Missed opportunities for integrated testing of HIV and tuberculosis on the GeneXpert platform in Lesotho

African Journal of Laboratory Medicine

 
 
Field Value
 
Title Missed opportunities for integrated testing of HIV and tuberculosis on the GeneXpert platform in Lesotho
 
Creator Gwaza, Gamuchirai P. Leqheka, Monkoe Mots’oane, Tsietso Dittrich, Sabine Kao, Kekeletso
 
Subject Public Health Tuberculosis; HIV; TB; GeneXpert; testing; integrated diagnosis; Lesotho
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.
 
Publisher AOSIS
 
Contributor Foundation for Innovative New Diagnostics (FIND)
Date 2023-08-28
 
Type info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion — Survey/Interview; Secondary data analysis
Format text/html application/epub+zip text/xml application/pdf
Identifier 10.4102/ajlm.v12i1.2132
 
Source African Journal of Laboratory Medicine; Vol 12, No 1 (2023); 7 pages 2225-2010 2225-2002
 
Language eng
 
Relation
The following web links (URLs) may trigger a file download or direct you to an alternative webpage to gain access to a publication file format of the published article:

https://ajlmonline.org/index.php/ajlm/article/view/2132/2740 https://ajlmonline.org/index.php/ajlm/article/view/2132/2741 https://ajlmonline.org/index.php/ajlm/article/view/2132/2742 https://ajlmonline.org/index.php/ajlm/article/view/2132/2743
 
Coverage Lesotho; Primary health Care — Health facilities
Rights Copyright (c) 2023 Gamuchirai P. Gwaza, Monkoe Leqheka, Tsietso Mots’oane, Sabine Dittrich, Kekeletso Kao https://creativecommons.org/licenses/by/4.0
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