Impact of a multi-disease integrated screening and diagnostic model for Covid-19, TB, and HIV in Lesotho

Bibliographic Data

ID19592117
AuthorsBulemba Katende (0000-0002-4562-0612, corresponding author), Moniek Bresser (0000-0001-8410-7910, Swiss Tropical and Public Health Institute, corresponding author), Mashaete Kamele (corresponding author), Lebohang Chere (Ministry of Health, corresponding author), Mosa Tlahali (Ministry of Health, corresponding author), Rahel Milena Erhardt (Swiss Tropical and Public Health Institute, corresponding author), Josephine Muhairwe (0000-0002-1314-4543, corresponding author), Irene Ayakaka (0000-0003-1051-5684, corresponding author), Tracy R Glass (0000-0001-7075-9803, Swiss Tropical and Public Health Institute, corresponding author), Morten Ruhwald (0000-0002-1597-441X, FIND, corresponding author), Bram van Ginneken (0000-0003-2028-8972, Radboud University Nijmegen, corresponding author), Keelin Murphy (0000-0001-6831-4020, Radboud University Nijmegen, corresponding author), Margaretha De Vos (0000-0003-3059-2986, FIND, corresponding author), Alain Amstutz (0000-0003-1716-993X, University of Basel, corresponding author), Mathabo Mareka (Ministry of Health, corresponding author), Sekhele Matabo Mooko (Ministry of Health, corresponding author), Klaus Reither (0000-0001-6195-8237, Swiss Tropical and Public Health Institute, corresponding author), Lucía González Fernández (0000-0003-0531-2698, Swiss Tropical and Public Health Institute, corresponding author)
EditorsJulio Croda (0000-0002-6665-6825)
Year2023
Volume3
Issue8
Pagese0001488
Publication date2023-08-02
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenuePLOS Global Public Health (JOURNAL)
Journal identifiersISSN: 2767-3375 • E-ISSN: 2767-3375
PublisherPublic Library of Science (PLoS) (PUBLISHER)
DOI10.1371/journal.pgph.0001488
PMID37531333
OpenAlexW4385490010
LanguageEN
References cited23

The surge of the COVID-19 pandemic challenged health services globally, and in Lesotho, the HIV and tuberculosis (TB) services were similarly affected. Integrated, multi-disease diagnostic services were proposed solutions to mitigate these disruptions. We describe and evaluate the effect of an integrated, hospital-based COVID-19, TB and HIV screening and diagnostic model in two rural districts in Lesotho, during the period between December 2020 and August 2022. Adults, hospital staff, and children above 5 years attending two hospitals were pre-screened for COVID-19 and TB symptoms. After a positive pre-screening, participants were offered to enroll in a service model that included clinical evaluation, chest radiography, SARS-CoV-2, TB, and HIV testing. Participants diagnosed with COVID-19, TB, or HIV were contacted after 28 days to evaluate their health status and linkage to HIV and/or TB care services. Of the 179160 participants pre-screened, 6623(3.7%) pre-screened positive, and 4371(66%) were enrolled in this service model. Of the total 458 diagnoses, only 17 happened in children. One positive rapid antigen test for SARS-CoV-2 was found per 11 participants enrolled, one Xpert-positive TB case was diagnosed per 85 people enrolled, and 1 new HIV diagnosis was done per 182 people enrolled. Of the 321(82.9%) participants contacted after 28 days of diagnosis, 304(94.7%) reported to be healthy. Of the individuals that were newly diagnosed with HIV or TB, 18/24(75.0%) and 46/51(90.1%) started treatment within 28 days of the diagnosis. This screening and diagnostic model successfully maintained same-day, integrated COVID-19, TB, and HIV testing services, despite frequent disruptions caused by the surge of COVID-19 waves, healthcare seeking patterns, and the volatile context (social measures, travel restrictions, population lockdowns). There were positive effects in avoiding diagnostic delays and ensuring linkage to services, however, diagnostic yields for adults and children were low. To inform future preparedness plans, research will need to identify essential health interventions and how to optimize them along each phase of the emergency response

Disease · Family medicine · HIV screening · Medical diagnosis · Men who have sex with men · Pandemic · Pathology · Tuberculosis · COVID-19 Clinical Research Studies · Medicine · Pneumocystis jirovecii pneumonia detection and treatment · Tuberculosis Research and Epidemiology · Internal Medicine · Pediatrics