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For newborn babies, the viral-load count is critical.Doctors can diagnose HIV in adults and older children with simple flow tests that identify the presence of antibodies directed against HIV, but these same antibodies diffuse across the placenta and can persist for up to 15 months in an infant’s blood.Driving a Jeep along dirt roads with more cows than traffic, “we were off the grid,” Barber recalls. and found about 20 people already waiting for them. An estimated 43 percent of people in Kasensero are HIV-positive, and these patients wanted to know whether the virus had started to damage their immune systems. The company is planning to roll out its portable CD4 tester this year across sub-Saharan Africa—first in Kenya, then in Ethiopia, South Africa, and practically every country in between.The medical team was there to check the patients’ CD4 counts, a measure of immune cells that indicates how well the body can stave off opportunistic infections such as tuberculosis. While the Daktari device is capable of providing same-day results, it was only being tested during Barber’s visit to Uganda. The Daktari device is part of a new wave of lab-in-a-backpack instruments that can bring diagnostic testing directly to patients and health workers in the developing world.Based on test results, some people would need to start antiretroviral therapy. So the Kasensero patients had to settle for the standard CD4 diagnostic procedure: testing on a large and expensive desktop instrument called a flow cytometer, which requires dedicated laboratories, highly trained technicians, and infrastructure for shipping refrigerated reagents long distances. The device looks like a vintage Fisher-Price tape player, with test cartridges taking the place of audiocassettes.

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“The clinical reality is, if we don’t get a [HIV-positive] baby on treatment within the first 8 to 12 weeks of life, the mortality is quite bad,” says Willem Pretorius, global product manager for HIV care at Alere.

Without optical detection, he says, the Daktari device has a longer battery life—up to two days or about 50 runs—and requires less maintenance than other systems.

“We believe that our product will go where other products that we’re competing with can’t go,” Oppenheimer says.

In 2015, “the bottleneck is not really in the technology” anymore, says Benjamin Roussel, an analyst with Yole.

“It’s mainly in the user, the doctor, and the medical world.