Comprehensive & cost effective laboratory monitoring of HIV/AIDS: an African role model.
Identifieur interne : 001034 ( Ncbi/Merge ); précédent : 001033; suivant : 001035Comprehensive & cost effective laboratory monitoring of HIV/AIDS: an African role model.
Auteurs : Denise Lawrie ; George Janossy ; Maarten Roos ; Deborah K. GlencrossSource :
- Journal of visualized experiments : JoVE [ 1940-087X ] ; 2010.
Descripteurs français
- KwdFr :
- Analyse coût-bénéfice, Antirétroviraux (usage thérapeutique), Cytométrie en flux (), Cytométrie en flux (économie), Humains, Infections à VIH (immunologie), Infections à VIH (traitement médicamenteux), Infections à VIH (économie), Lymphocytes T CD8+ (immunologie), Lymphocytes T auxiliaires (immunologie), Numération des lymphocytes (), Numération des lymphocytes (économie), République d'Afrique du Sud, Syndrome d'immunodéficience acquise (immunologie), Syndrome d'immunodéficience acquise (traitement médicamenteux), Syndrome d'immunodéficience acquise (économie).
- MESH :
- immunologie : Infections à VIH, Lymphocytes T CD8+, Lymphocytes T auxiliaires, Syndrome d'immunodéficience acquise.
- traitement médicamenteux : Infections à VIH, Syndrome d'immunodéficience acquise.
- usage thérapeutique : Antirétroviraux.
- économie : Cytométrie en flux, Infections à VIH, Numération des lymphocytes, Syndrome d'immunodéficience acquise.
- Analyse coût-bénéfice, Cytométrie en flux, Humains, Numération des lymphocytes, République d'Afrique du Sud.
- Wicri :
- geographic : Afrique du Sud.
English descriptors
- KwdEn :
- Acquired Immunodeficiency Syndrome (drug therapy), Acquired Immunodeficiency Syndrome (economics), Acquired Immunodeficiency Syndrome (immunology), Anti-Retroviral Agents (therapeutic use), CD8-Positive T-Lymphocytes (immunology), Cost-Benefit Analysis, Flow Cytometry (economics), Flow Cytometry (methods), HIV Infections (drug therapy), HIV Infections (economics), HIV Infections (immunology), Humans, Lymphocyte Count (economics), Lymphocyte Count (methods), South Africa, T-Lymphocytes, Helper-Inducer (immunology).
- MESH :
- chemical , therapeutic use : Anti-Retroviral Agents.
- geographic : South Africa.
- drug therapy : Acquired Immunodeficiency Syndrome, HIV Infections.
- economics : Acquired Immunodeficiency Syndrome, Flow Cytometry, HIV Infections, Lymphocyte Count.
- immunology : Acquired Immunodeficiency Syndrome, CD8-Positive T-Lymphocytes, HIV Infections, T-Lymphocytes, Helper-Inducer.
- methods : Flow Cytometry, Lymphocyte Count.
- Cost-Benefit Analysis, Humans.
Abstract
We present the video about assisting anti-retroviral therapy (ART) by an apt laboratory service - representing a South-African role model for economical large scale diagnostic testing. In the low-income countries inexpensive ART has transformed the prospects for the survival of HIV seropositive patients but there are doubts whether there is a need for the laboratory monitoring of ART and at what costs - in situations when the overall quality of pathology services can still be very low. The appropriate answer is to establish economically sound services with better coordination and stricter internal quality assessment than seen in western countries. This video, photographed at location in the National Health Laboratory Services (NHLS-SA) at the Witwatersrand University, Johannesburg, South Africa, provides such a coordinated scheme expanding the original 2-color CD4-CD45 PanLeucoGating strategy (PLG). Thus the six modules of the video presentation reveal the simplicity of a 4-color flow cytometric assay to combine haematological, immunological and virology-related tests in a single tube. These video modules are: (i) the set-up of instruments; (ii) sample preparations; (iii) testing absolute counts and monitoring quality for each sample by bead-count-rate; (iv) the heamatological CD45 test for white cell counts and differentials; (v) the CD4 counts, and (vi) the activation of CD8+ T cells measured by CD38 display, a viral load related parameter. The potential cost-savings are remarkable. This arrangement is a prime example for the feasibility of performing > 800-1000 tests per day with a stricter quality control than that applied in western laboratories, and also with a transfer of technology to other laboratories within a NHLS-SA network. Expert advisors, laboratory managers and policy makers who carry the duty of making decisions about introducing modern medical technology are frequently not in a position to see the latest technical details as carried out in the large regional laboratories with huge burdens of workload. Hence this video shows details of these new developments.
DOI: 10.3791/2312
PubMed: 21085099
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pubmed:21085099Le document en format XML
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<front><div type="abstract" xml:lang="en">We present the video about assisting anti-retroviral therapy (ART) by an apt laboratory service - representing a South-African role model for economical large scale diagnostic testing. In the low-income countries inexpensive ART has transformed the prospects for the survival of HIV seropositive patients but there are doubts whether there is a need for the laboratory monitoring of ART and at what costs - in situations when the overall quality of pathology services can still be very low. The appropriate answer is to establish economically sound services with better coordination and stricter internal quality assessment than seen in western countries. This video, photographed at location in the National Health Laboratory Services (NHLS-SA) at the Witwatersrand University, Johannesburg, South Africa, provides such a coordinated scheme expanding the original 2-color CD4-CD45 PanLeucoGating strategy (PLG). Thus the six modules of the video presentation reveal the simplicity of a 4-color flow cytometric assay to combine haematological, immunological and virology-related tests in a single tube. These video modules are: (i) the set-up of instruments; (ii) sample preparations; (iii) testing absolute counts and monitoring quality for each sample by bead-count-rate; (iv) the heamatological CD45 test for white cell counts and differentials; (v) the CD4 counts, and (vi) the activation of CD8+ T cells measured by CD38 display, a viral load related parameter. The potential cost-savings are remarkable. This arrangement is a prime example for the feasibility of performing > 800-1000 tests per day with a stricter quality control than that applied in western laboratories, and also with a transfer of technology to other laboratories within a NHLS-SA network. Expert advisors, laboratory managers and policy makers who carry the duty of making decisions about introducing modern medical technology are frequently not in a position to see the latest technical details as carried out in the large regional laboratories with huge burdens of workload. Hence this video shows details of these new developments.</div>
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