The NSEBA Demonstration Project: implementation of a point-of-care platform for early infant diagnosis of HIV in rural Zambia.
Trop Med Int Health
; 26(9): 1036-1046, 2021 09.
Article
in En
| MEDLINE
| ID: mdl-33999480
ABSTRACT
OBJECTIVES:
To describe the experience and resource requirements of implementing point-of-care testing for early infant diagnosis of HIV in rural Zambia.METHODS:
A demonstration project was conducted using a hub-and-spoke model in 2018-2019 at five clinics in rural Zambia. Two testing hubs were established, and all HIV-exposed infants were tested with the GeneXpert system. Data on costs, turnaround times and test results were collected.RESULTS:
Seven hundred and eighty six tests were conducted. At the hubs, results were available a median of 2.4 (IQR 2.1, 2.8) hours after sample collection and most mothers (84%) received same-day results. At the spoke facilities, results were available a median of 9 days (IQR 7, 12) after sample collection and provided to the mother a median of 16 days (IQR 10, 28) after sample collection. Eleven children tested positive, and 9 (82%) started treatment a median of 13 days (IQR 7, 21) after sample collection and on the day mothers received results. In contrast, results from matching samples sent for routine testing were available a median of 38 days (IQR 27, 61) after sample collection and provided to the mother a median of 91 days (IQR 47, 135) after sample collection.CONCLUSIONS:
Implementing point-of-care testing in a network of rural health centres in Zambia required significant initial and ongoing investment in infrastructure, training and supervision. However, point-of-care testing can rapidly diagnose HIV-infected infants, so they can benefit from early treatment.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Program Evaluation
/
HIV Infections
/
Program Development
/
Point-of-Care Testing
/
HIV Testing
Type of study:
Diagnostic_studies
/
Evaluation_studies
/
Prognostic_studies
Aspects:
Implementation_research
Limits:
Female
/
Humans
/
Infant
/
Male
/
Newborn
Country/Region as subject:
Africa
Language:
En
Journal:
Trop Med Int Health
Journal subject:
MEDICINA TROPICAL
/
SAUDE PUBLICA
Year:
2021
Document type:
Article
Affiliation country:
Estados Unidos
Publication country:
ENGLAND
/
ESCOCIA
/
GB
/
GREAT BRITAIN
/
INGLATERRA
/
REINO UNIDO
/
SCOTLAND
/
UK
/
UNITED KINGDOM