Diagnostic Infectious Diseases Testing Outside Clinics: A Global Systematic Review and Meta-analysis.
Diagnostic Infectious Diseases Testing Outside Clinics: A Global Systematic Review and Meta-analysis.
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DOI：
10.1093/ofid/ofaa360
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发表时间：
2020-10
影响因子：
4.2
通讯作者：
Tucker JD
中科院分区：
文献类型：
--
作者：
Kpokiri EE;Marley G;Tang W;Fongwen N;Wu D;Berendes S;Ambil B;Loveday SJ;Sampath R;Walker JS;Matovu JKB;Boehme C;Pai NP;Tucker JD
世界上大多数人无法获得基于设施的诊断检测，诊断检测可用性方面的差距是一个重大的公共卫生挑战。自我检测、自我采样和常规临床环境之外的机构检测正在改变中低收入国家的传染病诊断检测。我们检查了诊所外传染病诊断检测的交付模式，以评估对检测吸收和与护理联系的影响。我们进行了系统回顾和荟萃分析，检索了6个数据库，包括将诊所外检测与传统检测进行比较的原始研究手稿。主要的结果是测试的吸收和联系，护理，交付模式，和不良后果。汇集了在感兴趣的主题领域内具有类似干预措施和结果的研究数据，并使用GRADE评估证据质量。本研究已在PROSPERO（CRD 42019140828）中注册。我们确定了10386篇重复引文，纳入了76项研究。在荟萃分析中汇总了18项研究的数据。研究重点是艾滋病毒（48项研究）、衣原体（8项研究）和多种疾病（20项研究）。与基于机构的检测相比，HIV自我检测增加了检测吸收（9项研究：合并优势比[OR]，2.59; 95%CI，1.06-6.29;中等质量）。与基于机构的检测相比，性传播感染的自我采样增加了检测吸收（7项研究：合并OR，1.74; 95%CI，0.97-3.12;中等质量）。 结论：在诊所外进行的检测增加了检测的接受率，而没有显著的不良后果。 这些检测方法提供了一个机会，以扩大访问和赋予病人。需要在低收入国家背景下进一步开展实施研究，扩大有效的服务提供模式和政策。
Most people around the world do not have access to facility-based diagnostic testing, and the gap in availability of diagnostic tests is a major public health challenge. Self-testing, self-sampling, and institutional testing outside conventional clinical settings are transforming infectious disease diagnostic testing in a wide range of low- and middle-income countries (LMICs). We examined the delivery models of infectious disease diagnostic testing outside clinics to assess the impact on test uptake and linkage to care. We conducted a systematic review and meta-analysis, searching 6 databases and including original research manuscripts comparing testing outside clinics with conventional testing. The main outcomes were test uptake and linkage to care, delivery models, and adverse outcomes. Data from studies with similar interventions and outcomes within thematic areas of interest were pooled, and the quality of evidence was assessed using GRADE. This study was registered in PROSPERO (CRD42019140828). We identified 10 386 de-duplicated citations, and 76 studies were included. Data from 18 studies were pooled in meta-analyses. Studies focused on HIV (48 studies), chlamydia (8 studies), and multiple diseases (20 studies). HIV self-testing increased test uptake compared with facility-based testing (9 studies: pooled odds ratio [OR], 2.59; 95% CI, 1.06–6.29; moderate quality). Self-sampling for sexually transmitted infections increased test uptake compared with facility-based testing (7 studies: pooled OR, 1.74; 95% CI, 0.97–3.12; moderate quality). Conclusions. Testing outside of clinics increased test uptake without significant adverse outcomes. These testing approaches provide an opportunity to expand access and empower patients. Further implementation research, scale-up of effective service delivery models, and policies in LMIC settings are needed.
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影响因子：
8.1
作者：
Engel N;Wachter K;Pai M;Gallarda J;Boehme C;Celentano I;Weintraub R
通讯作者：
Weintraub R
影响因子：
4.4
作者：
Bassett IV;Regan S;Mbonambi H;Blossom J;Bogan S;Bearnot B;Robine M;Walensky RP;Mhlongo B;Freedberg KA;Thulare H;Losina E
通讯作者：
Losina E
影响因子：
7.2
作者：
Graseck AS;Secura GM;Allsworth JE;Madden T;Peipert JF
通讯作者：
Peipert JF
DOI：
10.1093/infdis/jiv040
发表时间：
2015-08-15
期刊：
The Journal of infectious diseases
影响因子：
--
作者：
Cambiano V;Ford D;Mabugu T;Napierala Mavedzenge S;Miners A;Mugurungi O;Nakagawa F;Revill P;Phillips A
通讯作者：
Phillips A
影响因子：
3.7
作者：
Hector J;Davies MA;Dekker-Boersema J;Aly MM;Abdalad CCA;Langa EBR;Ehmer J;Hobbins MA;Jefferys LF
通讯作者：
Jefferys LF