ArticleBMC health services research2025
Access to diagnostic testing for invasive fungal diseases and other opportunistic infections in Mexican health care centers caring for patients living with HIV.
Article in BMC health services research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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Who cites it
1 citing paper in PubMed.
- Trends in Incidence and Risk Factors of HIV-Associated Disseminated Histoplasmosis in the Americas: An Observational Cohort Study.Journal of the International AIDS Society · 2026Observational
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Authors and funding
4 authors.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundThe burden of opportunistic infections (OIs) remains high among people living with HIV (PLWH) in Mexico, despite improvements in mortality worldwide.
objectiveReporting the current access to diagnostics of OIs in Mexican Health Care Centers offering health-care services to PLWH.
methodsAn online questionnaire was sent to public health care facilities providing HIV care in Mexico. We evaluated capacities to 1) identify individuals with advanced-HIV, and 2) local and/or on-site access to: point-of-care assays, imaging studies, histological analysis, and microbiology tests useful to diagnose a wide variety of OIs.
resultsIn 2022, 46 centers answered the questionnaire, from 23/32 (71.8%) states of the country; 29 (63%) were primary care facilities, 5 (11%) general hospitals and 12 (26%) tertiary care hospitals, providing health services to 67,000 PLWH. These centers received 1,135 new patients/month, 48% with advance disease. Less than 50% could determine CD4 + T cell count (39%, N = 18), toxoplasma serology (41%, N = 19) and HIV viral load (41%, N = 19). Twenty-five centers could diagnose cryptococcosis and tuberculosis (54%). Meanwhile, 11 centers (24%) had access to aspergillosis or Histoplasma tests. Seven centers (11%) had access to coccidioidomycosis tests, five centers to any Pneumocystis diagnosis. In primary care centers, Mycobacterium tuberculosis complex GeneXPert was accessible in 41%, cryptococcal antigen by latex agglutination was available in one facility (3%), Indian ink in 9 centers (31%). No primary health center had access to lateral flow test for Cryptococcus or Histoplasma antigens.
conclusionsIn Mexico, most public HIV-dedicated health care centers lack on-site capacity to diagnose opportunistic infections, specifically fungal infections. Rapid tests and point-of-care tests are frequently unavailable, which is more pronounced in primary care centres. Considering that IFDs still contribute significantly to mortality among PLWH, better access to diagnostic tools in all levels of HIV-care is urgent.
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