ArticlePloS one2015
Dried blood spots for viral load monitoring in Malawi: feasible and effective.
Article in PloS one, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers, 3 of them syntheses that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
26 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Dried Blood Spots to Assess Cardiovascular-Kidney-Metabolic Health.Journal of the American Heart Association · 2025Pooled it
- The viral load monitoring cascade in HIV treatment programmes in sub-Saharan Africa: a systematic review.BMC public health · 2024Pooled it
- The risk of sexual transmission of HIV in individuals with low-level HIV viraemia: a systematic review.Lancet (London, England) · 2023Pooled it
- Acceptability and Feasibility of Providing Adherence Feedback Based on Tenofovir Diphosphate in Dried Blood Spots: Results from a Pilot Study Among Patients and Providers in Cape Town, South Africa.AIDS and behavior · 2023Trial
- HIV Prevalence, Virological Suppression, and Consistent Condom Use Among Social Venue-Going Men in Zimbabwe: Insights from the 2022 Priorities for Local AIDS Control Efforts (PLACE) Surveys.AIDS and behavior · 2026Article
- Feasibility and acceptability of task sharing collection of HIV viral load dried blood spot samples with community lay cadres: A cross-sectional diagnostic validation study in Zimbabwe.PLOS global public health · 2026Article
- The Development of a Standardized Quality Assessment Material to Support XpertDiagnostics (Basel, Switzerland) · 2021Article
- The preventive strategy for pandemics in the elderly is to collect in advance samples & data to counteract chronic inflammation (inflammaging).Ageing research reviews · 2020Review
- Observational
- Whatman FTA cards versus plasma specimens for the quantitation of HIV-1 RNA using two real-time PCR assays.Access microbiology · 2020Article
- Point-of-care viral load monitoring: outcomes from a decentralized HIV programme in Malawi.Journal of the International AIDS Society · 2019Article
- The burden of HIV among female sex workers, men who have sex with men and transgender women in Haiti: results from the 2016 Priorities for Local AIDS Control Efforts (PLACE) study.Journal of the International AIDS Society · 2019Article
- Point-of-Care HIV Viral Load Testing: an Essential Tool for a Sustainable Global HIV/AIDS Response.Clinical microbiology reviews · 2019Review
- Towards the third 90: improving viral load testing with a simple quality improvement program in health facilities in Malawi.International health · 2019Article
- Separation of Plasma from Whole Blood by Use of the cobas Plasma Separation Card: a Compelling Alternative to Dried Blood Spots for Quantification of HIV-1 Viral Load.Journal of clinical microbiology · 2019Article
- Article
- A targeted approach for routine viral load monitoring in Malawian adults on antiretroviral therapy.Tropical medicine & international health : TM & IH · 2018Article
- Sensitivity and specificity of two dried blood spot methods for HIV-1 viral load monitoring among patients in Hanoi, Vietnam.PloS one · 2018Article
- Returning HIV-1 viral load results to participant-selected health facilities in national Population-based HIV Impact Assessment (PHIA) household surveys in three sub-Saharan African Countries, 2015 to 2016.Journal of the International AIDS Society · 2017Article
- Journey towards universal viral load monitoring in Maputo, Mozambique: many gaps, but encouraging signs.International health · 2017Article
Corrections and comments
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Authors and funding
16 authors.
Funding
Abstract
objectivesTo evaluate the feasibility and effectiveness of dried blood spots (DBS) use for viral load (VL) monitoring, describing patient outcomes and programmatic challenges that are relevant for DBS implementation in sub-Saharan Africa.
methodsWe recruited adult antiretroviral therapy (ART) patients from five district hospitals in Malawi. Eligibility reflected anticipated Ministry of Health VL monitoring criteria. Testing was conducted at a central laboratory. Virological failure was defined as >5000 copies/ml. Primary outcomes were program feasibility (timely result availability and patient receipt) and effectiveness (second-line therapy initiation).
resultsWe enrolled 1,498 participants; 5.9% were failing at baseline. Median time from enrollment to receipt of results was 42 days; 79.6% of participants received results within 3 months. Among participants with confirmed elevated VL, 92.6% initiated second-line therapy; 90.7% were switched within 365 days of VL testing. Nearly one-third (30.8%) of participants with elevated baseline VL had suppressed (<5,000 copies/ml) on confirmatory testing. Median period between enrollment and specimen testing was 23 days. Adjusting for relevant covariates, participants on ART >4 years were more likely to be failing than participants on therapy 1-4 years (RR 1.7, 95% CI 1.0-2.8); older participants were less likely to be failing (RR 0.95, 95% CI 0.92-0.98). There was no difference in likelihood of failure based on clinical symptoms (RR 1.17, 95% CI 0.65-2.11).
conclusionsDBS for VL monitoring is feasible and effective in real-world clinical settings. Centralized DBS testing may increase access to VL monitoring in remote settings. Programmatic outcomes are encouraging, especially proportion of eligible participants switched to second-line therapy.
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