The World Health Organization (WHO)
published its first-ever list of essential diagnostic tests earlier this
year. The list includes tests
recommended by the WHO for use in ‘primary health care’ and ‘health care
facilities with clinical laboratories’.
The word ‘essential’ means that
these tests should be available at all times in primary health care or higher
health care facilities and they should be affordable with assured quality and
accuracy.
At the primary healthcare level,
the list starts with basic hematological investigations such as hemoglobin,
TLC, DLC, and recommends using a hemoglobinometer/dipstick, hematology analyser
or hemocytometer. Most hematological tests can be indirectly estimated by slide
method also.
To measure blood sugar level, the
use of a glucometer is suggested.
WHO has recommended using urine
dipstick to test for albumin, bilirubin, and glucose as well as to detect urinary
tract infection.
The list also includes microscopic
examination for routine hematological investigations, urine analysis, stool
examination, sputum for TB and to identify species of malaria parasite
(plasmodium).
Rapid diagnostic tests (RDTs) have
been included to test for hepatitis B surface antigen (HBsAg), hepatitis B e
antigen (HBeAg), anti-HCV antibodies, HIV, malaria and antibodies to Treponema
pallidum.
Once the list is made mandatory,
these will be the tests permitted to be done by GPs, at primary health care
centers and in Mohalla clinics.
In my view any test that can be
done with a microscope or for which RDT or Dipstick is available can be added
by the GP as and when required.
Tests for dengue, Chikungunya,
typhoid, Troponin T or I etc for which RDT or strips are available can be added
though not included in the WHO list at present.
Dr KK
Aggarwal
Padma
Shri Awardee
Vice
President CMAAO
Group
Editor-in-Chief IJCP Publications
President
Heart Care Foundation of India
Immediate
Past National President IMA
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