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• W776800601 abstract "South Africa has a severe HIV (human immunodeficiency virus) burden and the management of the disease is a priority, especially in the public healthcare sector. One element of managing the disease, is determining when to initiate an HIV positive individual onto anti-retroviral therapy (ART), a treatment that the patient will remain on for the remainder of their lifetime. For the majority of HIV positive individuals in the country, this decision is governed by the results of a CD4 (cluster of differentiation 4) test that is performed at set time intervals from the time that the patient is diagnosed with HIV until the patient is initiated onto ART. A device for CD4 measurement at the point of care (POC), the Alere PIMA—, has recently become commercially available. This has prompted a need to evaluate whether CD4 testing at the POC (i.e. at the patient serving healthcare facility) should be incorporated into the South African public healthcare sector’s HIV diagnostic service provision model. One challenge associated with the management of HIV in the country is the relatively large percentage of patients that are lost to follow-up at various points in the HIV treatment process. There is extensive evidence that testing CD4 levels at the POC (rather than in a laboratory, as is the current practice) reduces the percentage of patients that are lost to follow-up before being initiated onto ART. Therefore, though POC CD4 testing is more expensive than laboratory-based CD4 testing, the use of this technology in South Africa should be investigated for its potential to positively influence health outcomes. In this research, a multi-objective location science model is used to generate scenarios for the provision of CD4 testing capability. For each scenario, CD4 testing provision at 3 279 ART initiation facilities is considered. For each facility, either (i) a POC device is placed at the site; or (ii) the site’s" @default.
• W776800601 created "2016-06-24" @default.
• W776800601 creator A5074992405 @default.
• W776800601 date "2015-03-01" @default.
• W776800601 modified "2023-09-28" @default.
• W776800601 title "A location science model for the placement of POC CD4 testing devices as part of South Africa's public healthcare diagnostic service delivery model" @default.
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• W776800601 hasPublicationYear "2015" @default.
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