ArticleJournal of the International AIDS Society2018
Impact of a borderless sample transport network for scaling up viral load monitoring: results of a geospatial optimization model for Zambia.
Article in Journal of the International AIDS Society, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers.
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Who cites it
20 citing papers in PubMed.
- Cost and impact of decentralized tuberculosis testing: a modeling analysis of price thresholds for molecular instruments in high-burden settings.EClinicalMedicine · 2026Article
- Causes of Pediatric Deaths in Lusaka, Zambia: A Quantitative Geographic Information Systems Approach.medRxiv : the preprint server for health sciences · 2024Article
- An Integrated Sample Referral System for HIV Viral Load and Early Infant Diagnosis in North-Western Province, Zambia-A Retrospective Cross-Sectional Study.Healthcare (Basel, Switzerland) · 2024Article
- Using queueing models as a decision support tool in allocating point-of-care HIV viral load testing machines in Kisumu County, Kenya.Health policy and planning · 2024Article
- Laboratory services in the context of prevention of mother-to-child transmission of HIV testing requirements in Copperbelt Province, Zambia: a qualitative inquiry.BMC health services research · 2023Article
- Verification of dried blood spot as a sample type for HIV viral load and early infant diagnosis on Hologic Panther in Zambia.BMC research notes · 2023Article
- Application of diagnostic network optimization in Kenya and Nepal to design integrated, sustainable and efficient bacteriology and antimicrobial resistance surveillance networks.PLOS global public health · 2023Article
- Use of Physical Accessibility Modelling in Diagnostic Network Optimization: A Review.Diagnostics (Basel, Switzerland) · 2022Review
- Optimising courier specimen collection time improves patient access to HIV viral load testing in South Africa.African journal of laboratory medicine · 2022Article
- National optimisation of accessibility to emergency obstetrical and neonatal care in Togo: a geospatial analysis.BMJ open · 2021Article
- A Framework for Assessing Import Costs of Medical Supplies and Results for a Tuberculosis Program in Karakalpakstan, Uzbekistan.Health data science · 2021Article
- Bringing Data Analytics to the Design of Optimized Diagnostic Networks in Low- and Middle-Income Countries: Process, Terms and Definitions.Diagnostics (Basel, Switzerland) · 2020Review
- SNAPflex: a paper-and-plastic device for instrument-free RNA and DNA extraction from whole blood.Lab on a chip · 2020Article
- Cost and Impact of Dried Blood Spot Versus Plasma Separation Card for Scale-up of Viral Load Testing in Resource-limited Settings.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2020Article
- Accurate HIV viral load measurement in primary health care settings using the cobas® plasma separation card.PloS one · 2020Article
- Article
- Monitoring viral load for the last mile: what will it cost?Journal of the International AIDS Society · 2019Article
- Comparative cost analysis of point-of-care versus laboratory-based testing to initiate and monitor HIV treatment in South Africa.PloS one · 2019Article
- Optimizing viral load testing access for the last mile: Geospatial cost model for point of care instrument placement.PloS one · 2019Article
- Impact of a borderless sample transport network for scaling up viral load monitoring: results of a geospatial optimization model for Zambia.Journal of the International AIDS Society · 2018Article
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Authors and funding
11 authors.
Funding
Abstract
introductionThe World Health Organization recommends viral load (VL) monitoring at six and twelve months and then annually after initiating antiretroviral treatment for HIV. In many African countries, expansion of VL testing has been slow due to a lack of efficient blood sample transportation networks (STN). To assist Zambia in scaling up testing capacity, we modelled an optimal STN to minimize the cost of a national VL STN.
methodsThe model optimizes a STN in Zambia for the anticipated 1.5 million VL tests that will be needed in 2020, taking into account geography, district political boundaries, and road, laboratory and facility infrastructure. We evaluated all-inclusive STN costs of two alternative scenarios: (1) optimized status quo: each district provides its own weekly or daily sample transport; and (2) optimized borderless STN: ignores district boundaries, provides weekly or daily sample transport, and reaches all Scenario 1 facilities.
resultsUnder both scenarios, VL testing coverage would increase to from 10% in 2016 to 91% in 2020. The mean transport cost per VL in Scenario 2 was $2.11 per test (SD $0.28), 52% less than the mean cost/test in Scenario 1, $4.37 (SD $0.69), comprising 10% and 19% of the cost of a VL respectively.
conclusionsAn efficient STN that optimizes sample transport on the basis of geography and test volume, rather than political boundaries, can cut the cost of sample transport by more than half, providing a cost savings opportunity for countries that face significant resource constraints.
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