Détail du document
Identifiant
oai:pubmedcentral.nih.gov:1075...
Sujet
Health PolicyAuteur
Fajardo, Emmanuel Lastrucci, Céline Bah, Nayé Mingiedi, Casimir Manzengo Ba, Ndoungou Salla Mosha, Fausta Lule, Frank John Paul, Margaret Alia Samson Hughes, Lago Barr-DiChiara, Magdalena Jamil, Muhammad S Sands, Anita Baggaley, Rachel Johnson, CherylLangue
enEditeur
BMJ Publishing Group
Catégorie
BMJ Open
Année
2023
Date de référencement
11/06/2024
Mots clés
strategies three-test national recommended strategy hts adopted testing countries hiv policiesRésumé
OBJECTIVES: In 2019, the WHO released guidelines on HIV testing service (HTS).
We aim to assess the adoption of six of these recommendations on HIV testing strategies among African countries.
DESIGN: Policy review.
SETTING: 47 countries within the WHO African region.
PARTICIPANTS: National HTS policies from the WHO African region as of December 2021.
Primary and secondary outcome measures: Uptake of WHO recommendations across national HTS policies including the standard three-test strategy; discontinuation of a tiebreaker test to rule in HIV infection; discontinuation of western blotting (WB) for HIV diagnosis; retesting prior to antiretroviral treatment (ART) initiation and the use of dual HIV/syphilis rapid diagnostic tests (RDTs) in antenatal care.
Country policy adoption was assessed on a continuum, based on varying levels of complete adoption.
RESULTS: National policies were reviewed for 96% (n=45/47) of countries in the WHO African region, 38% (n=18) were published before 2019 and 60% (n=28) adopted WHO guidance.
Among countries that had not fully adopted WHO guidance, not yet adopting a three-test strategy was the most common reason for misalignment (45%, 21/47); of which 31% and 22% were in low-prevalence (<5%) and high-prevalence (≥5%) countries, respectively.
Ten policies (21%) recommended the use of WB and 49% (n=23) recommended retesting before ART initiation.
Dual HIV/syphilis RDTs were recommended in 45% (n=21/47) of policies.
CONCLUSIONS: Many countries in the African region have adopted WHO-recommended HIV testing strategies; however, efforts are still needed to fully adopt WHO guidance.
Countries should accelerate their efforts to adopt and implement a three-test strategy, retesting prior to ART initiation and the use of dual HIV/syphilis RDTs.
Fajardo, Emmanuel,Lastrucci, Céline,Bah, Nayé,Mingiedi, Casimir Manzengo,Ba, Ndoungou Salla,Mosha, Fausta,Lule, Frank John,Paul, Margaret Alia Samson,Hughes, Lago,Barr-DiChiara, Magdalena,Jamil, Muhammad S,Sands, Anita,Baggaley, Rachel,Johnson, Cheryl, 2023, Country adoption of WHO 2019 guidance on HIV testing strategies and algorithms: a policy review across the WHO African region, BMJ Publishing Group
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