Using drones to transport suspected COVID-19 samples; experiences from the second largest testing centre in Ghana, West Africa

Healthcare providers' and community stakeholders' perception of using drones for tuberculosis diagnosis in Nepal: an exploratory qualitative study

BACKGROUND

In rural Nepal, poor road and transport networks and few testing laboratories impede tuberculosis diagnosis. A drone transport system was established to transport sputum samples to laboratories with advanced molecular diagnostic machines - GeneXpert MTB/RIF. This study explored the perceptions of using drones for tuberculosis diagnosis among community stakeholders, female community health volunteers, and healthcare providers from communities with drones implemented and without drone programs.

METHODS

In December 2019, we conducted focus group discussions in two drone-implemented and three without drone programs. We purposively selected 40 participants: Female community health volunteers (n=16), community stakeholders (n=18), and healthcare providers (n=6). Focus group discussions employed semi-structured questions, which were audio-recorded, transcribed, and translated into English. Codebook thematic analysis was performed and charted using three levels of the socioecological model: individual, community, and health system.

RESULTS

We identified four themes (i) Trust in drones underpins successful use for tuberculosis diagnosis; (ii) Drone-based sample transport optimised connectivity and accessibility for people with tuberculosis and healthcare providers; (iii) Drones create opportunities to improve community and health system, and (iv) External factors impede the use of drones to facilitate tuberculosis diagnosis. The study reported, at an individual level, people's trust in drones mainly through community-based events. For local healthcare providers, drones reduce transport time, opportunity costs, and immediate cash costs of transport. At the community level, drone use creates opportunities to increase the skills of local people as drone pilots. At the health system level, drone transport increases efficient sputum sample delivery and provides opportunities to transport medicines and other biomedical samples. Perceived challenges of using drones were adverse weather, limitations in skilled human resources, and financial resources to operate drones sustainably.

CONCLUSIONS

Healthcare providers, female community health volunteers, and community stakeholders reported high levels of trust in drones and perceived their use for tuberculosis diagnosis and care to substantially benefit people with tuberculosis and providers in rural Nepal. There was a high level of demand for application to other healthcare services and wider geographical coverage, demonstrating drones as a potential tool for enhancing access to healthcare in geographically remote communities.

The effects of drone transportation on routine laboratory, immunohematology, flow cytometry and molecular analyses

OBJECTIVES

Transportation of medical samples between laboratories or hospital sites is typically performed by motorized ground transport. Due to the increased traffic congestions in urban environments, drone transportation has become an attractive alternative for fast shipping of samples. In accordance with the CLSI guidelines and the ISO 15189 standard, the impact of this transportation type on sample integrity and performance of laboratory tests must be thoroughly validated.

METHODS

Blood samples from 36 healthy volunteers and bacterial spiked urine samples were subjected to a 20-40 min drone flight before they were analyzed and compared with their counterparts that stayed on the ground. Effects on stability of 30 routine biochemical and hematological parameters, immunohematology tests and flow cytometry and molecular tests were evaluated.

RESULTS

No clinically relevant effects on blood group typing, flow cytometry lymphocyte subset testing and on the stability of the multicopy opacity-associated proteins (Opa) genes in bacterial DNA nor on the number of Abelson murine leukemia viral oncogene homolog 1 (abl) housekeeping genes in human peripheral blood cells were seen. For three of the 30 biochemistry and hematology parameters a statistically significant difference was found: gamma-glutamyl transferase (gamma-GT), mean corpuscular hemoglobin (MCH) and thrombocyte count. A clinically relevant effect however was only seen for potassium and lactate dehydrogenase (LDH).

CONCLUSIONS

Multi-rotor drone transportation can be used for medical sample transportation with no effect on the majority of the tested parameters, including flow cytometry and molecular analyses, with the exception of a limited clinical impact on potassium and LDH.

Unmanned aerial vehicles and pre-hospital emergency medicine

Unmanned aerial vehicles (UAVs) are used in many industrial and commercial roles and have an increasing number of medical applications. This article reviews the characteristics of UAVs and their current applications in pre-hospital emergency medicine. The key roles are transport of equipment and medications and potentially passengers to or from a scene and the use of cameras to observe or communicate with remote scenes. The potential hazards of UAVs both deliberate or accidental are also discussed.