scholarly journals Strategic site selection for placement of HIV early infant diagnosis point-of-care technology within a national diagnostic network in Lesotho

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Anafi Mataka ◽  
Esther A.J. Tumbare ◽  
Tsietso Motsoane ◽  
David Holtzman ◽  
Monkoe Leqheka ◽  
...  
Keyword(s):  
New Technologies ◽  
Point Of Care ◽  
Optimal Placement ◽  
Early Infant Diagnosis ◽  
Local Networks ◽  
Hub And Spoke ◽  
Early Infant ◽  
Infrastructure Investments ◽  
Hiv Exposed ◽  
Care Technology

Background: New technologies for rapid point-of-care (POC) diagnostic tests hold great potential for improving the health outcomes of HIV-exposed infants. POC testing for HIV early infant diagnosis (EID) was introduced in Lesotho in late 2016. Here we highlight critical requirements for selecting routine POC EID sites to ensure a sustainable and optimised EID diagnostic network.Intervention: Lesotho introduced POC EID in a phased approach that included assessments of national databases to identify sites with high test volumes, the creation of local networks of sites to potentially increase access to POC EID, and a standardised capacity assessment to determine site readiness. Potential site networks comprising ‘hub’ testing sites and ‘spoke’ specimen referring sites were created.Lessons learnt: After determining optimal placement, a total of 29 testing facilities were selected for placement of POC EID to potentially increase access to 189 facilities through the use of a hub-and-spoke model. Site capacity assessments identified vital human resources and infrastructure capacity gaps that needed to be addressed before introducing POC EID and informed appropriate POC platform selection.Recommendations: POC placement involves more than just purchasing the testing platforms. Considering the relatively small proportion of sites that can be eligible for placement of a POC platform, utilising a hub-and-spoke model can maximise the number of health facilities served by a POC platform while reducing the necessary capacity building and infrastructure investments to fewer sites.

scholarly journals Point of Care (POC) for Early Infant Diagnosis (EID) in Nigeria? Healthcare Workers Opinion

2021 ◽  
Vol 9 (1) ◽  
pp. 87-94
Author(s):  
Busari Olusegun
Keyword(s):  
Healthcare Workers ◽  
Point Of Care ◽  
Standard Of Care ◽  
Turnaround Time ◽  
Early Infant Diagnosis ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Healthcare Facilities ◽  
Early Infant ◽  
Hiv Exposed

Without access to life-saving drugs, including antiretroviral, about one-third of HIV exposed infants (HEI) will die by age 1 year and 50% by age 2 years. A 75% reduction in disease progression and 76% reduction in HIV mortality in infants has been attributed to early diagnosis of HIV and early commencement on ART. Early Infant Diagnosis (EID) of HIV aids timely commencement on antiretroviral therapy (ART). Several challenges have been identified with the current process. Point of care (POC) technologies are recommended as a veritable means of addressing these challenges and improving EID uptake. With the aim of assessing the standard of care and the acceptability of POC for the provision of EID. A descriptive cross-sectional survey was conducted across eight healthcare facilities in Nigeria. The survey was conducted among 72 healthcare workers using self-administered questionnaire; with a recovery rate of 61(84.7%). Analysis of participants’ responses indicate that 100% of the respondents believes there is a need for EID. Most respondent reported an average turnaround time (TAT) of 3-4 weeks (35.8%) and >6 weeks (34.0%). Most respondents identified distance to the PCR laboratories (45.7%) and long TAT (34.8%) as key issues affecting the conduct of EID. On the benefit of POC for EID; 90.2% of respondent believe it is beneficial; while 81.5% of respondent believe that with the introduction and use of POC for EID there will be an increase in EID uptake. The POC is a viable and acceptable alternative for EID to increase uptake.

scholarly journals Feasibility and acceptability of implementing early infant diagnosis of HIV in Papua New Guinea at the point of care: a qualitative exploration of health worker and key informant perspectives

BMJ Open ◽  
2020 ◽  
Vol 10 (11) ◽  
pp. e043679
Author(s):  
Yasmin Mohamed ◽  
Martha Kupul ◽  
Janet Gare ◽  
Steven G Badman ◽  
Selina Silim ◽  
...  
Keyword(s):  
Papua New Guinea ◽  
Standard Care ◽  
Health Workers ◽  
Point Of Care ◽  
Hiv Positive ◽  
Early Infant Diagnosis ◽  
Pmtct Programme ◽  
Early Infant ◽  
Qualitative Exploration ◽  
Hiv 1

IntroductionEarly infant diagnosis (EID) of HIV and timely initiation of antiretroviral therapy can significantly reduce morbidity and mortality among HIV-positive infants. Access to EID is limited in many low-income and middle-income settings, particularly those in which standard care involves dried blood spots (DBS) sent to centralised laboratories, such as in Papua New Guinea (PNG). We conducted a qualitative exploration of the feasibility and acceptability of implementing a point-of-care (POC) EID test (Xpert HIV-1 Qualitative assay) among health workers and key stakeholders working within the prevention of mother-to-child transmission of HIV (PMTCT) programme in PNG.MethodsThis qualitative substudy was conducted as part of a pragmatic trial to investigate the effectiveness of the Xpert HIV-1 Qualitative test for EID in PNG and Myanmar. Semistructured interviews were undertaken with 5 health workers and 13 key informants to explore current services, experiences of EID testing, perspectives on the Xpert test and the feasibility of integrating and scaling up POC EID in PNG. Coding was undertaken using inductive and deductive approaches, drawing on existing acceptability and feasibility frameworks.ResultsHealth workers and key informants (N=18) felt EID at POC was feasible to implement and beneficial to HIV-exposed infants and their families, staff and the PMTCT programme more broadly. All study participants highlighted starting HIV-positive infants on treatment immediately as the main advantage of POC EID compared with standard care DBS testing. Health workers identified insufficient resources to follow up infants and caregivers and space constraints in hospitals as barriers to implementation. Participants emphasised the importance of adequate human resources, ongoing training and support, appropriate coordination and a sustainable supply of consumables to ensure effective scale-up of the test throughout PNG.ConclusionsImplementation of POC EID in a low HIV prevalence setting such as PNG is likely to be both feasible and beneficial with careful planning and adequate resources.Trial registration number12616000734460.

scholarly journals Task shifting for point-of-care early infant diagnosis: a comparison of the quality of testing between nurses and laboratory personnel in Zimbabwe

2020 ◽  
Vol 18 (1) ◽  
Author(s):  
Francis M. Simmonds ◽  
Jennifer E. Cohn ◽  
Haurovi W. Mafaune ◽  
Tichaona H. Nyamundaya ◽  
Agnes Mahomva ◽  
...  
Keyword(s):  
Point Of Care ◽  
Task Shifting ◽  
Early Infant Diagnosis ◽  
Laboratory Personnel ◽  
Early Infant

Evaluation of a routine point-of-care intervention for early infant diagnosis of HIV: an observational study in eight African countries

2019 ◽  
Vol 6 (6) ◽  
pp. e373-e381 ◽  
Author(s):  
Flavia Bianchi ◽  
Jennifer Cohn ◽  
Emma Sacks ◽  
Rebecca Bailey ◽  
Jean-Francois Lemaire ◽  
...  
Keyword(s):  
Observational Study ◽  
Point Of Care ◽  
Early Infant Diagnosis ◽  
African Countries ◽  
Care Intervention ◽  
Early Infant

scholarly journals Successful Use of Near Point-of-Care Early Infant Diagnosis in NAMPHIA to Improve Turnaround Times in a National Household Survey

2021 ◽  
Vol 87 (1) ◽  
pp. S67-S72
Author(s):  
Robert A. Domaoal ◽  
Katrina Sleeman ◽  
Souleymane Sawadogo ◽  
Tafadzwa Dzinamarira ◽  
Ndahafa Frans ◽  
...  
Keyword(s):  
Point Of Care ◽  
Household Survey ◽  
Early Infant Diagnosis ◽  
Early Infant ◽  
National Household Survey

scholarly journals Operational experiences associated with the implementation of near point-of-care early infant diagnosis of HIV in Myanmar: a qualitative study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Win Lei Yee ◽  
Hla Htay ◽  
Yasmin Mohamed ◽  
Claire E. Nightingale ◽  
Htay Htay Tin ◽  
...  
Keyword(s):  
Healthcare Workers ◽  
Technical Assistance ◽  
Point Of Care ◽  
Scale Up ◽  
Hospital Staff ◽  
Public Hospitals ◽  
Early Infant Diagnosis ◽  
Structured Interviews ◽  
Early Infant ◽  
The Impact

Abstract Background Timely diagnosis and early initiation of life-saving antiretroviral therapy are critical factors in preventing mortality among HIV-infected infants. However, resource-limited settings experience numerous challenges associated with centralised laboratory-based testing, including low rates of testing, complex sample referral pathways and unacceptably long turnaround times for results. Point-of-care (POC) HIV testing for HIV-exposed infants can enable same-day communication of results and early treatment initiation for HIV-infected infants. However, complex operational issues and service integration can limit utility and must be well understood prior to implementation. We explored and documented the challenges and enabling factors in implementing the POC Xpert® HIV-1 Qual test (Cepheid, Sunnyvale, CA, USA) for early infant diagnosis (EID) as part of routine services in four public hospitals in Myanmar. Methods This sub-study was part of a randomised controlled stepped-wedge trial (Australian and New Zealand Clinical Trials Registry, number 12616000734460) designed to investigate the impact of POC testing for EID in Myanmar and Papua New Guinea. Infants recruited during the intervention phase underwent POC testing at the participating hospitals as part of routine care. Semi-structured interviews with 23 caregivers, 12 healthcare providers and 10 key informants were used to explore experiences of POC-EID testing. The research team and hospital staff documented and discussed implementation challenges throughout the study. Results Overall, caregivers and healthcare workers were satisfied with the short turnaround time of the POC test. Occasional delays in POC testing were mostly attributable to late receipt of samples by laboratory technicians and communication constraints among healthcare staff. Hospital staff valued technical assistance from the research group and the National Health Laboratory. Despite staff shortages and infrastructure challenges such as unreliable electricity supply and cramped space, healthcare workers and caregivers found the implementation of the POC test to be feasible at pilot sites. Conclusions As plans for national scale-up evolve, there needs to be a continual focus on staff training, communication pathways and infrastructure. Other models of care, such as allowing non-laboratory-trained personnel to perform POC testing, and cost effectiveness should also be evaluated.

Point-of-care assays for early infant diagnosis in Zimbabwe

2019 ◽  
Vol 6 (3) ◽  
pp. e146-e147 ◽  
Author(s):  
Sarah J Girdwood ◽  
Brooke E Nichols
Keyword(s):  
Point Of Care ◽  
Early Infant Diagnosis ◽  
Early Infant
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