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ORIGINAL ARTICLE
Open Access

Progress in Harmonizing Tiered HIV Laboratory Systems: Challenges and Opportunities in 8 African Countries

Jason Williams, Farouk Umaru, Dianna Edgil and Joel Kuritsky
Global Health: Science and Practice September 2016, 4(3):467-480; https://doi.org/10.9745/GHSP-D-16-00004
Jason Williams
aPartnership for Supply Chain Management (PFSCM), Supply Chain Management System (SCMS), Arlington, VA, USA. Now with the U.S. Agency for International Development (USAID), Bureau for Global Health, Office of HIV/AIDS, Supply Chain for Health, Washington, DC, USA
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  • For correspondence: jwilliams@usaid.gov
Farouk Umaru
bPFSCM, SCMS, Arlington, VA, USA
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Dianna Edgil
cUSAID, Bureau for Global Health, Office of HIV/AIDS, Supply Chain for Health, Washington, DC, USA
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Joel Kuritsky
cUSAID, Bureau for Global Health, Office of HIV/AIDS, Supply Chain for Health, Washington, DC, USA
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Figures & Tables

Figures

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  • FIGURE 1.
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    FIGURE 1.

    Example of a Hierarchical Tiered Laboratory System

    Adapted from the 2008 Maputo Declaration.2

  • FIGURE 2.
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    FIGURE 2.

    An Evidence‐Based 2‐Phase Approach to Developing a Harmonization and Standardization Proposal

  • FIGURE 3.
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    FIGURE 3.

    Instrument Counts in 8 African Countries, by Diagnostic Area

  • FIGURE 4.
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    FIGURE 4.

    Growth in Instrument Counts in 3 African Countries, by Diagnostic Area, 2009–2015

    Abbreviations: EID, early infant diagnosis; PCR, polymerase chain reaction; VL, viral load.

  • FIGURE 5.
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    FIGURE 5.

    Diversity of Instrument Types in 8 African Countries, by Diagnostic Area

  • FIGURE 6.
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    FIGURE 6.

    Comparison of Current and Proposed Instrument Diversity in 6 African Countries With Harmonization Proposals

  • FIGURE 7.
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    FIGURE 7.

    Shifts in Instrument Diversity in 4 African Countries Following Their Harmonization Proposals

    Note: Country C has 75 additional instruments for chemistry and 55 additional instruments for hematology that are not included in the bar chart.

Tables

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    TABLE Proposed Instrument Reductions by Instrument Type
    CountryProposed Instrument Reduction
    CD4ChemistryHematologyMolecular
    Country A-50%-82%-56%-33%
    Country B0%-22%-33%0%
    Country CN/AN/AN/AN/A
    Country D-17%-55%-71%-50%
    Country E0%-76%-67%0%
    Country F0%-20%-75%0%
    Country GN/AN/AN/AN/A
    Country H0%-88%-80%0%
    • Note: Percentage reduction cannot be calculated for Country C and Country G due to lack of data on instrument diversity in these countries before harmonization efforts began.

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Global Health: Science and Practice: 4 (3)
Global Health: Science and Practice
Vol. 4, No. 3
September 28, 2016
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Progress in Harmonizing Tiered HIV Laboratory Systems: Challenges and Opportunities in 8 African Countries
Jason Williams, Farouk Umaru, Dianna Edgil, Joel Kuritsky
Global Health: Science and Practice Sep 2016, 4 (3) 467-480; DOI: 10.9745/GHSP-D-16-00004

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Progress in Harmonizing Tiered HIV Laboratory Systems: Challenges and Opportunities in 8 African Countries
Jason Williams, Farouk Umaru, Dianna Edgil, Joel Kuritsky
Global Health: Science and Practice Sep 2016, 4 (3) 467-480; DOI: 10.9745/GHSP-D-16-00004
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  • Article
    • ABSTRACT
    • INTRODUCTION
    • ESTABLISHING A STRATEGY FOR LABORATORY HARMONIZATION AND STANDARDIZATION
    • METHODOLOGY FOR REVIEWING PROGRESS IN HARMONIZATION AND STANDARDIZATION
    • FINDINGS
    • CONCLUSION
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