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. 2021 Aug 24;10(1):1156.
doi: 10.4102/ajlm.v10i1.1156. eCollection 2021.

Strategic site selection for placement of HIV early infant diagnosis point-of-care technology within a national diagnostic network in Lesotho

Anafi Mataka  1 , Esther A J Tumbare  2 , Tsietso Motsoane  3 , David Holtzman  4 , Monkoe Leqheka  3 , Kolisang Phatsoane  3 , Emma Sacks  5 , Anthony Isavwa  6 , Appolinaire Tiam  7
Affiliations

Strategic site selection for placement of HIV early infant diagnosis point-of-care technology within a national diagnostic network in Lesotho

Anafi Mataka et al. Afr J Lab Med. .

Abstract

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 network.

Intervention: 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 created.

Lessons 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 selection.

Recommendations: 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; increased health access; point-of-care; site selection.

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Conflict of interest statement

The authors declare that they have no financial or personal relationships that may have inappropriately influenced them in writing this article.

Figures

FIGURE 1
FIGURE 1
Median performance scores per Stepwise Process for Improving the Quality of HIV-Related Point-of-Care Testing checklist domain of potential point-of-care early infant diagnosis health facilities (N = 15) in Lesotho, February 2016.
See this image and copyright information in PMC

References

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