Original Research

Increased utilisation of PEPFAR-supported laboratory services by non-HIV patients in Tanzania

Margaret Mcnairy, Charon Gwynn, Miriam Rabkin, Gretchen Antelman, Yingfeng Wu, Bereket Alemayehu, Travis Lim, Rubina Imtiaz, Fausta Mosha, Michael Mwasekaga, Asha A. Othman, Jessica Justman
African Journal of Laboratory Medicine | Vol 5, No 1 | a318 | DOI: https://doi.org/10.4102/ajlm.v5i1.318 | © 2016 Margaret Mcnairy, Charon Gwynn, Miriam Rabkin, Gretchen Antelman, Yingfeng Wu, Bereket Alemayehu, Travis Lim, Rubina Imtiaz, Fausta Mosha, Michael Mwasekaga, Asha A. Othman, Jessica Justman | This work is licensed under CC Attribution 4.0
Submitted: 03 April 2015 | Published: 16 February 2016

About the author(s)

Margaret Mcnairy, ICAP, Columbia University, New York and Weill Cornell Medical College, New York, United States
Charon Gwynn, ICAP, Columbia University, New York, United States
Miriam Rabkin, ICAP, Columbia University, New York, United States
Gretchen Antelman, ICAP, Columbia University, New York, United States
Yingfeng Wu, ICAP, Columbia University, New York, United States
Bereket Alemayehu, ICAP, Columbia University, New York, United States
Travis Lim, Centers for Disease Control and Prevention, Atlanta, Georgia, United States
Rubina Imtiaz, Centers for Disease Control and Prevention, Atlanta, Georgia, United States
Fausta Mosha, Ministry of Health and Social Welfare, Dar es Salaam, Tanzania, United Republic of
Michael Mwasekaga, Centers for Disease Control and Prevention, Dar es Salaam, Tanzania, United Republic of
Asha A. Othman, Ministry of Health, Zanzibar, Tanzania, United Republic of
Jessica Justman, ICAP, Columbia University, New York, United States


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Abstract

Background: It is unknown to what extent the non-HIV population utilises laboratories supported by the President’s Emergency Plan for AIDS Relief (PEPFAR).

Objectives: We aimed to describe the number and proportion of laboratory tests performed in 2009 and 2011 for patients referred from HIV and non-HIV services (NHSs )in a convenience sample collected from 127 laboratories supported by PEPFAR in Tanzania. We then compared changes in the proportions of tests performed for patients referred from NHSs in 2009 vs 2011.

Methods: Haematology, chemistry, tuberculosis and syphilis test data were collected from available laboratory registers. Referral sources, including HIV services, NHSs, or lack of a documented referral source, were recorded. A generalised linear mixed model reported the odds that a test was from a NHS.

Results: A total of 94 132 tests from 94 laboratories in 2009 and 157 343 tests from 101 laboratories in 2011 were recorded. Half of all tests lacked a documented referral source. Tests from NHSs constituted 42% (66 084) of all tests in 2011, compared with 31% (29 181) in 2009. A test in 2011 was twice as likely to have been referred from a NHS as in 2009 (adjusted odds ratio: 2.0 [95% confidence interval: 2.0–2.1]).

Conclusion: Between 2009 and 2011, the number and proportion of tests from NHSs increased across all types of test. This finding may reflect increased documentation of NHS referrals or that the laboratory scale-up originally intended to service the HIV-positive population in Tanzania may be associated with a ‘spillover effect’ amongst the general population.


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