title: Increased utilisation of PEPFAR-supported laboratory services by non-HIV patents in Tanzania.
abstract: BACKGROUND
  It is unknown to what extent the non-HIV population utilises laboratories supported by the President's Emergency Plan for AIDS Relief (PEPFAR).
  
  
  OBJECTIVE
  We aimed to describe the number and proportion of laboratory tests performed in 2009 and 2011 for patients referred from HIV and non-HIV services (NHSs) in a convenience sample collected from 127 laboratories supported by PEPFAR in Tanzania. We then compared changes in the proportions of tests performed for patients referred from NHSs in 2009 vs 2011.
  
  
  METHODS
  Haematology, chemistry, tuberculosis and syphilis test data were collected from available laboratory registers. Referral sources, including HIV services, NHSs, or lack of a documented referral source, were recorded. A generalised linear mixed model reported the odds that a test was from a NHS.
  
  
  RESULTS
  A total of 94 132 tests from 94 laboratories in 2009 and 157 343 tests from 101 laboratories in 2011 were recorded. Half of all tests lacked a documented referral source. Tests from NHSs constituted 42% (66 084) of all tests in 2011, compared with 31% (29 181) in 2009. A test in 2011 was twice as likely to have been referred from a NHS as in 2009 (adjusted odds ratio: 2.0 [95% confidence interval: 2.0-2.1]).
  
  
  CONCLUSIONS
  Between 2009 and 2011, the number and proportion of tests from NHSs increased across all types of test. This finding may reflect increased documentation of NHS referrals or that the laboratory scale-up originally intended to service the HIV-positive population in Tanzania may be associated with a 'spillover effect' amongst the general population.
authors.affiliation: ICAP, Columbia University, New York, New York, United States; Weill Cornell Medical College, New York, New York, United States.
authors.forename: Margaret L
authors.initials: ML
authors.lastname: McNairy
authors.affiliation: ICAP, Columbia University, New York, New York, United States.
authors.forename: Charon
authors.initials: C
authors.lastname: Gwynn
authors.affiliation: ICAP, Columbia University, New York, New York, United States.
authors.forename: Miriam
authors.initials: M
authors.lastname: Rabkin
authors.affiliation: ICAP, Columbia University, New York, New York, United States.
authors.forename: Gretchen
authors.initials: G
authors.lastname: Antelman
authors.affiliation: ICAP, Columbia University, New York, New York, United States.
authors.forename: Yingfeng
authors.initials: Y
authors.lastname: Wu
authors.affiliation: ICAP, Columbia University, New York, New York, United States.
authors.forename: Bereket
authors.initials: B
authors.lastname: Alemayehu
authors.affiliation: Centers for Disease Control and Prevention, Atlanta, Georgia, United States.
authors.forename: Travis
authors.initials: T
authors.lastname: Lim
authors.affiliation: Centers for Disease Control and Prevention, Atlanta, Georgia, United States.
authors.forename: Rubina
authors.initials: R
authors.lastname: Imtiaz
authors.affiliation: Ministry of Health and Social Welfare, Dar es Salaam, Republic of Tanzania.
authors.forename: Fausta
authors.initials: F
authors.lastname: Mosha
authors.affiliation: Centers for Disease Control and Prevention, Dar es Salaam, Republic of Tanzania.
authors.forename: Michael
authors.initials: M
authors.lastname: Mwasekaga
authors.affiliation: Ministry of Health, Zanzibar, Republic of Tanzania.
authors.forename: Asha A
authors.initials: AA
authors.lastname: Othman
authors.affiliation: ICAP, Columbia University, New York, New York, United States.
authors.forename: Jessica
authors.initials: J
authors.lastname: Justman