Monday, August 27, 2018

WHO list of essential diagnostic tests in primary healthcare

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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