Global Health . The challenges of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) testing in low-middle income countries and possible cost-effective measures in resource-limited settings

[tetano]

Global Health


. 2022 Jan 22;18(1):5.
doi: 10.1186/s12992-022-00796-7.
The challenges of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) testing in low-middle income countries and possible cost-effective measures in resource-limited settings


Zamathombeni Duma ^{1 2} , Anil A Chuturgoon ³ , Veron Ramsuran ⁴ , Vinodh Edward ⁵ , Pragalathan Naidoo ^{4 6} , Miranda N Mpaka-Mbatha ^{4 6 7} , Khethiwe N Bhengu ^{4 6 7} , Nomzamo Nembe ^{4 6} , Roxanne Pillay ^{4 6 7} , Ravesh Singh ⁴ , Zilungile L Mkhize-Kwitshana ^{4 6}



Affiliations

• PMID: 35065670
• DOI: 10.1186/s12992-022-00796-7

Abstract

Diagnostic testing for the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection remains a challenge around the world, especially in low-middle-income countries (LMICs) with poor socio-economic backgrounds. From the beginning of the pandemic in December 2019 to August 2021, a total of approximately 3.4 billion tests were performed globally. The majority of these tests were restricted to high income countries. Reagents for diagnostic testing became a premium, LMICs either cannot afford or find manufacturers unwilling to supply them with expensive analytical reagents and equipment. From March to December 2020 obtaining testing kits for SARS-CoV-2 testing was a challenge. As the number of SARS-CoV-2 infection cases increases globally, large-scale testing still remains a challenge in LMICs. The aim of this review paper is to compare the total number and frequencies of SARS-CoV-2 testing in LMICs and high-income countries (HICs) using publicly available data from Worldometer COVID-19, as well as discussing possible interventions and cost-effective measures to increase testing capability in LMICs. In summary, HICs conducted more SARS-CoV-2 testing (USA: 192%, Australia: 146%, Switzerland: 124% and Canada: 113%) compared to middle-income countries (MICs) (Vietnam: 43%, South Africa: 29%, Brazil: 27% and Venezuela: 12%) and low-income countries (LICs) (Bangladesh: 6%, Uganda: 4% and Nigeria: 1%). Some of the cost-effective solutions to counteract the aforementioned problems includes using saliva instead of oropharyngeal or nasopharyngeal swabs, sample pooling, and testing high-priority groups to increase the number of mass testing in LMICs.

Keywords: Cost-effective strategies; Diagnostic testing challenges; Low-middle-income countries; Resource-limited settings; SARS-CoV-2.