Testing programs for severe acute respiratory syndrome coronavirus 2 have relied on high-throughput polymerase chain reaction laboratory tests and rapid antigen assays to meet diagnostic needs. Both technologies are essential; however, issues of cost, accessibility, manufacturing delays, and performance have limited their use in low-resource settings and contributed to the global inequity in coronavirus disease 2019 testing. Emerging low-cost, multidisease point-of-care nucleic acid tests may address these limitations and strengthen pandemic preparedness, especially within primary healthcare where most cases of disease first present. Widespread deployment of these novel technologies will also help close long-standing test access gaps for other diseases, including tuberculosis, human immunodeficiency virus, cervical cancer, viral hepatitis, and sexually transmitted infections. We propose a more optimized testing framework based on greater use of point-of-care nucleic acid tests together with rapid immunologic assays and high-throughput laboratory molecular tests to improve the diagnosis of priority endemic and epidemic diseases, as well as strengthen the overall delivery of primary healthcare services.

中文翻译：

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核酸即时检测以提高诊断准备

严重急性呼吸系统综合症冠状病毒 2 的检测项目依赖高通量聚合酶链反应实验室检测和快速抗原检测来满足诊断需求。这两种技术都是必不可少的；然而，成本、可及性、制造延迟和性能等问题限制了它们在资源匮乏环境中的使用，并导致了 2019 年冠状病毒病检测的全球不公平。新兴的低成本、多疾病床旁核酸检测可能会解决这些局限性并加强大流行病的准备，尤其是在大多数疾病病例首先出现的初级保健中。这些新技术的广泛部署也将有助于缩小其他疾病的长期检测准入差距，包括结核病、人类免疫缺陷病毒、宫颈癌、病毒性肝炎、和性传播感染。我们提出了一个更优化的检测框架，该框架基于更多地使用床旁核酸检测以及快速免疫学检测和高通量实验室分子检测，以改进重点地方病和流行病的诊断，并加强整体交付的初级保健服务。