Molecular Diagnosis in Resource-Limited Settings

The advantages of molecular testing for accurate diagnosis and optimal therapeutic management of patients infected with microorganisms is well established, yet many test methods are not feasible in underdeveloped or resource-limited settings. The disparity in testing methods is controversial from ethical, financial, and scientific perspectives. Over the years, philanthropic funding for early and accurate diagnosis has helped curtail the spread of disease and improved overall survival, yet infections caused by microorganisms are still the leading cause of death in the resource-limited parts of the world. Fortunately, there are promising new tests that are inexpensive, portable, easy-to-use, and practical at even small, rural, and remote health centers. This review describes the potential problems encountered in the routine implementation and performance of molecular assays in resource-poor settings and discusses the adaptations and alternative methodologies that are routinely used in most microbiology laboratories in such settings.