About Respiratory Infection POCT
The Aboriginal and Torres Strait Islander Respiratory Infection Point-of-Care (POC) Testing Program was implemented during the COVID-19 pandemic (utilising existing infrastructure developed by the TTANGO STI testing Program) to provide rapid access to COVID-19 testing, and to facilitate timely public health responses, within Aboriginal and Torres Strait Islander communities. It has since been expanded to include testing for influenza (Flu) A and B and respiratory syncytial virus (RSV).
The program provides on-site, rapid access for Aboriginal and Torres Strait islander people to molecular (PCR) testing for respiratory infections within the primary care environment, in areas where access to POC testing in a decentralised, culturally sensitive setting may improve health outcomes for vulnerable individuals and communities.
Background to the Program
In many remote Aboriginal and Torres Strait Islander communities in Australia, there are significant distances between health services and laboratories. In the same communities, the risk of morbidity and mortality due to respiratory infections is higher due to pre-existing comorbidities and overcrowding, which also makes social distancing practices impractical. Timely detection of respiratory infections in these communities is essential to break the spread of transmission, reduce mortality and avoid unnecessary evacuations.
In mid-April 2020, the Kirby Institute (University of New South Wales) and the Flinders University International Centre for Point-of-Care Testing (ICPOCT) were awarded a grant by the Australian Government Department of Health to manage and implement COVID-19 point-of-care (POC) testing in remote Indigenous communities across Australia, on behalf of the Australian Government.
The Aboriginal and Torres Strait Islander COVID-19 Point-of-Care Testing Program was implemented utilising the GeneXpert POC testing device (Cepheid Inc), which employs state-of-the-art reverse transcriptase (RT) nucleic acid amplification technology (NAAT) to detect COVID-19 directly and, as such, has close to 100% sensitivity and specificity. The new TGA-approved Xpert SARS-CoV-2 test cartridge for use on the Xpert platform enabled the detection of COVID-19 in 45 minutes, at or close to the point-of-care.
The COVID-19 POC project leveraged from the TTANGO2 (Test, Treat ANd Go) POC testing network for sexually transmitted infections which also uses the GeneXpert platform. The majority of existing TTANGO2 sites took part in the COVID-19 POCT Program.
The Aboriginal and Torres Strait Islander COVID-19 POC testing network in the primary care sector complemented COVID-testing conducted at regional laboratories across Australia and enable reach to remote areas beyond that which the laboratories can service. The COVID-19 program team worked closely with state jurisdictions, Aboriginal community controlled health organisations and services, and the pathology sector to identify priority sites for the GeneXperts to be placed strategically within the Aboriginal and Torres Strait Islander COVD-19 POC Testing Program’s remote network.
The re-named Respiratory Infection POCT network now includes over 100 sites and was enhanced in 2022 with the introduction of a multiplex assay which can detect COVID-19, Influenza A, Influenza B and Respiratorry Syncytial Virus (RSV) in one test, providing a result for all four infections in less than 40 minutes.