Abstract

MATAKA, Anafi et al. Strategic site selection for placement of HIV early infant diagnosis point-of-care technology within a national diagnostic network in Lesotho. Afr. J. Lab. Med. [online]. 2021, vol.10, n.1, pp.1-6. ISSN 2225-2010.  https://doi.org/10.4102/ajlm.v10i1.1156.

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 networkINTERVENTION: 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 createdLESSONS 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 selectionRECOMMENDATIONS: 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

Keywords : HIV early infant diagnosis; point-of-care; increased health access; site selection.

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