One of the key risk factors for cardiovascular disease is hypertension. Hypertension, which leads to heart attacks and strokes, already affects one billion people worldwide, making it a global public health issue. Incidence prevalence condition on rise in low- middle-income countries, with biggest increase sub-Saharan Africa South at forefront. We examined prevalence, incidence, predictors, treatment, control hypertension among HIV-positive patients ART large African observational cohort.We...

The South African National Health Laboratory Service (NHLS) responded to HIV treatment initiatives with two-tiered CD4 laboratory services in 2004. Increasing programmatic burden, as more patients access anti-retroviral therapy (ART), has demanded extending meet increasing clinical needs. aim of this study was review existing and develop a service-model that integrated laboratory-based point-of-care testing (POCT), extend national coverage, improve local turn-around/(TAT) contain costs.NHLS...

In 2015 South Africa established a national cryptococcal antigenemia (CrAg) screening policy targeted at HIV-infected patients with CD4+ T-lymphocyte (CD4) counts <100 cells/ μl who are not yet on antiretroviral treatment (ART). Two strategies included in guidelines: reflex screening, where CrAg test is performed remnant blood samples from CD4 testing; and provider-initiated providers order after patient returns for results. The objective of this study was to compare costs effectiveness...

Background: Reflexed cryptococcal antigenaemia (CrAg) testing has been offered on remnant CD4 specimens with a count 100 cells/µL from 2017 in South Africa. The Western Cape is the only province to introduce CrAg for counts of 200 cells/µL.Objectives: objective this study was assess reflexed detection rate Cape.Method: retrospective analysis laboratory data conducted between September 2022 and May 2024. reported following categories at provincial, district, sub-district levels: (1) cells/µL,...

An integrated tiered service delivery model (ITSDM) has been proposed to provide 'full-coverage' of CD4 services throughout South Africa. Five tiers are described, defined by testing volumes and number referring health-facilities. These include: (1) Tier-1/decentralized point-of-care (POC) in a single site; Tier-2/POC-hub servicing processing < 30-40 samples from 8-10 health-clinics; Tier-3/Community laboratories ∼ 50 health-clinics, 150 samples/day; high-volume centralized (Tier-4 Tier-5)...

Background. Prostate cancer ( PCa) is the leading male neoplasm in South Africa (SA) and second most frequently diagnosed among men globally. Age-specific incidence rates (ASIRs) vary by up to 189-fold globally, with an ASIR of 68.0 per 100 000 2018 SA. Objectives. To describe PCa undergoing prostate biopsy Gauteng Province, Methods. We undertook a retrospective descriptive study using data collected from National Health Laboratory Service (NHLS) database between 2006 2016. extracted...

This study seeks to describe the rollout and current state of South Africa’s GeneXpert molecular diagnostic program for tuberculosis (TB). Xpert MTB/RIF was introduced in 2011 with a subsequent expansion include extra-pulmonary paediatric testing, followed by Ultra 2017. Through centralised laboratory information system use standardised platform more than decade, over 23 million tests were analysed, describing numbers tested, Mycobacterium complex detection, rifampin resistance, unsuccessful...

South Africa (SA)'s Comprehensive HIV and AIDS Care, Management Treatment (CCMT) programme has reduced new infections HIV-related deaths. In spite of progress made, 11.2% Africans (4.02 million) were living with in 2015.The National Health Laboratory Service (NHLS) SA performs CD4 testing support the CCMT collates data through NHLS Corporate Data Warehouse. The objective this study was to assess distribution counts &lt;100 cells/µL (defining severely immunosuppressed HIV-positive patients)...

HIV viral load (VL) testing plays a key role in the clinical management of as marker adherence and antiretroviral efficacy. To date, national international treatment recommendations have evolved to endorse routine VL testing. South Africa (SA) has recommended since 2004. Progressively, centralised program managed by its National Health Laboratory Service (NHLS) undergone expansive growth. Retrospective de-identified data from 2013 2022 were evaluated review performance. Test volumes...

Introduction Cryptococcal meningitis (CM) is an opportunistic fungal disease with a high mortality among HIV-positive patients severe immunosuppression (CD4 count <100 cells/μl). Reflexed screening for cryptococcal antigen (CrAg) in remnant blood samples was initially piloted at selected CD4 testing laboratories of the National Health Laboratory Service (NHLS) prior to implementation national programme using lateral flow assay (LFA) (IMMY, Norman, OK, USA). The aim this study assess CrAg...

Obesity is a major long-term concern in HIV-positive patients due to the pathogenic link between obesity and noncommunicable chronic diseases (NCDs). We aim characterize changes BMI over time on antiretroviral therapy (ART) investigate association weight gain survival South Africa.A prospective cohort study among adults first-line ART April 2004 2015 Johannesburg, Africa. used latent-class growth modelling (adjusted for age, sex CD4 cell count) identify groups of individuals with similar...

This study aimed at evaluating diabetic control and compliance with testing guidelines, across healthcare facilities of Gauteng Province, South Africa, as well factors associated time to achieve control. Africa's estimated total unmet need for care patients type 2 diabetes mellitus is 80%.The data 511 781 were longitudinally evaluated. Results reported by year, age category, race, sex, facility test types. HbA1C ≤7% was normal, >7 - ≤9% poor >9% very The chi-squared used assess the...

Introduction Cryptococcal meningitis is a major cause of mortality and morbidity in countries with high HIV prevalence, primarily affecting patients whose CD4 are < = 100 cells/μl. Routine Antigen (CrAg) screening thus recommended the South African treatment guidelines for all counts cells/μl, followed by pre-emptive anti-fungal therapy where CrAg results positive. A laboratory-based reflexed approach, using Lateral Flow Assay (LFA) on remnant EDTA blood samples, was piloted at three...

In South Africa's National Health Laboratory Service, ad hoc mean turn-around time (TAT) reporting is an important indicator of performance. However, historic static TAT did not assess very long or short times. An interactive dashboard was developed using the following measures; (1) median, (2) 75th percentile and (3) percentage within cut-off to allow for improved differentiation performance.The objective our study demonstrate increased efficiency achieved by dashboard.A retrospective...

Background. Estimates of prevalence anti-SARS-CoV-2 antibody positivity (seroprevalence) for tracking the COVID-19 epidemic are lacking most African countries. Objectives. To determine antibodies against SARS-CoV-2 in a sentinel cohort patient samples received routine testing at tertiary laboratories Johannesburg, South Africa. Methods. This study was conducted using remnant serum three National Health Laboratory Service City Johannesburg (CoJ) district. Collection from 1 August to 31...

Background: Mean turn-around time (TAT) reporting for testing laboratories in a national network is typically static and not immediately available meaningful corrective action does allow test-by-test or site-by-site interrogation of individual laboratory performance. Objective: The aim this study was to develop an easy-to-use, visual dashboard report interactive graphical TAT data provide weekly snapshot efficiency. Methods: An developed by staff from the National Priority Programme Central...

The National Health Laboratory Service provides CD4 testing through an integrated tiered service delivery model with a target laboratory turn-around time (TAT) of 48 h. Mean TAT insight into national performance. However, it is not sensitive enough to identify inefficiencies outlying laboratories or predict the percentage samples meeting target. aim this study was describe use median, 75th percentile and within data categorise performance.Retrospective for 2015-2016 fiscal year were...

The CD4 integrated service delivery model (ITSDM) provides for reasonable access to pathology services across South Africa (SA) by offering three new tiers that extend into remote, under-serviced areas. ITSDM identified Pixley ka Seme as such an district.To address the poor in this area, a community (tier 3) laboratory was established De Aar, SA. Laboratory performance and turnaround time (TAT) were monitored post implementation assess impact on local delivery.Using National Health Service...

ABSTRACT To ensure there is adequate investment into diagnostics, an understanding of the magnitude impact and return on necessary. We therefore sought to understand health economic impacts molecular diagnostic programme in South Africa, deepen broad value diagnostics guide future healthcare investments. calculated 10-year (where data were available) total cost DALYs averted associated with diagnosis TB testing (2013-2022), HIV viral load monitoring early infant infection SARS-CoV-2...

&lt;sec&gt;&lt;title&gt;INTRODUCTION&lt;/title&gt;In South Africa, Xpert ® MTB/RIF Ultra (Ultra) is the recommended diagnostic assay for TB with line-probe assays first- (LPAfl) and second-line drugs (LPAsl) providing additional drug susceptibility testing (DST) samples that were rifampicin-resistant (RR-TB). To guide implementation of recently launched MTB/XDR (MTB/XDR) assay, a cost-outcomes analysis was conducted comparing total costs genotypic DST (gDST) persons diagnosed RR-TB...

Background: Reflexed cryptococcal antigenaemia (CrAg) testing has been offered since 2016 in South Africa, on remnant CD4 specimens, for people with a count 100 cells/μL. Local guidelines recommended extending to 200 cells/μL.Objectives: This study assessed the cost per result and annual equivalent costs (AEC) counts cells/μL cells/μL, as well determining find one CrAg-positive case.Method: An ingredients-based costing was used determine result. The CrAg detection rate obtained from...

During 2016, the National Health Laboratory Service (NHLS) introduced laboratory-based reflexed Cryptococcal antigen (CrAg) screening to detect early disease in immunosuppressed HIV+ patients with a confirmed CD4 count of 100 cells/μl or less.The aim this study was assess cost-per-result national program across different tiers laboratory service, variable daily CrAg test volumes. The impact potential ART treatment guideline and target changes on volumes, platform choice workflow are...

A major challenge facing South Africa is the concomitant HIV and tuberculosis epidemics. The National Health Laboratory Service provides testing for staging HIV-positive patients, monitoring patients on antiretroviral therapy (ART) diagnosing tuberculosis. Not all health districts have equivalent ART-related coverage in particular CD4 viral load testing.The Integrated Tiered Delivery Model precinct approach was used to address service gaps a manner that balances cost, quality equity.An...