Last data update: Sep 16, 2024. (Total: 47680 publications since 2009)
Records 1-3 (of 3 Records) |
Query Trace: Habiyambere V [original query] |
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Forecasting the global demand for HIV monitoring and diagnostic tests: A 2016-2021 analysis
Habiyambere V , Dongmo Nguimfack B , Vojnov L , Ford N , Stover J , Hasek L , Maggiore P , Low-Beer D , Perez Gonzalez M , Edgil D , Williams J , Kuritsky J , Hargreaves S , NeSmith T . PLoS One 2018 13 (9) e0201341 INTRODUCTION: Despite considerable progress, just over half of the 37 million people eligible to start antiretroviral therapy (ART) have accessed treatment and millions of HIV-positive people still do not know their status. With demand for ART continuing to grow, meeting the ambitious 90-90-90 HIV treatment targets will depend on improved access to high-quality diagnostics to both diagnose infection and monitor treatment adherence in low and middle-income countries (LMICs). Robust projections of future demand for CD4, viral load (VL), HIV early-infant-diagnosis (EID) tests and HIV rapid diagnostic tests (RDTs) are needed as scale-up continues. METHODS: We estimate the current coverage for HIV diagnostics and project future demand to 2021 using a consolidated forecast using data on past coverage and current demand from a number of sources, from 130 predominantly LMIC countries. RESULTS: We forecast that the overall number of CD4 tests is expected to decline between now and 2021 as more countries adopt test-and-treat and shift to VL testing for patient monitoring. Our consolidated forecast projects a gradual decline in demand for CD4 tests to 16.6 million by 2021. We anticipate that demand for VL tests will increase to 28.5 million by 2021, reflecting the increasing number of people who will receive ART and the adoption of VL testing for patient monitoring. We expect that the demand for EID tests will grow more rapidly than in past years, driven by the implementation of testing at birth in programmes globally, in line with WHO guideline recommendations, doubling to 2.1 million tests by 2021. Demand for rapid diagnostic tests is also likely to increase, reaching 509 million tests by 2021. DISCUSSION: In order to achieve the ambitious 90-90-90 targets, it will be essential to maintain and improve access to CD4, VL, EID tests and RDTs. These projections provide insight into the global demand we can expect to see for these HIV monitoring and diagnostic tests, both in relation to historical trends, and the 90-90-90 targets. Our projections will better enable producers to ensure adequate supply, and to support procurement organisations in planning future funding and purchase plans to meet the anticipated demand. The findings highlight the ongoing need for governments and international funding bodies to prioritise improving capacity and access to HIV diagnostic and monitoring technologies in line with demand. |
Availability and use of HIV monitoring and early infant diagnosis technologies in WHO Member States in 2011-2013: analysis of annual surveys at the facility level
Habiyambere V , Ford N , Low-Beer D , Nkengasong J , Sands A , Perez Gonzalez M , Fernandes P , Milgotina E . PLoS Med 2016 13 (8) e1002088 BACKGROUND: The Joint United Nations Programme on HIV and AIDS (UNAIDS) 90-90-90 targets have reinforced the importance of functioning laboratory services to ensure prompt diagnosis and to assess treatment efficacy. We surveyed the availability and utilization of technologies for HIV treatment monitoring and early infant diagnosis (EID) in World Health Organization (WHO) Member States. METHODS AND FINDINGS: The survey questionnaire included 14 structured questions focusing on HIV testing, cluster of differentiation 4 (CD4) testing, HIV viral load (VL) testing, and EID and was administered annually from 2012 to 2014 through WHO country offices, with each survey covering the previous 12-mo period. Across 127 targeted countries, survey response rates were 60% in 2012, 67% in 2013, and 78% in 2014. There were encouraging trends towards increased procurement of CD4 and VL/EID instruments in reporting countries. Globally, the capacity of available CD4 instruments was sufficient to meet the demand of all people living with HIV/AIDS (PLWHA), irrespective of treatment status (4.62 theoretical tests per PLWHA in 2013 [median 7.33; interquartile range (IQR) 3.44-17.75; median absolute deviation (MAD) 4.35]). The capacity of VL instruments was inadequate to cover all PLWHA in many reporting countries (0.44 tests per PLWHA in 2013 [median 0.90; IQR 0.30-2.40; MAD 0.74]). Of concern, only 13.7% of existing CD4 capacity (median 4.3%; IQR 1.1%-12.1%; MAD 3.8%) and only 36.5% of existing VL capacity (median 9.4%; IQR 2.3%-28.9%; MAD 8.2%) was being utilized across reporting countries in 2013. By the end of 2013, 7.4% of all CD4 instruments (5.8% CD4 conventional instruments and 11.0% of CD4 point of care [POC]) and 10% of VL/EID instruments were reportedly not in use because of lack of reagents, the equipment not being installed or deployed, maintenance, and staff training requirements. Major limitations of this survey included under-reporting and/or incomplete reporting in some national programmes and noncoverage of the private sector. CONCLUSION: This is the first attempt to comprehensively gather information on HIV testing technology coverage in WHO Member States. The survey results suggest that major operational changes will need to be implemented, particularly in low- and middle-income countries, if the 90-90-90 targets are to be met. |
Ensuring quality: a key consideration in scaling-up HIV-related point-of-care testing programs
Fonjungo PN , Osmanov S , Kuritsky J , Ndihokubwayo JB , Bachanas P , Peeling RW , Timperi R , Fine G , Stevens W , Habiyambere V , Nkengasong JN . AIDS 2016 30 (8) 1317-23 OBJECTIVE: The objective of the World Health Organization (WHO)/U.S. President's Emergency Plan for AIDS Relief (PEPFAR) consultation was to discuss innovative strategies, offer guidance and develop a comprehensive policy framework for implementing quality-assured HIV-related point-of-care testing (POCT). METHODS: The consultation was attended by representatives from international agencies (WHO, UNICEF, UNITAID, Clinton Health Access Initiative [CHAI]), USAID, Centers for Disease Control and Prevention [CDC]/PEPFAR Cooperative Agreement Partners, and experts from more than 25 countries including policy makers, clinicians, laboratory experts and program implementers. MAIN OUTCOMES: There was strong consensus among all participants that ensuring access to quality of POCT represents one of the key challenges for the success of HIV prevention, treatment and care programs. The following four strategies were recommended: 1) implement a newly proposed concept of a sustainable quality assurance cycle that includes (a) careful planning; (b) definition of goals and targets; (c) timely implementation; (d) continuous monitoring; (e) improvements and adjustments, where necessary; and (f) a detailed evaluation; 2) the importance of supporting a cadre of workers (e.g. volunteer quality corps [Q-Corps]) with the role to ensure that the quality assurance cycle is followed and sustained; 3) implementation of the new strategy should be seen as a step-wise process, supported by development of appropriate policies and tools; and 4) joint partnership under the leadership of the Ministries of Health to ensure sustainability of implementing novel approaches. CONCLUSIONS: The outcomes of this consultation have been well received by program implementers in the field. The recommendations also laid the groundwork for developing key policy and quality documents for the implementation of HIV-related POCT. |
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