ArticlePloS one2019
Comparative cost analysis of point-of-care versus laboratory-based testing to initiate and monitor HIV treatment in South Africa.
Article in PloS one, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 31 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
31 citing papers in PubMed, 1 synthesis or guideline pooled it, 43 citations in OpenAlex.
- Pooled 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
- Early HIV viral suppression associated with subsequent 12-month treatment success among people living with HIV in South Africa.HIV medicine · 2024Trial
- Impact of Point-of-Care Testing on the Management of Sexually Transmitted Infections in South Africa: Evidence from the HVTN702 Human Immunodeficiency Virus Vaccine Trial.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2023Trial
- Point-of-care HIV viral load and targeted drug resistance mutation testing versus standard care for Kenyan children on antiretroviral therapy (Opt4Kids): an open-label, randomised controlled trial.The Lancet. Child & adolescent health · 2022Trial
- Point-of-care CD4 testing: Differentiated care for the most vulnerable.Journal of global health · 2022Trial
- Biophotonics point-of-care diagnostics in low-resource settings: a South African perspective.Journal of biomedical optics · 2026Review
- Review
- Engaging Mentor Mothers in Rapid Return of Viral Load Results to Pregnant and Postpartum Women Living with HIV: An Implementation Pilot Study.AIDS and behavior · 2026Article
- The Critical Importance of Clinical Use Case to Inform Point-of-Care Technology Development: A Case Study of HIV Nucleic Acid Assays in the United States.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2026Article
- Optimizing the location of point-of-care infant HIV testing devices in Zimbabwe to maximize impact and value: A modeling analysis.PloS one · 2026Article
- Community pharmacy-led point-of-care testing (POCT): expanding roles and strengthening health systems in low- and middle-income countries (LMICs).Journal of pharmaceutical policy and practice · 2025Article
- Cost-effectiveness of viral load testing for transitioning antiretroviral therapy-experienced children to dolutegravir in South Africa: a modelling analysis.The Lancet. Global health · 2024Article
- A Generalizable Decision-Making Framework for Selecting Onsite versus Send-out Clinical Laboratory Testing.Medical decision making : an international journal of the Society for Medical Decision Making · 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
- Impact of point-of-care HIV viral load and targeted drug resistance mutation testing on viral suppression among Kenyan pregnant and postpartum women: results from a prospective cohort study (Opt4Mamas).Journal of the International AIDS Society · 2023Article
- Field performance and cost-effectiveness of a point-of-care triage test for HIV virological failure in Southern Africa.Journal of the International AIDS Society · 2023Article
- Nucleic Acid Point-of-Care Testing to Improve Diagnostic Preparedness.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2022Article
- Pragmatic considerations and approaches for measuring staff time as an implementation cost in health systems and clinics: key issues and applied examples.Implementation science communications · 2022Article
- The Costs of Creatinine Testing in the Context of a HIV Pre-Exposure Prophylaxis Demonstration Project in Eswatini.AIDS and behavior · 2022Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
10 authors at 4 institutions in 2 countries.
Funding
Abstract
backgroundThe number of people living with HIV (PLHIV) in need of treatment monitoring in low-and-middle-income countries has been rapidly expanding, placing an increasing burden on laboratories. Promising new point-of-care (POC) test have the potential to reduce laboratory workloads, but the implementation cost is uncertain. We sought to estimate the costs of decentralized POC testing compared to centralized laboratory testing for PLHIV initiating treatment in South Africa.
methodsWe conducted a microcosting analyses comparing clinic-based POC testing to centralized laboratory testing for HIV viral load, creatinine, and CD4 count monitoring. We completed time-and-motion studies to assess staff time for sample collection and processing. Instrument costs were estimated assuming five-year lifespans and we applied a 3% annual discount rate. Total costs and cost per patient were estimated over a five-year period: the first year of ART initiation and four years of routine HIV monitoring, following World Health Organization ART monitoring guidelines.
resultsWe estimated that per-patient costs of POC HIV viral load, CD4, and creatinine tests were USD $25, $11, and $9, respectively, assuming a clinic volume of 50 patients initiated per month. At centralized laboratories, per-patient costs of POC HIV viral load, CD4, and creatinine tests were USD $26, $6, $3. Total monitoring costs of all testing over a 5-year period was $45 higher for POC testing compared to centralized laboratory testing ($210 vs $166).
conclusionsPOC testing for HIV care and treatment can be feasibly implemented within clinics in South Africa, particularly those with larger patient volumes. POC HIV viral load costs are similar to lab-based testing while CD4 count and creatinine testing are more costly as POC tests. Our cost estimates are useful to policymakers in planning resource allocation and can inform cost-effectiveness analyses of POC testing.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.