Flow cytometry as the spearhead for delivering sustainable and versatile laboratory services to HIV-burdened health care systems of the developing world: A Caribbean model

Abayomi, E. A.; Landis, R. Clive

doi:10.1002/cyto.b.20400

Cited by 11 publications

(10 citation statements)

References 10 publications

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“…Regrettably, these manual CD4 counting techniques also fail when faced with the huge increase in the demand for CD4 counts and when the continued monitoring of patients who are already on anti‐retroviral therapy is requested (19). Health care reform in general (35) and increasing the number of trained health professionals in particular (36) are not problems that those of us who develop and use cytometric methods can solve, although we can, should, and do participate in efforts to define the qualities of the optimal systems to use and to improve distribution of reagents and apparatus and support and maintenance of the latter (32, 33, 37, 38).…”

Section: Cd4 Counting In Resource‐poor Environments: Lessons Learnedmentioning

confidence: 99%

Simplified cytometry for routine monitoring of infectious diseases

Jánossy

Shapiro²

2008

Cytometry

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The interacting epidemics of HIV/AIDS, tuberculosis (TB) and malaria in resource-poor areas of the world have created a critical need for rapid, simple, affordable apparatus and tests that will permit patients with these diseases to be promptly diagnosed and properly managed.As documented in the current issue of Clinical Cytometry, complex flow cytometric analyses used in affluent countries for CD4+ T cell counting in HIV/AIDS have been simplified, introduced, and quality assessed in resource-restricted countries of Africa and the Caribbean, where simple gating protocols such as panleucogating now provide accurate and precise CD4+ T cell counts on a large scale. CD4/CD8 ratios in infants may replace more expensive molecular tests for HIV infection; simplified flow cytometry is also compatible with HIV viral load-associated lymphocyte activation tests and with antigen-specific cellular immune response assays that rapidly diagnose active TB in both HIV-negative and HIV-TB coinfected individuals.In addition, it is becoming evident that smaller, much less expensive fluorescence imaging cytometers can be used for CD4 counting, immunophenotyping, and hematology and for other applications such as diagnosis and drug-susceptibility testing of TB and diagnosis of malaria. With the gradual, organized expansion of the much-needed diagnostic networks in the underprivileged countries, the most cost-effective apparatus may be one capable of performing tests for all the three diseases mentioned. The most sustainable systems will be those that can be assembled and maintained, to the greatest extent possible, in the countries where they will be used. q

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Section: Cd4 Counting In Resource‐poor Environments: Lessons Learnedmentioning

confidence: 99%

Simplified cytometry for routine monitoring of infectious diseases

Jánossy

Shapiro²

2008

Cytometry

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“…Significant challenges to effective implementation of HIV/AIDS activities in the Caribbean include the lack of a trained workforce, inadequate health systems and infrastructure and limited access to quality-assured laboratory services to support scale-up of HIV diagnosis and clinical monitoring of patients receiving treatment (Abayomi and Landis 2008). In particular, the role of laboratory systems and services as part of health care delivery in this region has not been given proper importance.…”

Section: Introductionmentioning

confidence: 97%

Strengthening national laboratory health systems in the Caribbean region

Alemnji

Branch²,

Best

et al. 2012

Global Public Health

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The President's Emergency Plan for AIDS Relief (PEPFAR) programme for the Caribbean Region was established in 2008 to address health system challenges, including fragile laboratory services and systems. The laboratory component of this programme consisted of several phases: assessment of laboratory needs of all 12 countries engaged in the programme; addressing gaps identified during the assessment; and monitoring and evaluation of the progress achieved. After one year of PEPFAR collaboration with national governments and other partners, laboratory services and systems greatly improved. Some of the milestones include: (1) the accreditation of a public laboratory; (2) improved access to HIV diagnosis with faster turnaround time; (3) establishment of capacity for platforms for DNA PCR, viral load and HIV drug resistance; (4) development of the laboratory workforce; and (5) establishment of a framework for implementation of sustainable quality management systems for laboratory accreditation. The progress recorded in strengthening laboratory health systems after one year of initiating this collaboration shows that with a rigorous initial assessment, programme design and intervention and strategic partnership, national laboratory health systems can be greatly enhanced to support programme implementation. Continued collaboration and country leadership is critical to create an integrated and sustainable laboratory network in the Caribbean.

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“…To this end, PCR (4) and cell‐based analysis (i.e. CD4 counting) by flow cytometry (5, 6) or automated microscopic cytometry (7) is often the method of choice. The current PCR assays, however, often fail to detect virus variants that are prevalent in the third world.…”

mentioning

confidence: 99%

Flow and image cytometry side by side for the new frontiers in quantitative single‐cell analysis

Tárnok

2009

Cytometry Pt A

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Flow cytometry as the spearhead for delivering sustainable and versatile laboratory services to HIV-burdened health care systems of the developing world: A Caribbean model

Cited by 11 publications

References 10 publications

Simplified cytometry for routine monitoring of infectious diseases

Simplified cytometry for routine monitoring of infectious diseases

Strengthening national laboratory health systems in the Caribbean region

Flow and image cytometry side by side for the new frontiers in quantitative single‐cell analysis

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