Current Innovations in the Development and Application of qPCR in a Resource-Limited Setting

The application of a technologically advanced molecular tool such as quantitative polymerase chain reaction (qPCR) may seem incongruous in resource-limited settings where the advantages to both the researcher and the local community may initially appear doubtful. While disease burden is greatest in resource-limited settings (sub-Saharan Africa alone carries 25% of the world’s disease burden1), should the highly technical molecular diagnostic tool of qPCR be applied to answering such questions where limited resources could well be spent addressing the causes of disease or improving treatment rather than the diagnosis? The benefit to the individual from rapid, accurate disease diagnosis, as long as diagnosis goes hand in hand with prompt and effective treatment, is clear.2–4 The benefit to the wider community is also immediately obvious for diagnosis of infectious disease. But what are the possible benefits of using qPCR for such disease diagnosis? The use of any diagnostic or research tool should be driven by its usefulness in answering the clinical/scientific questions posed, regardless of the setting. It is clear that qPCR offers many advantages for disease diagnosis, such as speed, increased sensitivity of detection, accurate quantification of the target DNA, ease of data comparison, the ability to amplify and quantify multiple targets in the same assay, the use of a small starting volume of sample, and a completely closed system of analysis compared to conventional PCR and equivalent molecular tests such as lateral flow assays. Both commercial and in-house assays have been developed for many important diseases common in resource-poor settings, including malaria, HIV, and tuberculosis. The development of the assay is the first step to conducting qPCR in a resource-limited setting, accurately, appropriately, and sustainably for the benefit of all.