{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T21:40:52Z","timestamp":1793396452446,"version":"4.5.0"},"reference-count":86,"publisher":"Oxford University Press (OUP)","issue":"10","license":[{"start":{"date-parts":[[2020,8,19]],"date-time":"2020-08-19T00:00:00Z","timestamp":1597795200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"name":"Foundation for Innovative New Diagnostics"},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["NIAID K24AI143471"],"award-info":[{"award-number":["NIAID K24AI143471"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["NICHD UG3HD096929"],"award-info":[{"award-number":["NICHD UG3HD096929"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,10,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Most people around the world do not have access to facility-based diagnostic testing, and the gap in availability of diagnostic tests is a major public health challenge. Self-testing, self-sampling, and institutional testing outside conventional clinical settings are transforming infectious disease diagnostic testing in a wide range of low- and middle-income countries (LMICs). We examined the delivery models of infectious disease diagnostic testing outside clinics to assess the impact on test uptake and linkage to care.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We conducted a systematic review and meta-analysis, searching 6 databases and including original research manuscripts comparing testing outside clinics with conventional testing. The main outcomes were test uptake and linkage to care, delivery models, and adverse outcomes. Data from studies with similar interventions and outcomes within thematic areas of interest were pooled, and the quality of evidence was assessed using GRADE. This study was registered in PROSPERO (CRD42019140828).<\/jats:p>\n                  <jats:p>We identified 10 386 de-duplicated citations, and 76 studies were included. Data from 18 studies were pooled in meta-analyses. Studies focused on HIV (48 studies), chlamydia (8 studies), and multiple diseases (20 studies). HIV self-testing increased test uptake compared with facility-based testing (9 studies: pooled odds ratio [OR], 2.59; 95% CI, 1.06\u20136.29; moderate quality). Self-sampling for sexually transmitted infections increased test uptake compared with facility-based testing (7 studies: pooled OR, 1.74; 95% CI, 0.97\u20133.12; moderate quality).<\/jats:p>\n                  <jats:p>Conclusions. \u2003Testing outside of clinics increased test uptake without significant adverse outcomes. These testing approaches provide an opportunity to expand access and empower patients. Further implementation research, scale-up of effective service delivery models, and policies in LMIC settings are needed.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ofid\/ofaa360","type":"journal-article","created":{"date-parts":[[2020,8,19]],"date-time":"2020-08-19T04:26:49Z","timestamp":1597811209000},"source":"Crossref","is-referenced-by-count":35,"title":["Diagnostic Infectious Diseases Testing Outside Clinics: A Global Systematic Review and Meta-analysis"],"prefix":"10.1093","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1180-1439","authenticated-orcid":false,"given":"Eneyi E","family":"Kpokiri","sequence":"first","affiliation":[{"name":"Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gifty","family":"Marley","sequence":"additional","affiliation":[{"name":"School of Public Health, Nanjing Medical University, Jiangsu, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Weiming","family":"Tang","sequence":"additional","affiliation":[{"name":"Dermatology Hospital, Southern Medical University, Guangzhou, China"},{"name":"University of North Carolina at Chapel Hill, Project-China, Chapel Hill, North Carolina, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noah","family":"Fongwen","sequence":"additional","affiliation":[{"name":"Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0415-5467","authenticated-orcid":false,"given":"Dan","family":"Wu","sequence":"additional","affiliation":[{"name":"Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sima","family":"Berendes","sequence":"additional","affiliation":[{"name":"Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bhavana","family":"Ambil","sequence":"additional","affiliation":[{"name":"Department of Global Health, North Carolina State University, Raleigh, North Carolina, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah-Jane","family":"Loveday","sequence":"additional","affiliation":[{"name":"Foundation for Innovative New Diagnostics, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ranga","family":"Sampath","sequence":"additional","affiliation":[{"name":"Foundation for Innovative New Diagnostics, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer S","family":"Walker","sequence":"additional","affiliation":[{"name":"Health Sciences Library, University of North Carolina, Chapel Hill, North Carolina, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph K B","family":"Matovu","sequence":"additional","affiliation":[{"name":"Makerere University School of Public Health, Kampala, Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catharina","family":"Boehme","sequence":"additional","affiliation":[{"name":"Foundation for Innovative New Diagnostics, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nitika Pant","family":"Pai","sequence":"additional","affiliation":[{"name":"CORE, Research Institute of McGill University Health Centre, Montreal, Quebec, Canada"},{"name":"Division of Clinical Epidemiology & Infectious Diseases, Department of Medicine, McGill University, Montreal, Quebec, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph 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