The readiness of the national health laboratory system in supporting care and treatment of HIV/AIDS in Tanzania

Mboera, Leonard E. G.; Ishengoma, Deus S.; Kilale, Andrew M.; Massawe, Isolide S.; Rutta, Acleus S. M.; Kagaruki, Gibson B.; Kamugisha, Erasmus; Baraka, Vito; Magesa, Stephen

doi:10.1186/s12913-015-0923-z

Cited by 9 publications

(9 citation statements)

References 15 publications

(22 reference statements)

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“…The test and treat strategy, the recommended and increasing donor support for routine HVL testing, and the consequent decrease in CD4 count testing as per guidelines all likely contributed to the lower access to CD4 count testing observed in our study [43][44][45]. A declining trend of CD4 count measurement has been observed in many southern African countries since the beginning of the Test and Treat era in alignment with our findings [46][47][48]. Despite this, the considerably high access to HVL testing observed in Shinyanga likely reflects the donor-funded status of this service.…”

Section: Discussionsupporting

confidence: 81%

The Shinyanga Patient: A Patient’s Journey through HIV Treatment Cascade in Rural Tanzania

Okere

Sambu²,

Ndungile³

et al. 2021

IJERPH

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The 2016–2017 Tanzania HIV Impact Survey (THIS) reported the accomplishments towards the 90-90-90 global HIV targets at 61-94-87, affirming the need to focus on the first 90 (i.e., getting 90% of people living with HIV (PLHIV) tested). We conducted a patient-pathway analysis to understand the gap observed, by assessing the alignment between where PLHIV seek healthcare and where HIV services are available in the Shinyanga region, Tanzania. We used existing and publicly available data from the National AIDS Control program, national surveys, registries, and relevant national reports. Region-wide, the majority (n = 458/722, 64%) of THIS respondents accessed their last HIV test at public sector facilities. There were 65.9%, 45.1%, and 74.1% who could also access antiretroviral therapy (ART), CD4 testing, and HIV viral load testing at the location of their last HIV test, respectively. In 2019, the viral suppression rate estimated among PLHIV on ART in the Shinyanga region was 91.5%. PLHIV access HIV testing mostly in public health facilities; our research shows that synergies can be achieved to improve access to services further down the cascade in this sector. Furthermore, effective engagement with the private sector (not-for-profit and for-profit) will help to achieve the last mile toward ending the HIV epidemic.

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Section: Discussionsupporting

confidence: 81%

The Shinyanga Patient: A Patient’s Journey through HIV Treatment Cascade in Rural Tanzania

Okere

Sambu²,

Ndungile³

et al. 2021

IJERPH

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“…This is contrary to the national guidelines which stipulate that all hospitals and health centres should provide HIV diagnostic services for detection of infection status and supportive tests for management and care of PLHA [18, 30]. Furthermore, the low coverage of HIV care and treatment services at low level HFs and in rural areas, which serve the majority of the population [31], suggests that most of the PLHA may have limited access to the critically needed services. However, with laboratories in 13.4% of the dispensaries and most of the health centres (95.2%) in rural areas, there exists a room for scaling up of HIV diagnostic and supportive services in the country.…”

Section: Discussionmentioning

confidence: 95%

Performance of health laboratories in provision of HIV diagnostic and supportive services in selected districts of Tanzania

Ishengoma

Kamugisha

Rutta

et al. 2017

BMC Health Serv Res

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BackgroundRoll-out and implementation of antiretroviral therapy (ART) necessitated many countries in Sub-Saharan Africa to strengthen their national health laboratory systems (NHLSs) to provide high quality HIV diagnostic and supportive services. This study was conducted to assess the performance of health laboratories in provision of HIV diagnostic and supportive services in eight districts (from four regions of Iringa, Mtwara, Tabora and Tanga), after nine years of implementation of HIV/AIDS care and treatment plan in Tanzania.MethodsIn this cross-sectional study, checklists and observations were utilized to collect information from health facilities (HFs) with care and treatment centres (CTCs) for HIV/AIDS patients; on availability of laboratories, CTCs, laboratory personnel, equipment and reagents. A checklist was also used to collect information on implementation of quality assurance (QA) systems at all levels of the NHLS in the study areas.ResultsThe four regions had 354 HFs (13 hospitals, 41 Health Centres (HCs) and 300 dispensaries); whereby all hospitals had laboratories and 11 had CTCs while 97.5 and 61.0% of HCs had both laboratories and CTCs, respectively. Of the dispensaries, 36.0 and 15.0% had laboratories and CTCs (mainly in urban areas). Thirty nine HFs (12 hospitals, 21 HCs and six dispensaries) were assessed and 56.4% were located in urban areas. The assessed HFs had 199 laboratory staff of different cadres (laboratory assistants = 35.7%; technicians =32.7%; attendants = 22.6%; and others = 9.1%); with >61% of the staff and 72.3% of the technicians working in urban areas. All laboratories were using rapid diagnostic tests for HIV testing. Over 74% of the laboratories were performing internal quality control and 51.4% were participating in external QA programmes. Regional and district laboratories had all key equipment and harmonization was maintained for Fluorescence-Activated Cell Sorting (FACS) machines. Most of the biochemical (58.0%) and haematological analysers (74.1%) were available in urban areas. Although >81% of the equipment were functional with no mechanical faulty, 62.6% had not been serviced in the past three years.ConclusionDiagnostic and supportive services for HIV were available in most of the HCs and hospitals while few dispensaries were providing the services. Due to limitations such as shortage of staff, serving of equipment and participation in QA programmes, the NHLS should be strengthened to ensure adequate human resource, implementation of QA and sustainable preventive maintenance services of equipment.

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“…(Hickman et al, 2014). A paper by Mboera et al (2015) found that a wellestablished National Health Laboratory System was in place in Tanzania, however, the coordination of HIV laboratory services was found to be weak. Physical access to health services has significantly improved in Tanzania with the construction and renovation of PHC facilities in rural areas.…”

Section: Service Deliverymentioning

confidence: 99%

“…Strong health laboratory systems and networks capable of providing high quality services are critical components of the health system and play a key role in routine diagnosis, care, treatment and disease surveillance. A paper by Mboera et al (2015) found that a well-established National Health Laboratory System was in place in Tanzania, however, the coordination of HIV laboratory services was found to be weak. The authors reported that whilst in most laboratories, guidelines for HIV diagnosis were available, health care providers were not aware of their availability.…”

Section: Laboratory Facilitiesmentioning

confidence: 99%

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Malaria, HIV and TB in Tanzania: Epidemiology, Disease Control Challenges and Interventions

Avis¹

2022

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Tanzania, officially the United Republic of Tanzania, is a country in East Africa within the African Great Lakes region. The population is estimated to be 61 million in 2021. Malaria, HIV and tuberculosis (TB) are significant public health concerns in Tanzania. HIV/AIDS was the third leading cause of death in the country in 2019 (Global Burden of Disease, 2021), accounting for 27,000 deaths in 2020 (UNAIDS, 2020). Tanzania is among the ten countries with the highest malaria cases and deaths (3% of the global cases, 13.4% of cases in East and Southern Africa, and 5% of global deaths) (Severe Malaria Observatory, 2021). Tanzania is one of the High TB Burden Countries, and one of the High TB/HIV Burden Countries. In Tanzania, it is estimated that of 154,000 new cases of TB in 2017, 31% (48,000) were also HIV positive (WHO, 2018). TB has been the leading cause of death among HIV positive individuals (Mollel et al., 2019), a close monitoring of its occurrence in this subgroup of people is important. This rapid literature review highlights key aspects of the epidemiology of malaria, HIV and TB in Tanzania and challenges in prevention, detection and treatment; and surveys select interventions that seek to address these challenges. This is part of a series of reports looking into Epidemiology of Malaria, human immune deficiency virus (HIV) and tuberculosis (TB) across a set of African Nations.

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The readiness of the national health laboratory system in supporting care and treatment of HIV/AIDS in Tanzania

Cited by 9 publications

References 15 publications

The Shinyanga Patient: A Patient’s Journey through HIV Treatment Cascade in Rural Tanzania

The Shinyanga Patient: A Patient’s Journey through HIV Treatment Cascade in Rural Tanzania

Performance of health laboratories in provision of HIV diagnostic and supportive services in selected districts of Tanzania

Malaria, HIV and TB in Tanzania: Epidemiology, Disease Control Challenges and Interventions

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