Point of care testing: a delight or a dilemma in the developing world?: an overview.

OBJECTIVES: This is to highlight the use of POCT especially by the untrained laboratorians, and its disadvantages and advantages. PATIENTS AND METHODS: The results of urinalysis carried out in Antenatal Clinic and Central Chemical Pathology laboratory for a two-year period were analysed to determine how the results were interpreted, whether there were further request(s) and how relevant they were. The results of 56 out of 303 oral glucose tolerance tests carried out because of positive glucose in urine (glycosuria) were reviewed. Similarly the results of 176 pregnant women who had proteinuria on urinalysis in Antenatal Clinic and 92 patients who had positive bilirubin-diglucuronide in their urine (bilirubinuria) were also reviewed. RESULTS: The result shows that only 18 out of the 56 patients who had OGTT based on positive glucose in their urine had glycosuria on fasting urine sample on the OGTT day. 4 of them had gestational diabetes mellitus, 2 were diabetic before conception 5 had impaired glucose tolerance, while 7 had renal glycosuria. Thirty-eight results were false positives with repeat urinalysis and OGTT. Also out of the 176 pregnant women who had proteinuria on urinalysis only 57(32.4%) were confirmed on repeat urinalysis and/or 24 hr urinary protein quantification, 51 became negative after successful treatment of their UTI, while 68(38.6%) were false positives. Similarly out of 92 patients who had bilirubinuria only 23 showed abnormalities suggestive of some degree of liver disease. CONCLUSION: Results obtained on POCT must be validated in the central laboratory.