Botswana's Lab-In-A-Briefcase: A Position Paper

Detecting and managing communicable and non-communicable diseases in rural settings of Africa raises numerous structural, syntactical and semantic issues. Further, it has been observed that both Communicable Diseases (CDs) such as TB and Non-Communicable Diseases (NCDs), such as cancer, diabetes, cardiovascular diseases and chronic respiratory disease, are on the rise in sub-Saharan African countries and estimated to account for about 25% of deaths (Bloomfield et al., 2014) [8]. In Botswana, NCDs account for more than a third of all deaths in the country (WHO NCD country profile, 2014) [9]. For cash-poor part of Africa, this additional spend-requirement in healthcare is unfortunately substantial. One approach to reducing death related to CD/NCD is early detection and control through data collection and appropriate intervention. In sub-Saharan Africa countries, most of the population lives in rural areas where access to healthcare facilities is very limited. In such circumstances, a low-cost and mobile healthcare facility along with associated Information and Communication Technologies (ICT) would be of great assistance. This paper investigates the application of the "lab-in-a-briefcase" technology for the management of CDs/NCDs in Botswana and other SADC countries. The "lab-in-a-briefcase is designed to provide a portable laboratory diagnosis toolkit with rapid results (about 15 minutes) that can be used in areas where access to laboratory or healthcare facility is limited and can be used with minimal training. It contains all the necessary tools and chemicals/reagents which are packaged in a briefcase form so that they can easily be carried. In addition, the Lab-in-a-briefcase employs mini-HPLC and smart camera, microphone, credit card-sized ECG and microscope so that a variety of tests can be performed quickly and efficiently in a portable manner. This paper details the design and deployment of "Lab-in-a-briefcase" and associated software tools at primary care health facilities so that diagnosis can be quickly carried out and the resulting medical records are automatically generated, converted into appropriate format and securely shared with different health information systems. The deployment of this system requires adaptation of the system in the context of the linguistic, legal, security, and other policy requirements of the participating countries. As part of the demonstration of the applicability, pilot studies will be extended to all participating African countries. Our end-objective is to develop a fully optioned prototype.