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Comprehensive & Cost Effective Laboratory Monitoring of HIV/AIDS: an African Role Model
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Indicator-condition-guided HIV testing in rural DRC.

Pascal Migaud1,2, Julia Naidenow3, Leyli Ghaeni3

  • 1Department of Infectious Diseases, St. Joseph Hospital, Wüsthoffstrasse 15, 12101, Berlin, Germany. pascal.migaud@sjk.de.

Infection
|March 21, 2024
PubMed
Summary
This summary is machine-generated.

Indicator-triggered HIV testing in the Democratic Republic of the Congo identified many HIV-positive patients despite limited test kits. However, high patient loss to follow-up remains a significant challenge.

Keywords:
HIVIndicator-condition-guided testingLimited resourcesProvider-initiated

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Area of Science:

  • Public Health
  • Infectious Diseases
  • Clinical Medicine

Background:

  • HIV testing is crucial for achieving global 95-95-95-0 targets.
  • Limited HIV test kit availability in the Democratic Republic of the Congo necessitates alternative testing strategies.
  • Targeted testing based on HIV indicator conditions is a feasible approach in resource-limited settings.

Purpose of the Study:

  • To evaluate the effectiveness of indicator condition-guided HIV testing in a resource-limited emergency room setting.
  • To assess the yield of HIV diagnoses using this targeted approach.
  • To identify challenges associated with HIV testing and linkage to care in the study area.

Main Methods:

  • An indicator condition-guided HIV testing project was implemented in the Emergency Room of Hôpital Géneral de Référence de Kikwit, DRC.
  • Patients were screened for the presence of HIV indicator conditions.
  • Positive cases were confirmed through HIV testing.

Main Results:

  • 1274 patients were screened for indicator conditions.
  • HIV indicator conditions were diagnosed in 94 (7.4%) patients.
  • 34 patients (2.7% of screened) tested HIV-positive.
  • A significant proportion (52%) of newly diagnosed patients were lost to follow-up within two months.

Conclusions:

  • Indicator-triggered HIV testing is an effective strategy for identifying HIV-positive individuals in resource-limited settings with scarce test kits.
  • High rates of loss to follow-up among newly diagnosed patients present a major challenge to effective HIV care.
  • Further interventions are needed to improve patient retention in care after HIV diagnosis.