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

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 ro...

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Autores principales: Mataka, Anafi, Tumbare, Esther A.J., Motsoane, Tsietso, Holtzman, David, Leqheka, Monkoe, Phatsoane, Kolisang, Sacks, Emma, Isavwa, Anthony, Tiam, Appolinaire
Formato: Online Artículo Texto
Lenguaje:English
Publicado: AOSIS 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8424766/
https://www.ncbi.nlm.nih.gov/pubmed/34522629
http://dx.doi.org/10.4102/ajlm.v10i1.1156
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author Mataka, Anafi
Tumbare, Esther A.J.
Motsoane, Tsietso
Holtzman, David
Leqheka, Monkoe
Phatsoane, Kolisang
Sacks, Emma
Isavwa, Anthony
Tiam, Appolinaire
author_facet Mataka, Anafi
Tumbare, Esther A.J.
Motsoane, Tsietso
Holtzman, David
Leqheka, Monkoe
Phatsoane, Kolisang
Sacks, Emma
Isavwa, Anthony
Tiam, Appolinaire
author_sort Mataka, Anafi
collection PubMed
description 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.
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spelling pubmed-84247662021-09-13 Strategic site selection for placement of HIV early infant diagnosis point-of-care technology within a national diagnostic network in Lesotho Mataka, Anafi Tumbare, Esther A.J. Motsoane, Tsietso Holtzman, David Leqheka, Monkoe Phatsoane, Kolisang Sacks, Emma Isavwa, Anthony Tiam, Appolinaire Afr J Lab Med Lessons from the Field 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. AOSIS 2021-08-24 /pmc/articles/PMC8424766/ /pubmed/34522629 http://dx.doi.org/10.4102/ajlm.v10i1.1156 Text en © 2021. The Authors https://creativecommons.org/licenses/by/4.0/Licensee: AOSIS. This work is licensed under the Creative Commons Attribution License.
spellingShingle Lessons from the Field
Mataka, Anafi
Tumbare, Esther A.J.
Motsoane, Tsietso
Holtzman, David
Leqheka, Monkoe
Phatsoane, Kolisang
Sacks, Emma
Isavwa, Anthony
Tiam, Appolinaire
Strategic site selection for placement of HIV early infant diagnosis point-of-care technology within a national diagnostic network in Lesotho
title Strategic site selection for placement of HIV early infant diagnosis point-of-care technology within a national diagnostic network in Lesotho
title_full Strategic site selection for placement of HIV early infant diagnosis point-of-care technology within a national diagnostic network in Lesotho
title_fullStr Strategic site selection for placement of HIV early infant diagnosis point-of-care technology within a national diagnostic network in Lesotho
title_full_unstemmed Strategic site selection for placement of HIV early infant diagnosis point-of-care technology within a national diagnostic network in Lesotho
title_short Strategic site selection for placement of HIV early infant diagnosis point-of-care technology within a national diagnostic network in Lesotho
title_sort strategic site selection for placement of hiv early infant diagnosis point-of-care technology within a national diagnostic network in lesotho
topic Lessons from the Field
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8424766/
https://www.ncbi.nlm.nih.gov/pubmed/34522629
http://dx.doi.org/10.4102/ajlm.v10i1.1156
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