ArticlePloS one2018
Multidisease testing for HIV and TB using the GeneXpert platform: A feasibility study in rural Zimbabwe.
Article in PloS one, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 67 papers, 7 of them syntheses that pooled it.
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Who cites it
67 citing papers in PubMed, 7 syntheses or guidelines pooled it.
- Implementation determinants of rapid diagnostic tests for fever management in sub-Saharan Africa: a mixed-studies systematic review.Nature communications · 2026Pooled it
- Pooled it
- Implementation strategies to increase the uptake and impact of molecular WHO-recommended rapid diagnostic tests: evidence from a mixed-methods systematic review.BMJ global health · 2025Pooled it
- Cost-effectiveness of point-of-care versus centralised, laboratory-based nucleic acid testing for diagnosis of HIV in infants: a systematic review of modelling studies.The lancet. HIV · 2023Pooled it
- Point-of-care viral load tests to detect high HIV viral load in people living with HIV/AIDS attending health facilities.The Cochrane database of systematic reviews · 2022Pooled it
- Point-of-care tests detecting HIV nucleic acids for diagnosis of HIV-1 or HIV-2 infection in infants and children aged 18 months or less.The Cochrane database of systematic reviews · 2021Pooled it
- Systematic review of the performance and clinical utility of point of care HIV-1 RNA testing for diagnosis and care.PloS one · 2019Pooled it
- Cost and clinical flow of point-of-care urine tenofovir testing for treatment monitoring among people living with HIV initiating ART in South Africa.Journal of the International AIDS Society · 2025Trial
- Evaluating the impact of point-of-care HIV viral load assessment on linkage to care in Baltimore, MD: a randomized controlled trial.BMC infectious diseases · 2023Trial
- Trial
- Operational experiences associated with the implementation of near point-of-care early infant diagnosis of HIV in Myanmar: a qualitative study.BMC health services research · 2021Trial
- Trial
- Task shifting of point-of-care testing to lay health workers in rural primary health facilities in Nsanje, Malawi.Global health action · 2026Article
- Analytical Agreement of the GeneXpert HIV-1 Viral Load Assay Compared with the Abbott Alinity m HIV-1 Assay.Diagnostics (Basel, Switzerland) · 2026Article
- The future of diagnostics in Africa.Nature medicine · 2026Review
- Development and validation of a sample-to-result real time multiplex RT-PCR test for human African trypanosomiasis and arboviral febrile illnesses in the Democratic Republic of the Congo.BMC infectious diseases · 2026Observational
- Article
- Utilizing rapid diagnostic tests in infectious disease surveillance and response in humanitarian emergencies.Frontiers in public health · 2026Review
- Article
- Optimizing hepatitis B diagnosis for mothers in a low-resource setting: A field pilot of Xpert point-of-care viral load testing in Ugandan antenatal clinics.PLOS global public health · 2026Article
7 more citing papers are in PubMed but not listed here.
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Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundHIV Viral Load and Early Infant Diagnosis technologies in many high burden settings are restricted to centralized laboratory testing, leading to long result turnaround times and patient attrition. GeneXpert (Cepheid, CA, USA) is a polyvalent near point-of-care platform and is widely implemented for Xpert MTB/RIF diagnosis. This study sought to evaluate the operational feasibility of integrated HIV VL, EID and MTB/RIF testing in new GeneXpert platforms.
methodsWhole blood samples were collected from consenting patients due for routine HIV VL testing and DBS samples from infants due for EID testing, at three rural health facilities in Zimbabwe. Sputum samples were collected from all individuals suspected of TB. GeneXpert testing was reserved for all EID, all TB suspects and priority HIV VL at each site. Blood samples were further sent to centralized laboratories for confirmatory testing. GeneXpert polyvalent testing results and patient outcomes, including infrastructural and logistical requirements are reported. The study was conducted over a 10-month period.
resultsThe fully automated GeneXpert testing device, required minimal training and biosafety considerations. A total of 1,302 HIV VL, 277 EID and 1,581 MTB/RIF samples were tested on a four module GeneXpert platform in each study site. Xpert HIV-1 VL testing was prioritized for patients who presented with advanced HIV disease, pregnant women, adolescents and suspected ART failures patients. On average, the study sites had a GeneXpert utilization rate of 50.4% (Gutu Mission Hospital), 63.5% (Murambinda Mission Hospital) and 17.5% (Chimombe Rural Health Centre) per month. GeneXpert polyvalent testing error rates remained lower than 4% in all sites. Decentralized EID and VL testing on Xpert had shorter overall median TAT (1 day [IQR: 0-4] and 1 day [IQR: 0-1] respectively) compared to centralized testing (17 days [IQR: 13-21] and 26 days [IQR: 23-32] respectively). Among patients with VL >1000 copies/ml (73/640; 11.4%) at GMH health facility, median time to enhanced adherence counselling was 8 days and majority of those with documented outcomes had re-suppressed VL (20/32; 62.5%). Median time to ART initiation among Xpert EID positive infants at GMH was 1 day [IQR: 0-1].
conclusionImplementation of near point-of-care GeneXpert platform for integrated multi-disease testing within district and sub-district healthcare settings is feasible and will increase access to VL, and EID testing to priority populations. Quality management systems including monitoring of performance indicators, together with regular on-site supervision are crucial, and near-POC test results must be promptly actioned-on by clinicians for patient management.
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