2008
DOI: 10.1002/cyto.b.20416
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Challenges in implementing CD4 testing in resource-limited settings

Abstract: The scale-up of HIV antiretroviral therapy in recent years has led to a rapid increase in CD4 and CD4% count capacity to meet the diagnostic needs of staging and monitoring disease progression and treatment efficacy in adults and infants. The speed of implementation of this technology has been unrivalled in recent years and has met challenges with technology selection, laboratory infrastructure development, human resource limitations, cost-effectiveness, instrument maintenance, and ensuring testing access and … Show more

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Cited by 48 publications
(51 citation statements)
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“…Establishing, maintaining and demonstrating the accuracy of diagnostic tests is a major challenge for most laboratories in SSA, and the complexity and cost of setting up and main training quality assurance systems mean that very few laboratories, mainly tertiary or privately owned, can achieve these standards [6,7]. The common perception that EQA is costly or unnecessary has hindered the widespread enrolment of laboratories into EQA programs [8].EQA can be applied in three main ways, each with advantages and disadvantages: 1) …”
Section: The World Health Organization (Who) Defines Externalmentioning
confidence: 99%
“…Establishing, maintaining and demonstrating the accuracy of diagnostic tests is a major challenge for most laboratories in SSA, and the complexity and cost of setting up and main training quality assurance systems mean that very few laboratories, mainly tertiary or privately owned, can achieve these standards [6,7]. The common perception that EQA is costly or unnecessary has hindered the widespread enrolment of laboratories into EQA programs [8].EQA can be applied in three main ways, each with advantages and disadvantages: 1) …”
Section: The World Health Organization (Who) Defines Externalmentioning
confidence: 99%
“…In developed countries, CD4 þ T-lymphocyte (CD4) quantification is considered an essential tool in the initiation and monitoring of ARV therapy, and can be performed using both automated and manual bead-based methods. The introduction of lowcost, automated flow cytometric CD4 assays has provided a more affordable option for RLS (1,6,(14)(15)(16); however, affordable flow cytometry remains impractical in many RLS (12,15,17), as even the simplest flow cytometers require ongoing instrument support and better infrastructure than is currently offered in these regions (10,12).…”
Section: Introductionmentioning
confidence: 98%
“…[1][2][3][4][5][6][7] The scale up of public ART programs globally 8 has led to an increased demand for CD4 count tests, especially to assess treatment eligibility. Despite expansion of laboratory infrastructure and services, access to CD4 testing remains a bottleneck to ART scale-up.…”
Section: Introductionmentioning
confidence: 99%