Endemic Non-Communicable Diseases

Dear Michael,

I would like to highly recommend visual blood glucose strips for measuring blood glucose levels in Diabetes. The strips are very cheap (about 10% of the cost of meter strips, and that doesn't even include the cost of the meters, batteries (usually very small / flat / circular / unusual and expensive types and hard to find in remote provinces to replace flat ones) and calibration issues) and accurate and can be used not only for initial screening but also for affordable ongoing monitoring.

We have shared these strips with families of children living with T1DM in Vietnam - they have been well accepted (the crowds around the demonstration tables were 10 deep at the Club meetings until we found better ways to show how to use them), visual instructions show how to use them and families really love the price. It's not official, but you can also cut the strips in half (lengthways) and get two tests for the price of 1... We have been told that some people cut them up even thinner (++), but perhaps more testing would be needed to see at what point cutting needs to stop! :) The strips do not need refrigeration, are light-weight and ...

Dear Michael,

I would like to highly recommend visual blood glucose strips for measuring blood glucose levels in Diabetes. The strips are very cheap (about 10% of the cost of meter strips, and that doesn't even include the cost of the meters, batteries (usually very small / flat / circular / unusual and expensive types and hard to find in remote provinces to replace flat ones) and calibration issues) and accurate and can be used not only for initial screening but also for affordable ongoing monitoring.

We have shared these strips with families of children living with T1DM in Vietnam - they have been well accepted (the crowds around the demonstration tables were 10 deep at the Club meetings until we found better ways to show how to use them), visual instructions show how to use them and families really love the price. It's not official, but you can also cut the strips in half (lengthways) and get two tests for the price of 1... We have been told that some people cut them up even thinner (++), but perhaps more testing would be needed to see at what point cutting needs to stop! :) The strips do not need refrigeration, are light-weight and come with 50 strips per bottle (a bottle could easily hold over 100 though - health workers could carry very large numbers of strips around).

Here is a link to the brand we have been using (Betachek - made in Australia - http://www.betachek.com/bv.htm). There is also a brand from Russia I believe.

In our opinion it is really important that families and governments have cheaper options such as this available to them... but the main barriers are availability (they are not well known and so not well promoted nor imported unless someone is making a specific effort to make them available); health professionals tend to use meters in hospitals and are unfamiliar with visual strips (so tend to promote meters to families - even to those who can't realistically afford them); unless families are specifically educated that the visual strips are accurate they naturally believe meters are more "technical" and therefore superior (education can overcome this perception).... Also, the meter market is very well financed, and at Club meetings there will be a number of companies promoting their meters to families - the visual strips producers don't have the same money behind them, so it has really been a labour of love promoting them and making them available. The difference in numbers (families at the Betachek table versus meter table) is profound though, and reassures you that you are on the right track.

One final comment... Our goal has been to focus on asking not "do you test BGLs?" but rather "How often do you test BGLs?"... If families are testing once a month because that's all they can afford (we see it all too often), then visual strips are a great option.

Good luck - and thanks for doing this,
Kate Armstrong
President
CLAN (Caring & Living As Neighbours)
www.clanchildhealth.org

Hi Michael,

I would recommend that you take a look into http://www.dfa.org/index.html - Diagnostics for All. I heard their CEO speak at the Unite for Sight Global Health Conference at Yale University this year. They are developing low cost point of care diagnostic. Currently they are testing the technology for Liver based diseases but they have the technology to diagnose TB, Malaria, HIV, etc.
Thanks
Smitha

I would be happy to be a part of a trial to assess them.

Dear Michael,

Diagnostics for All is non-profit dedicated to creating low-cost, easy-to-use, point-of-care diagnostics designed specifically for resource limited settings. Our devices require minimal training to use, practically no sample preparation, no electricity or additional equipment to process a sample, and easy visual readout. Our most advanced diagnostic to date is a liver function test and our platform can be adapted to perform other clinical assays and disease detection.

We greatly appreciate Smitha's referral, however, we do not currently have diagnostic tests ready for testing for the diseases listed in your initial posting. We are currently seeking funding to develop tests for these illnesses and hope to have them in the pipeline in the near future.

Best regards,
Matthew

Mathew,that is interesting.Would like to interact with you directly to learn more.