title: Opportunities and challenges for cost-efficient implementation of new point-of-care diagnostics for HIV and tuberculosis.
abstract: Stakeholders agree that supporting high-quality diagnostics is essential if we are to continue to make strides in the fight against human immunodeficiency virus (HIV) and tuberculosis. Despite the need to strengthen existing laboratory infrastructure, which includes expanding and developing new laboratories, there are clear diagnostic needs where conventional laboratory support is insufficient. Regarding HIV, rapid point-of-care (POC) testing for initial HIV diagnosis has been successful, but several needs remain. For tuberculosis, several new diagnostic tests have recently been endorsed by the World Health Organization, but a POC test remains elusive. Human immunodeficiency virus and tuberculosis are coendemic in many high prevalence locations, making parallel diagnosis of these conditions an important consideration. Despite its clear advantages, POC testing has important limitations, and laboratory-based testing will continue to be an important component of future diagnostic networks. Ideally, a strategic deployment plan should be used to define where and how POC technologies can be most efficiently and cost effectively integrated into diagnostic algorithms and existing test networks prior to widespread scale-up. In this fashion, the global community can best harness the tremendous capacity of novel diagnostics in fighting these 2 scourges.
authors.affiliation: Division of AIDS, Henry M. Jackson Foundation for Advancement of Military Medicine, National Institutes of Health, Bethesda, Maryland 20892-7628, USA. schitom@niaid.nih.gov
authors.forename: Marco
authors.initials: M
authors.lastname: Schito
authors.forename: Trevor F
authors.initials: TF
authors.lastname: Peter
authors.forename: Sean
authors.initials: S
authors.lastname: Cavanaugh
authors.forename: Amy S
authors.initials: AS
authors.lastname: Piatek
authors.forename: Gloria J
authors.initials: GJ
authors.lastname: Young
authors.forename: Heather
authors.initials: H
authors.lastname: Alexander
authors.forename: William
authors.initials: W
authors.lastname: Coggin
authors.forename: Gonzalo J
authors.initials: GJ
authors.lastname: Domingo
authors.forename: Dennis
authors.initials: D
authors.lastname: Ellenberger
authors.forename: Eugen
authors.initials: E
authors.lastname: Ermantraut
authors.forename: Ilesh V
authors.initials: IV
authors.lastname: Jani
authors.forename: Achilles
authors.initials: A
authors.lastname: Katamba
authors.forename: Kara M
authors.initials: KM
authors.lastname: Palamountain
authors.forename: Shaffiq
authors.initials: S
authors.lastname: Essajee
authors.forename: David W
authors.initials: DW
authors.lastname: Dowdy
mesh_terms: D001431:Bacteriological Techniques / Q000191:economics / Q000379:methods*; D015658:HIV Infections / Q000175:diagnosis*; D006801:Humans; D007753:Laboratories; D019095:Point-of-Care Systems / Q000191:economics*; D011785:Quality Assurance, Health Care / Q000191:economics / Q000379:methods; D014376:Tuberculosis / Q000175:diagnosis*; D014773:Virology / Q000191:economics / Q000379:methods*