles due to gaps in the availability and accuracy of current tests. The journey to develop new diagnostic tools is complex, involving the CDC Foundation’s collaboration with various partners to conduct rigorous research, testing, and evaluation to introduce new tests that are both accurate and scalable.
In the early stages of testing research, researchers often delve into the microscopic details of infections. Their work frequently focuses on identifying antibody biomarkers—molecules that signify the presence of an infection. After these biomarkers are identified, researchers can then create tests designed to detect these molecules within a sample.
The CDC Foundation plays a vital role in supporting the discovery of biomarkers specifically related to neglected tropical diseases (NTDs). NTDs comprise a wide array of infections, many dating back thousands of years, and are notably prevalent in tropical and subtropical regions across Africa, Asia, Central America, and South America. Affecting nearly a billion people globally, NTDs pose significant human, social, and economic challenges. Unfortunately, many current testing procedures for these diseases are outdated or inefficient.
In American Samoa, for instance, lymphatic filariasis—a mosquito-borne parasitic disease—afflicts disadvantaged communities, exacerbating their struggles with inadequate access to medical care and sanitation. To combat this, the CDC Foundation focuses on developing rapid and efficient tests for NTDs like lymphatic filariasis. Utilizing an innovative method called serum epitope repertoire analysis (SERA), scientists can extract intricate data from a single specimen, thereby identifying the antibodies linked with specific infections. This foundational knowledge is crucial for formulating accurate diagnostic tests.
However, even after a promising test is developed and validated through trials, the next challenge is scaling up the evaluation process. This phase includes assessing how effectively the tests can assist health departments in the U.S. and ministries of health worldwide in preventing outbreaks. A current evaluation in the Democratic Republic of the Congo (DRC) aims to determine whether increased use of rapid diagnostic tests (RDTs) can enhance early detection of cholera outbreaks, a disease that has claimed over 95,000 lives globally each year.
Dr. Welo reiterates the importance of timely cholera testing: “Improving the speed of cholera testing can make a big difference in how quickly cases are identified and will also allow for faster outbreak detection and response.” In DRC, access to these diagnostic tests is integral for collecting timely data that can help avert potentially catastrophic outbreaks that could spread internationally.
For some diseases, such as tuberculosis (TB), diagnostic tests must be performed in laboratory settings, which can pose financial challenges for many areas. Nevertheless, alternative screening tools, including chest X-rays and the tuberculin skin test, provide reliable means for identifying individuals in need of treatment without necessitating laboratory tests immediately.
In Vietnam, which faces a persistent TB burden with approximately 13,800 deaths annually, the CDC Foundation partnered with Friends for International TB Relief (FIT) from 2019 to 2023 to bolster a mobile chest X-ray initiative in Ho Chi Minh City. This campaign expanded to incorporate testing for latent TB infections, effectively offering vital information and care to individuals at risk who might not have otherwise sought testing services. Luan Vo, CEO of FIT, notes, “We were able to go out into the community and provide access to TB screening to those who might not have otherwise sought out testing, and we were able to diagnose TB which would’ve otherwise been missed.”
In our interconnected society, diseases can spread rapidly, underscoring the need for proactive health measures. The ongoing initiatives by the CDC Foundation to develop new diagnostic tests, evaluate their efficacy, and address gaps in testing availability are crucial in enhancing our preparedness against potential outbreaks in the future.
This commitment to advancing diagnostic testing is not just about technological progress; it translates into real-world impacts, saving lives and improving the health outcomes for communities around the globe.
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