Missed opportunities for integrated testing of HIV and tuberculosis on the GeneXpert platform in Lesotho
Background: Integrated testing, treatment and care are key strategies for addressing the dual burdens of tuberculosis and HIV. The GeneXpert instrument allows simultaneous HIV and tuberculosis testing, but its utilisation for integrated testing remains suboptimal. Objective: The study determined th...
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| Format: | Article |
| Language: | English |
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AOSIS
2023-08-01
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| Series: | African Journal of Laboratory Medicine |
| Subjects: | |
| Online Access: | https://ajlmonline.org/index.php/ajlm/article/view/2132 |
| _version_ | 1827854628114399232 |
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| author | Gamuchirai P. Gwaza Monkoe Leqheka Tsietso Mots’oane Sabine Dittrich Kekeletso Kao |
| author_facet | Gamuchirai P. Gwaza Monkoe Leqheka Tsietso Mots’oane Sabine Dittrich Kekeletso Kao |
| author_sort | Gamuchirai P. Gwaza |
| collection | DOAJ |
| description | Background: Integrated testing, treatment and care are key strategies for addressing the dual burdens of tuberculosis and HIV. The GeneXpert instrument allows simultaneous HIV and tuberculosis testing, but its utilisation for integrated testing remains suboptimal.
Objective: The study determined the extent to which tuberculosis testing and HIV early infant detection (EID) were integrated on the GeneXpert platform, or the potential for integration at selected health facilities.
Methods: A mixed methods evaluation was conducted using retrospective secondary data analysis of laboratory records from 2017 to 2019, and semi-structured interviews. Data were collected between January 2020 and March 2020 in Lesotho.
Results: Forty-four health staff were interviewed across 13 health facilities: one regional, nine district, and three clinic level. Six were government facilities, six were mission hospitals, and one was a non-profit clinic. All facilities selected had at least one GeneXpert instrument used for tuberculosis or HIV testing; none included simultaneous testing for tuberculosis and HIV. In 2017, the average utilisation rate for the GeneXpert instrument for tuberculosis and EID testing was 63% and 24%, while in 2019, the average utilisation rate was 61% for tuberculosis testing and 27% for EID.
Conclusion: Except for three sites where the testing rates were high, utilisation rates were sufficiently low that all the HIV EID and tuberculosis tests undertaken in 2017 and 2019 could have been performed using only the instruments currently dedicated to tuberculosis testing. There is a missed opportunity for the integration of testing for tuberculosis and HIV on the GeneXpert instrument.
What this study adds: This study adds to the body of evidence on the need for integration of testing and highlights some practical and technical considerations for successful implementation of integrated tuberculosis and HIV testing. |
| first_indexed | 2024-03-12T11:25:23Z |
| format | Article |
| id | doaj.art-b3f86328174f4a7bbbb6a0011758d108 |
| institution | Directory Open Access Journal |
| issn | 2225-2002 2225-2010 |
| language | English |
| last_indexed | 2024-03-12T11:25:23Z |
| publishDate | 2023-08-01 |
| publisher | AOSIS |
| record_format | Article |
| series | African Journal of Laboratory Medicine |
| spelling | doaj.art-b3f86328174f4a7bbbb6a0011758d1082023-09-01T09:42:35ZengAOSISAfrican Journal of Laboratory Medicine2225-20022225-20102023-08-01121e1e710.4102/ajlm.v12i1.2132444Missed opportunities for integrated testing of HIV and tuberculosis on the GeneXpert platform in LesothoGamuchirai P. Gwaza0Monkoe Leqheka1Tsietso Mots’oane2Sabine Dittrich3Kekeletso Kao4Department of Impact, Foundation for Innovative New Diagnostics (FIND), Geneva, Switzerland; and, Department of Continuing Education, University of Oxford, OxfordDepartment of Research and Laboratory Services, Ministry of Health, MaseruDepartment of Research and Laboratory Services, Ministry of Health, MaseruDepartment of Global Public Health, Deggendorf Institute of Technology, DeggendorfDepartment of Access, Foundation for Innovative New Diagnostics (FIND), GenevaBackground: Integrated testing, treatment and care are key strategies for addressing the dual burdens of tuberculosis and HIV. The GeneXpert instrument allows simultaneous HIV and tuberculosis testing, but its utilisation for integrated testing remains suboptimal. Objective: The study determined the extent to which tuberculosis testing and HIV early infant detection (EID) were integrated on the GeneXpert platform, or the potential for integration at selected health facilities. Methods: A mixed methods evaluation was conducted using retrospective secondary data analysis of laboratory records from 2017 to 2019, and semi-structured interviews. Data were collected between January 2020 and March 2020 in Lesotho. Results: Forty-four health staff were interviewed across 13 health facilities: one regional, nine district, and three clinic level. Six were government facilities, six were mission hospitals, and one was a non-profit clinic. All facilities selected had at least one GeneXpert instrument used for tuberculosis or HIV testing; none included simultaneous testing for tuberculosis and HIV. In 2017, the average utilisation rate for the GeneXpert instrument for tuberculosis and EID testing was 63% and 24%, while in 2019, the average utilisation rate was 61% for tuberculosis testing and 27% for EID. Conclusion: Except for three sites where the testing rates were high, utilisation rates were sufficiently low that all the HIV EID and tuberculosis tests undertaken in 2017 and 2019 could have been performed using only the instruments currently dedicated to tuberculosis testing. There is a missed opportunity for the integration of testing for tuberculosis and HIV on the GeneXpert instrument. What this study adds: This study adds to the body of evidence on the need for integration of testing and highlights some practical and technical considerations for successful implementation of integrated tuberculosis and HIV testing.https://ajlmonline.org/index.php/ajlm/article/view/2132tuberculosishivtbgenexperttestingintegrated diagnosislesotho |
| spellingShingle | Gamuchirai P. Gwaza Monkoe Leqheka Tsietso Mots’oane Sabine Dittrich Kekeletso Kao Missed opportunities for integrated testing of HIV and tuberculosis on the GeneXpert platform in Lesotho African Journal of Laboratory Medicine tuberculosis hiv tb genexpert testing integrated diagnosis lesotho |
| title | Missed opportunities for integrated testing of HIV and tuberculosis on the GeneXpert platform in Lesotho |
| title_full | Missed opportunities for integrated testing of HIV and tuberculosis on the GeneXpert platform in Lesotho |
| title_fullStr | Missed opportunities for integrated testing of HIV and tuberculosis on the GeneXpert platform in Lesotho |
| title_full_unstemmed | Missed opportunities for integrated testing of HIV and tuberculosis on the GeneXpert platform in Lesotho |
| title_short | Missed opportunities for integrated testing of HIV and tuberculosis on the GeneXpert platform in Lesotho |
| title_sort | missed opportunities for integrated testing of hiv and tuberculosis on the genexpert platform in lesotho |
| topic | tuberculosis hiv tb genexpert testing integrated diagnosis lesotho |
| url | https://ajlmonline.org/index.php/ajlm/article/view/2132 |
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