The NSEBA Demonstration Project: implementation of a point-of-care platform for early infant diagnosis of HIV in rural Zambia.
The NSEBA Demonstration Project: implementation of a point-of-care platform for early infant diagnosis of HIV in rural Zambia.
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DOI：
10.1111/tmi.13627
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发表时间：
2021-09
期刊：
影响因子：
--
通讯作者：
Moss WJ
中科院分区：
文献类型：
--
作者：
Sutcliffe CG;Moyo N;Schue JL;Mutanga JN;Hamahuwa M;Munachoonga P;Maunga S;Thuma PE;Moss WJ
描述赞比亚农村地区实施婴儿艾滋病毒早期诊断护理点检测的经验和资源需求。2018-2019年，在赞比亚农村地区的五家诊所使用轴辐模式开展了一个示范项目。建立了两个检测中心，所有接触艾滋病毒的婴儿都用GeneXpert系统进行了检测。收集了关于成本、周转时间和测试结果的数据。共进行了786次试验。在中心，结果可在样本采集后2.4（IQR：2.1，2.8）小时内获得，大多数母亲（84%）在同一天收到结果。在分支机构，结果在样本采集后的中位时间为9天（IQR：7，12），并在样本采集后的中位时间为16天（IQR：10，28）提供给母亲。11名儿童检测呈阳性，9名（82%）在样本采集后中位数13天（IQR：7，21）和母亲收到结果当天开始治疗。相比之下，发送用于常规检测的匹配样本的结果在样本采集后的中位数38天（IQR：27，61）内可用，并在样本采集后的中位数91天（IQR：47，135）内提供给母亲。在赞比亚的农村保健中心网络实施护理点检测需要在基础设施、培训和监督方面进行大量的初始和持续投资。然而，即时检测可以快速诊断感染艾滋病毒的婴儿，因此他们可以从早期治疗中受益。
To describe the experience and resource requirements of implementing point-of-care testing for early infant diagnosis of HIV in rural Zambia. 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. 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. 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.
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DOI：
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