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Open Access Uptake of the lateral flow urine LAM test in Europe and Central Asia

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INTRODUCTION: Since 2015 (updated in 2019), the WHO has recommended to include the commercial lateral flow urine lipoarabinomannan TB test (LF-LAM), AlereLAM, in the diagnostic toolkit for severely ill people living with HIV.

METHODS: To assess the current use and barriers to the implementation of the test, we conducted an electronic survey among national focal points and managers of TB and HIV programmes in the 53 Member States of the WHO European Region and a European network of clinicians working in TB and HIV medicine.

RESULTS: In all, 45 individual responses (37 countries) were received from programme managers and focal points and 17 responses (14 countries) from clinicians. Only eight countries reported adopting LF-LAM policies, with only four currently using the AlereLAM (Armenia, Belarus, Ukraine and Uzbekistan). The most commonly reported barriers to implementing the test were the small number of eligible patients (with HIV-TB co-infections), the test not being included in the TB or HIV programme´s mandate and lack of budget allocation.

CONCLUSION: Consistent with findings from high TB burden countries in Africa and Asia, the survey demonstrated that uptake of AlereLAM is almost non-existent. Addressing the identified barriers and the intrinsic limitations of the test could help to increase the use of the test.

Keywords: HIV; infection; lung disease; tuberculosis

Document Type: Research Article

Affiliations: 1: Centre of Excellence for Health, Immunity and Infections (CHIP), University of Copenhagen, Copenhagen, Denmark, Department of Infectious Disease, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark 2: WHO Regional Office for Europe, Copenhagen, Denmark 3: Centre of Excellence for Health, Immunity and Infections (CHIP), University of Copenhagen, Copenhagen, Denmark 4: Centre of Excellence for Health, Immunity and Infections (CHIP), University of Copenhagen, Copenhagen, Denmark, Department of Pulmonary Medicine, Bispebjerg Hospital, Copenhagen, Denmark 5: WHO Collaborating Centre in Tuberculosis Laboratory Strengthening and the TB Supranational Reference Laboratory, San Raffaele Scientific Institute, Milan, Italy 6: European Centre for Disease Prevention and Control, Stockholm, Sweden

Publication date: September 1, 2022

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