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Point‑of‑Care Testing Could Improve Early Detection of Chronic Kidney Disease in Africa By Carbonatix A 2026 systematic review and meta‑analysis found that chronic kidney disease (CKD) stages 1–5 affect about 13.7 % of adults in 19 African countries. Early detection remains difficult because many people lack access to laboratory services and routine screening, especially those with hypertension, diabetes or cardiovascular disease. Point‑of‑care testing (POCT) – diagnostic tests performed near the patient rather than in centralized laboratories – has been proposed as a way to bridge this gap. POCT can provide rapid results for blood creatinine, which estimates glomerular filtration rate (eGFR), and urine albumin, which signals kidney damage. The 2024 Kidney Disease: Improving Global Outcomes (KDIGO) guideline recommends POCT for creatinine, urine albumin or protein in settings with limited laboratory access, noting that decentralised testing can facilitate earlier detection and reduce delays in clinical decision‑making. The World Health Organization has also listed point‑of‑care creatinine testing on its Model List of Essential In Vitro Diagnostics for use in community outreach and primary health facilities without laboratories. Key considerations for implementing POCT in Africa 1. Diagnostic performance and clinical utility POCT devices vary in accuracy. Under‑estimation of creatinine can falsely reassure clinicians, while over‑estimation may trigger unnecessary referrals. Similarly, false‑negative urine albumin results can miss early kidney damage, and false‑positives can lead to unwarranted investigations. Devices should be evaluated against laboratory standards and WHO’s REASSURED criteria (Real‑time connectivity, Ease of specimen collection, Affordability, Sensitivity, Specificity, User‑friendliness, Rapidity, Robustness, Equipment‑free, Deliverable to end‑users). Confirmatory laboratory testing remains essential before diagnosing CKD, which requires persistent abnormalities for at least three months. 2. Affordability and equitable access Decentralised testing can reduce travel costs for patients in rural or hard‑to‑reach communities. However, abnormal POCT results often necessitate further laboratory investigations and treatment. Cost‑effectiveness analyses must consider equipment, consumables, staff training, quality assurance, maintenance, confirmatory testing and follow‑up care. Sustainable financing and integration into existing primary‑care services can minimise out‑of‑pocket expenses and ensure timely care. 3. Integration into primary health care Screening is only the first step. Clear protocols are needed for who is screened, how abnormal results are communicated, when repeat testing should occur, and how patients are linked to specialist care. Task‑sharing with community health workers (CHWs) can extend screening to underserved populations, but requires structured training, defined scopes of practice, supervision, quality assurance and reliable referral pathways. CHWs should not diagnose CKD independently; they can facilitate specimen transport, patient reminders and result communication. 4. Multimorbidity and integrated screening Many patients with CKD also have diabetes, hypertension, HIV or other chronic conditions. Integrating kidney health assessment into routine chronic‑disease management can reduce fragmented care and optimise resource use. Integrated screening models must be evaluated for effectiveness, acceptability and impact on health outcomes without overburdening patients or health workers. 5. Home‑based testing and self‑monitoring Two approaches exist: patient‑performed self‑testing and healthcare‑worker‑led testing during home visits. Both can extend access beyond health facilities, especially for high‑risk groups. Suitability depends on the intended users, test type and clinical purpose. Technologies designed for self‑testing require rigorous validation before widespread deployment. Looking ahead While POCT offers promise for improving CKD detection in Africa, its success depends on accurate devices, affordable confirmatory testing, robust integration into primary‑care pathways, and thoughtful consideration of multimorbidity and home‑based options. Policymakers, clinicians and manufacturers must collaborate to ensure that rapid testing translates into timely diagnosis, appropriate referrals and ultimately better kidney health outcomes for African populations. Article source: My Joy Online | Image credit: My Joy Online
Point‑of‑Care Testing Could Improve Early Detection of Chronic Kidney Disease in Africa By Carbonatix A 2026 systematic review and meta‑analysis found that chronic kidney disease (CKD) stages 1–5 affect about 13.7 % of adults in 19 African countries. Early detection remains difficult because many people lack access to laboratory services and routine screening, especially those with hypertension, diabetes or cardiovascular disease. Point‑of‑care testing (POCT) – diagnostic tests performed near the patient rather than in centralized laboratories – has been proposed as a way to bridge this gap. POCT can provide rapid results for blood creatinine, which estimates glomerular filtration rate (eGFR), and urine albumin, which signals kidney damage. The 2024 Kidney Disease: Improving Global Outcomes (KDIGO) guideline recommends POCT for creatinine, urine albumin or protein in settings with limited laboratory access, noting that decentralised testing can facilitate earlier detection and reduce delays in clinical decision‑making. The World Health Organization has also listed point‑of‑care creatinine testing on its Model List of Essential In Vitro Diagnostics for use in community outreach and primary health facilities without laboratories. Key considerations for implementing POCT in Africa 1. Diagnostic performance and clinical utility POCT devices vary in accuracy. Under‑estimation of creatinine can falsely reassure clinicians, while over‑estimation may trigger unnecessary referrals. Similarly, false‑negative urine albumin results can miss early kidney damage, and false‑positives can lead to unwarranted investigations. Devices should be evaluated against laboratory standards and WHO’s REASSURED criteria (Real‑time connectivity, Ease of specimen collection, Affordability, Sensitivity, Specificity, User‑friendliness, Rapidity, Robustness, Equipment‑free, Deliverable to end‑users). Confirmatory laboratory testing remains essential before diagnosing CKD, which requires persistent abnormalities for at least three months. 2. Affordability and equitable access Decentralised testing can reduce travel costs for patients in rural or hard‑to‑reach communities. However, abnormal POCT results often necessitate further laboratory investigations and treatment. Cost‑effectiveness analyses must consider equipment, consumables, staff training, quality assurance, maintenance, confirmatory testing and follow‑up care. Sustainable financing and integration into existing primary‑care services can minimise out‑of‑pocket expenses and ensure timely care. 3. Integration into primary health care Screening is only the first step. Clear protocols are needed for who is screened, how abnormal results are communicated, when repeat testing should occur, and how patients are linked to specialist care. Task‑sharing with community health workers (CHWs) can extend screening to underserved populations, but requires structured training, defined scopes of practice, supervision, quality assurance and reliable referral pathways. CHWs should not diagnose CKD independently; they can facilitate specimen transport, patient reminders and result communication. 4. Multimorbidity and integrated screening Many patients with CKD also have diabetes, hypertension, HIV or other chronic conditions. Integrating kidney health assessment into routine chronic‑disease management can reduce fragmented care and optimise resource use. Integrated screening models must be evaluated for effectiveness, acceptability and impact on health outcomes without overburdening patients or health workers. 5. Home‑based testing and self‑monitoring Two approaches exist: patient‑performed self‑testing and healthcare‑worker‑led testing during home visits. Both can extend access beyond health facilities, especially for high‑risk groups. Suitability depends on the intended users, test type and clinical purpose. Technologies designed for self‑testing require rigorous validation before widespread deployment. Looking ahead While POCT offers promise for improving CKD detection in Africa, its success depends on accurate devices, affordable confirmatory testing, robust integration into primary‑care pathways, and thoughtful consideration of multimorbidity and home‑based options. Policymakers, clinicians and manufacturers must collaborate to ensure that rapid testing translates into timely diagnosis, appropriate referrals and ultimately better kidney health outcomes for African populations.
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