The Consensus on the Use of Rapid Tests in Latin America highlights the importance of quickly identifying and treating acute respiratory infections (ARIs), as they are one of the leading causes of illness and death. The pandemic underscored the need for effective and accessible diagnostic tools. In this context, we spoke with Esteban Muñoz from the IMSS Coordination for Quality of Supplies and Specialized Laboratories about how this document serves as a fundamental guide for doctors, researchers, and health policy makers. With this consensus, the use of rapid tests is promoted as a key tool in the diagnosis and treatment of respiratory infections, thereby improving medical care and quality of life.
Key points
- Rapid tests complement diagnostic methods like PCR to enhance diagnostic accuracy.
- These tests provide broader access to diagnostics in regions with infrastructural limitations, benefiting vulnerable populations.
- Early identification of respiratory infections allows for timely initiation of appropriate treatments, reducing complications and hospitalizations.
- Rapid tests help differentiate between various respiratory infections, such as COVID-19, influenza, and RSV, which is vital for clinical management.
- Identifying the causative agent of the infection reduces the inappropriate use of antibiotics and antivirals, aiding in the fight against antimicrobial resistance.
- The implementation of these tests strengthens epidemiological surveillance systems, enabling a quicker response to disease outbreaks.
- It is crucial to establish regulations that ensure the quality and effectiveness of rapid tests on the market, ensuring their safe use.
Consensus on the Use of Rapid Tests in Latin America
Recently, doctors from Latin America published the Consensus on the Use of Rapid Tests in Latin America (Alvarez-Moreno et al., 2024), highlighting the importance of rapid tests for diagnosing and treating acute respiratory infections (ARIs), such as influenza and SARS-CoV-2, which are common in the region. This consensus was developed by a group of experts and published in the journal Covid.
Context and Need
In Latin America, influenza and SARS-CoV-2 account for 7% and 13% of respiratory infections, respectively. The region, still affected by the pandemic, needs to improve the diagnosis and treatment of infections. The consensus emphasizes that rapid point-of-care (POC) tests are key for public health decisions, outbreak control, and infection prevention.
Benefits of Rapid Tests
Rapid tests offer multiple benefits:
- Diagnostic Accuracy: They help distinguish between COVID-19, influenza, and respiratory syncytial virus (RSV), crucial for appropriate treatment, especially in vulnerable populations.
- Reduction in Antibiotic Use: By providing quick and accurate diagnoses, unnecessary antibiotic prescriptions are reduced, combating bacterial resistance.
- Healthcare System Efficiency: By reducing hospitalizations and prolonged emergency stays, rapid tests alleviate the healthcare system’s burden.
- Epidemiological Surveillance: They enable real-time monitoring, facilitating quick interventions to control outbreaks.
Challenges and Opportunities
The Consensus on the Use of Rapid Tests in Latin America also identified challenges in implementing these tests, such as regulatory barriers and lack of infrastructure. Proposed solutions include:
- Establishing Regulatory Frameworks: To ensure the quality and effectiveness of the tests. Investment in Diagnostic Innovation: To adapt to future virus variants.
- Educational Initiatives: Training the public and health professionals on the proper use of these tests.
Funding Statement for the Consensus on the Use of Rapid Tests in Latin America
The authors disclose receiving financial support from Abbott for conducting the research and discussion process that were part of developing the Consensus on the Use of Rapid Tests in Latin America. Despite the support received, the authors independently drafted the content and recommendations of the manuscript, which is solely their work.
Interview with Esteban Muñoz on the Consensus on the Use of Rapid Tests in Latin America: Keys to Effective Diagnosis
This consensus marks a significant advancement in the fight against acute respiratory infections, paving the way for more accessible and efficient diagnosis and treatment. In an interview with Dr. José Esteban Muñoz, head of the Sample Bank at the Coordination of Quality of Supplies and Specialized Laboratories of the Mexican Social Security Institute (IMSS), we delve into how these tests can transform medical care in Mexico and beyond.
If you could explain to someone without medical knowledge why rapid tests are valuable, what would you say?
I would tell them that it’s always good to have more information about people’s health, and these tools allow us to know when someone is experiencing an illness and, in some cases, differentiate between similar symptoms.
What are the main points of the consensus on the use of rapid tests for respiratory infections that everyone should know, and how can it affect our health and the treatment of diseases like COVID, influenza, and RSV?
I believe the main points we agreed on during our discussions are that there is a niche, a segment of the population. Generally speaking, these tests are not meant to replace specific tests already in use, like real-time PCR. They are a complement to what exists, particularly in regions with access to those specific tests.
Another important point is that, despite many tests being produced during the pandemic, not all of them worked. It’s necessary to legislate about which ones can be used and which cannot. So, in general, they are needed; the ones available complement existing options, and we must be very careful about which ones are chosen.
What does it mean that rapid tests have been established at the point of care for diagnosing respiratory infections?
This was a watershed moment in Mexico, at least for epidemiological surveillance; it hasn’t been as much in the private sector, as those have been used for a long time there. But in terms of the tests available and the cases counted by the General Directorate of Epidemiology, this is the first time that rapid tests are accepted to consider a case truly positive.
So it’s a paradigm shift; it’s a before and after. It seems to me that this opens the door to using these tests to complement existing diagnostic algorithms.
What is the importance of quickly differentiating between COVID-19, influenza, and RSV?
The ability to perform this differentiation allows for appropriate treatment and also from an epidemiological standpoint, enabling isolation of that person or carrying out surveillance activities related to whether it’s a respiratory infection, influenza, or SARS, which are different.
How could rapid tests transform doctors’ treatment for patients with respiratory symptoms?
When access to testing isn’t available, a doctor often has to rely solely on their experience as well as on the signs and symptoms of the patient. This might lead them to prescribe antibiotics or some antiviral, even specific for influenza, in a case of COVID or respiratory syncytial virus; thus complicating that person’s recovery.
How can these tests help prevent unnecessary antibiotic prescriptions?
If you know the agent causing the infection, you can use the antibiotic or antiviral that is needed at that moment.
What are the greatest benefits you have seen in public health thanks to these rapid tests?
I believe it’s increasing the number of tests that can be performed. During the pandemic, they were conducting even more rapid tests than PCR tests due to costs and difficulties regarding where rapid tests could be implemented. So complementing, as I mentioned earlier, existing algorithms with the inclusion of a rapid test allows access to a larger number of people in the population, benefiting not only those who get infected but also preventing them from infecting others.
Can you share an experience where you had significant success in your practice?
Of course. What I mentioned earlier: during the pandemic, it was a very good decision to consider this type of test, which emerged at that moment from an epidemiology team to complement the diagnostic algorithm. The testing capacity in health sector laboratories for PCR was strained by existing cases.
The option was either to leave these cases without any diagnosis or allow the implementation of this type of test; that was the decision made. I think it was the right one. It helped reduce the workload on specialized laboratories by allowing them to focus on severe cases for hospitalization and further testing. Meanwhile, symptomatic but outpatient individuals could undergo this type of testing, addressing both groups.
What challenges does the medical community face in effectively using these medical rapid tests in health centers?
I believe it’s legislation and evaluation of these tests. Because one thing is obtaining registration so they can be sold, while another is ensuring they have sensitivity parameters, specificity, and predictive values that truly add value to diagnosis. We need legislation and regulation to ensure that only tests meeting requirements can be applied. This way, the population—who may not know which brands are reliable—will have access to them. This was evident during the pandemic when they were sold in pharmacies and outside subway stations. Even private individuals started buying them online and selling them to their neighbors.
How can we help the medical community overcome these challenges?
With information. It’s necessary to generate information. Evaluating these tests and disseminating results is crucial, along with advocating for legislation and regulation regarding their use. As we progress in these areas, the medical community will be able to choose from high-quality options.
How do you feel knowing that rapid tests can help detect diseases in rural areas where access to medical care is limited? What impact do you think this would have on families who depend on these diagnostics to care for their loved ones?
As I mentioned earlier, this acts as a complement to what is already available. Even those individuals in hard-to-reach places will eventually find themselves in another location or have the opportunity to choose between a PCR and a rapid test; the better choice is PCR. However, between having a rapid test or nothing at all, it’s better to take a rapid test—especially if they go through this regulatory process and already have sufficient sensitivity values to provide evidence for treatment.
What specific changes would you like to see in implementing these rapid tests over the next five years?
I believe that within five years there should be proper legislation and evaluation in place and that diagnostic algorithms should be permanently integrated—not just during emergencies. Not only for respiratory infections, which was the case during the pandemic. For instance, with dengue at the end of last year, we had many dengue cases where rapid testing wasn’t utilized; there is significant opportunity to complement various algorithms with this type of testing.
Is there anything else you would like to comment on or add?
In summary of what we’ve discussed, I see this as a very important opportunity for health in Mexico. In developing countries like ours, many areas could benefit from access to these new developments. Legislation and their inclusion in algorithms would allow not just foreign products but also local ones to contribute to developing tools that benefit beneficiaries.
Well, finally thank you for your work; we should always express gratitude to those working in health care. Good afternoon and have an excellent day. Likewise. Thank you very much, Dr. Esteban, for this opportunity.
Conclusion
Rapid tests for diagnosing and treating acute respiratory infections represent a significant advancement in public health, especially in areas with limited access to more complex diagnostics. It is crucial that these tests are effectively integrated into healthcare systems and epidemiological surveillance as we move toward a post-pandemic future.
To advance the implementation and effectiveness of rapid tests, and based on what Esteban Muñoz mentioned, we can propose the following steps:
- Development of Regulatory Frameworks: It is essential to establish clear regulations that ensure the quality, sensitivity, and specificity of rapid tests. This will ensure that only reliable and effective tests are used for diagnosing respiratory infections.
- Continuous Training: Investing in training programs for healthcare professionals to learn how to properly use rapid tests is vital. This will improve diagnostic accuracy and foster confidence in these tools within the medical community.
- Encouraging Research: Promoting research into new technologies and diagnostic methods will help adapt rapid tests to virus variants and other respiratory infections. Continuous innovation is key to maintaining the relevance of these tests in an ever-changing health landscape.
- Strengthening Infrastructure: Investing in improving healthcare infrastructure in vulnerable regions will ensure that rapid tests are accessible to all populations. This includes ensuring an adequate supply of tests and the capacity to process them efficiently.
- Public Health Promotion: Implementing educational campaigns about the importance of rapid tests and their role in early diagnosis can increase their acceptance and use among the population. Clear and accessible information is vital to empower communities to seek timely medical attention.
- Monitoring and Evaluation: Establishing monitoring systems to assess the impact of rapid tests on public health outcomes will allow for identifying areas for improvement and adapting strategies as needed.
These steps would enhance the response to acute respiratory infections and strengthen a more resilient and equitable healthcare system. The implementation of rapid tests can improve medical diagnosis, protect public health, and elevate the quality of life in communities.
References
- Alvarez-Moreno, C. A., De Araújo, E. S. A., Baumeister, E., Crespo, K. a. N., Kalergis, A. M., Medina, J. E. M., Tsukayama, P., & Ugarte-Gil, C. (2024). Differential Diagnosis in the Management of Acute Respiratory Infections through Point-of-Care Rapid Testing in a Post-Pandemic Scenario in Latin America: Special Focus on COVID-19, Influenza, and Respiratory Syncytial Virus. COVID, 4(2), 221–260. https://doi.org/10.3390/covid4020017
- COVID. (2025). Diagnóstico diferenciado en el manejo de infecciones respiratorias agudas mediante pruebas rápidas en el punto de atención en un escenario pospandémico en América Latina: Enfoque especial en COVID-19, influenza y virus sincitial respiratorio. MDPI. https://www.mdpi.com/2673-8112/4/2/17
- FluNet. (n.d.). Global influenza surveillance and response system. World Health Organization. https://www.who.int/initiatives/global-influenza-surveillance-and-response-system
Bibliography
- Boukadida, C., Taboada, B., Escalera-Zamudio, M., Isa, P., Ramírez-González, J. E., Vazquez-Perez, J. A., Muñoz-Medina, J. E., Grajales-Muñiz, C., González-Torres, C., Gaytán-Cervantes, F. J., Rincón-Rubio, A., Matías-Florentino, M., Paz-Juárez, H. E., Sanchez-Flores, A., Mendieta-Condado, E., Barrera-Badillo, G., Hernández-Rivas, L., López, S., López-Martínez, I., . . . Arias, C. F. (2022). Genomic Characterization of SARS-CoV-2 Isolated from Patients with Distinct Disease Outcomes in Mexico. Microbiology Spectrum, 10(1). https://doi.org/10.1128/spectrum.01249-21
- Castelán-Sánchez, H. G., Delaye, L., Inward, R. P., Dellicour, S., Gutierrez, B., De La Vina, N. M., Boukadida, C., Pybus, O. G., De Anda Jáuregui, G., Guzmán, P., Flores-Garrido, M., Fontanelli, Ó., Rosales, M. H., Meneses, A., Olmedo-Alvarez, G., Herrera-Estrella, A. H., Sánchez-Flores, A., Muñoz-Medina, J. E., Comas-García, A., . . . Zamudio, M. E. (2023). Comparing the evolutionary dynamics of predominant SARS-CoV-2 virus lineages co-circulating in Mexico. eLife, 12. https://doi.org/10.7554/elife.82069
- Coy-Arechavaleta, A. S., Alvarado-Yaah, J. E., Uribe-Noguez, L. A., Guerra-Castillo, F. X., Santacruz-Tinoco, C. E., Ramón-Gallegos, E., Muñoz-Medina, J. E., & Fernandes-Matano, L. (2024). Relationship between the Viral Load in Patients with Different COVID-19 Severities and SARS-CoV-2 Variants. Microorganisms, 12(3), 428. https://doi.org/10.3390/microorganisms12030428
- De La Luz Galván-Ramírez, M., Salas-Lais, A. G., Muñoz-Medina, J. E., Fernandes-Matano, L., Pérez, L. R. R., & De León, K. F. (2023). Association of toxoplasmosis and COVID-19 in a Mexican
population. Microorganisms, 11(6), 1441. https://doi.org/10.3390/microorganisms11061441 - Fernandes-Matano, L., Muñoz, I. E. M., Uribe-Noguez, L. A., & Muñoz-Medina, J. E. (2021). Coinfections by SARS-CoV-2 and other respiratory viruses and their clinical outcome. ResearchGate. https://www.researchgate.net/publication/357093932_Coinfections_by_SARS-CoV-2_and_other_respiratory_viruses_and_their_clinical_outcome
- Garay, E., Whelan, S. P. J., DuBois, R. M., O’Rourke, S. M., Salgado-Escobar, A. E., Muñoz-Medina, J. E., Arias, C. F., & López, S. (2024). Immune response to SARS-CoV-2 variants after immunization with different vaccines in Mexico. Epidemiology and Infection, 152. https://doi.org/10.1017/s0950268824000219
- García-López, R., Taboada, B., Zárate, S., Muñoz-Medina, J. E., Salas-Lais, A. G., Herrera-Estrella, A., Boukadida, C., Vazquez-Perez, J. A., Gómez-Gil, B., Sanchez-Flores, A., & Arias, C. F. (2024). Exploration of low-frequency allelic variants of SARS-CoV-2 genomes reveals coinfections in Mexico occurred during periods of VOCs turnover. Microbial Genomics, 10(3). https://doi.org/10.1099/mgen.0.001220
- Jiménez-Gil, K., Cerón-Albarrán, J. A., Gonzalez-Fernandez, M. D., Sevilla-Montoya, R., Hidalgo-Bravo, A., Angeles-Martínez, J., Montes-Herrera, D., Villavicencio-Carrisoza, O., García-Romero, C. S., Muñoz-Medina, J. E., & Monroy-Muñoz, I. E. (2024). Association of Single-Nucleotide Variants in ACE2 with the Persistence of Positive qPCR Test for SARS-CoV-2 in Healthcare Professionals During the First Wave of the COVID-19 Pandemic. Microorganisms, 12(12), 2560. https://doi.org/10.3390/microorganisms12122560
- Molina-Mora, J. A., Reales-González, J., Camacho, E., Duarte-Martínez, F., Tsukayama, P., Soto-Garita, C., Brenes, H., Cordero-Laurent, E., Santos, A. R. D., Salgado, C. G., Silva, C. S., De Souza, J. S., Nunes, G., Negri, T., Vidal, A., Oliveira, R., Oliveira, G., Muñoz-Medina, J. E., Salas-Lais, A. G., . . . Herrera-Estrella, A. (2023). Overview of the SARS-CoV-2 genotypes circulating in Latin America during 2021. Frontiers in Public Health, 11. https://doi.org/10.3389/fpubh.2023.1095202
- Muñoz-Medina, J. E., Grajales-Muñiz, C., Salas-Lais, A. G., Fernandes-Matano, L., López-Macías, C., Monroy-Muñoz, I. E., Coy-Arechavaleta, A. S., Palomec-Nava, I. D., Duque-Molina, C., Madera-Sandoval, R. L., Rivero-Arredondo, V., González-Ibarra, J., Alvarado-Yaah, J. E., Rojas-Mendoza, T., Santacruz-Tinoco, C. E., González-Bonilla, C. R., & Borja-Aburto, V. H. (2021). SARS-CoV-2 IgG Antibodies Seroprevalence and Sera Neutralizing Activity in MEXICO: A National Cross-Sectional Study during 2020. Microorganisms, 9(4), 850. https://doi.org/10.3390/microorganisms9040850
- Ruiz-Pacheco, J. A., Muñoz-Medina, E. J., Castillo-Díaz, L. A., Chacón-Salinas, R., & Escobar-Gutiérrez, A. (2023). Dengue virus increases the expression of TREM-1 and CD10 on human neutrophils. Viral Immunology. https://doi.org/10.1089/vim.2022.0124
- Taboada, B. I., Zárate, S., García-López, R., Muñoz-Medina, J. E., Gómez-Gil, B., Herrera-Estrella, A., Sanchez-Flores, A., Salas-Lais, A. G., Roche, B., Martínez-Morales, G., Zárate, H. D., Molina, C. D., Hernández, R. A., López, S., & Arias, C. F. (2023). SARS-CoV-2 Omicron variants BA.4 and BA.5 dominated the fifth COVID-19 epidemiological wave in Mexico. Microbial Genomics, 9(12). https://doi.org/10.1099/mgen.0.001120
- Taboada, B., Zarate, S., García-López, R., Muñoz-Medina, J., Gómez-Gil, B., Herrera-Estrella, A., Sanchez-Flores, A., Lais, A. G. S., Roche, B., Martínez-Morales, G., Zárate, H. D., Molina, C. D., Hernández, R. A., López, S., & Arias, C. F. (2023). SARS-CoV-2 Omicron variants BA.4 and BA.5 dominated the fifth COVID-19 epidemiological wave in Mexico. Authorea (Authorea). https://doi.org/10.22541/au.168533832.23499167/v1
Glossary
- Acute Respiratory Infection (ARI): A disease affecting the respiratory system that develops rapidly, often caused by viruses or bacteria, and can include symptoms such as cough, fever, and difficulty breathing.
- Antibiotic: A chemical substance used to combat infections caused by bacteria by inhibiting their growth or destroying them.
- Antimicrobial Resistance: The ability of microorganisms, such as bacteria and viruses, to resist the effects of medications that were previously effective in their treatment, making it more difficult to cure infections.
- Epidemiology: A branch of medicine that studies the distribution, frequency, and determinants of diseases in populations, as well as methods for controlling and preventing them.
- Epidemiological Surveillance: A systematic process of collecting, analyzing, and interpreting data on the health of populations to detect disease outbreaks and facilitate public health decision-making.
- Rapid Test: A diagnostic tool that allows for quick results regarding the presence of a disease or infection, usually conducted at the point of care without the need for complex laboratories.
- Regulatory Framework: A set of rules and laws that establish the procedures and requirements necessary for the approval and use of products, such as medications and diagnostic tests, in a country or region.
