April 14, 2009
BBC News on Sunday examined how the Bwindi Community Hospital -- located in a remote region on the border between Uganda and the Democratic Republic of Congo -- has improved its capacity to monitor HIV-positive people using a portable blood-testing device, called the PointCare NOW machine. According to BBC News, the Bwindi hospital provides health care to about 40,000 people, including 1,000 people living with HIV. However, the area's lack of transportation and roads pose obstacles for people seeking health services. Therefore, the hospital dispatches a four-wheel-drive "community ambulance," which carries the PointCare NOW machine, to reach remote communities.
PointCare, a U.S.-based company that specializes in diagnostic equipment for developing countries, developed the machine in response to demand from health workers in southern Africa. According to company co-founder Petra Krauledat, during a visit to the region in the 1990s, she and co-founder Peter Hansen discovered that "tons of donated instruments just sat in storage," because the chemicals needed to conduct the diagnostic tests had expired in the heat. According to Krauledat, they determined that health workers in the region needed "a test that could be used in a little shack of a clinic, transported to remote areas and that could withstand the high temperatures." With the development of the PointCare NOW machine, Krauledat said, "We've fulfilled that quest."
According to BBC News, traditional HIV screening tests use fluorescent markers to label antibodies and count CD4+ T cells. The fluorescent chemicals cannot withstand high temperatures and must be refrigerated. Therefore, Hansen developed a new technique to label antibody cells using colloidal gold, which is heat-stable, can be freeze-dried and stored at temperatures greater than 42 degrees Celsius for one year. In order to use the PointCare NOW machine, health workers liquify the freeze-dried gold-labeled antibodies and combine them with the blood sample. A chemical accelerator then allows the antibodies to attach to the cells. According to Krauledat, the test produces results in about eight minutes. In addition, the PointCare NOW machine is less expensive to maintain than traditional equipment because it runs on a battery pack and does not consume much power, Krauledat said.
The machine, which the hospital received as a donation in 2008, counts CD4+ cells and five other subtypes of white blood cells. The results provide physicians with a complete picture of the patient's immune system, as well as indicators of whether the patient might have anemia, tuberculosis or other opportunistic infections. It also allows health workers to monitor antiretroviral treatment. Paul Williams, a physician working with the Bwindi Community Hospital, said that in the past, it could take several days or weeks for an HIV-positive person to receive the results of a blood test. "Now, with this simple piece of technology, we can deal with problems immediately," he said. According to Williams, the machine also has contributed to declining HIV mortality rates. "We're able to diagnose it early, manage it early and keep people living with HIV fit and well," Williams said. He added, "Over a reasonably short period of time, we've been able to change HIV from being a death sentence into something that people can live with and lead productive lives" (Gill, BBC News, 4/12).
Reprinted with permission from kaisernetwork.org. You can view the entire Kaiser Daily HIV/AIDS Report, search the archives, or sign up for email delivery at www.kaisernetwork.org/dailyreports/hiv. The Kaiser Daily HIV/AIDS Report is published for kaisernetwork.org, a free service of the Kaiser Family Foundation, by The Advisory Board Company. © 2009 by The Advisory Board Company and Kaiser Family Foundation. All rights reserved.