{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,8]],"date-time":"2026-05-08T07:05:22Z","timestamp":1778223922221,"version":"3.51.4"},"reference-count":44,"publisher":"European Centre for Disease Control and Prevention (ECDC)","issue":"29","license":[{"start":{"date-parts":[[2022,7,21]],"date-time":"2022-07-21T00:00:00Z","timestamp":1658361600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,7,21]]},"abstract":"<jats:p>Technical advances in diagnostic techniques have permitted the possibility of multi-disease-based approaches for diagnosis and treatment monitoring of several infectious diseases, including tuberculosis (TB), human immunodeficiency virus (HIV), viral hepatitis and sexually transmitted infections (STI). However, in many countries, diagnosis and monitoring, as well as disease response programs, still operate as vertical systems, potentially causing delay in diagnosis and burden to patients and preventing the optimal use of available resources. With countries facing both human and financial resource constraints, during the COVID-19 pandemic even more than before, it is important that available resources are used as efficiently as possible, potential synergies are leveraged to maximise benefit for patients, continued provision of essential health services is ensured. For the infectious diseases, TB, HIV, hepatitis C (HCV) and STI, sharing devices and integrated services starting with rapid, quality-assured, and complete diagnostic services is beneficial for the continued development of adequate, efficient and effective treatment strategies. Here we explore the current and future potential (as well as some concerns), importance, implications and necessary implementation steps for the use of platforms for multi-disease testing for TB, HIV, HCV, STI and potentially other infectious diseases, including emerging pathogens, using the example of the COVID-19 pandemic.<\/jats:p>","DOI":"10.2807\/1560-7917.es.2022.27.29.2100930","type":"journal-article","created":{"date-parts":[[2022,7,22]],"date-time":"2022-07-22T10:15:25Z","timestamp":1658484925000},"update-policy":"https:\/\/doi.org\/10.2807\/1560-7917.es.crp2020","source":"Crossref","is-referenced-by-count":8,"title":["Integrated use of laboratory services for multiple infectious diseases in the WHO European Region during the COVID-19 pandemic and beyond"],"prefix":"10.2807","volume":"27","author":[{"given":"Daniel","family":"Sim\u00f5es","sequence":"first","affiliation":[{"name":"Member of the European Laboratory Initiative on TB, HIV and Viral Hepatitis (ELI) core group. The additional members of the ELI core group are listed under Acknowledgements"},{"name":"Instituto de Sa\u00fade P\u00fablica \u2013 Universidade do Porto, Porto, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7183-1464","authenticated-orcid":false,"given":"Soudeh","family":"Ehsani","sequence":"additional","affiliation":[{"name":"WHO Regional Office for Europe, Copenhagen, Denmark"}]},{"given":"Maja","family":"Stanojevic","sequence":"additional","affiliation":[{"name":"Institute of Microbiology and Immunology, Faculty of Medicine, University of Belgrade, Belgrade, Serbia"},{"name":"Member of the European Laboratory Initiative on TB, HIV and Viral Hepatitis (ELI) core group. The additional members of the ELI core group are listed under Acknowledgements"}]},{"given":"Natalia","family":"Shubladze","sequence":"additional","affiliation":[{"name":"National Reference Laboratory, National Center for Tuberculosis and Lung Diseases, Tbilisi, Georgia"},{"name":"Member of the European Laboratory Initiative on TB, HIV and Viral Hepatitis (ELI) core group. The additional members of the ELI core group are listed under Acknowledgements"}]},{"given":"Gulmira","family":"Kalmambetova","sequence":"additional","affiliation":[{"name":"National TB Reference Laboratory, Bishkek, Kyrgyzstan"},{"name":"Member of the European Laboratory Initiative on TB, HIV and Viral Hepatitis (ELI) core group. The additional members of the ELI core group are listed under Acknowledgements"}]},{"given":"Roger","family":"Paredes","sequence":"additional","affiliation":[{"name":"Infectious Diseases Department & irsiCaixa AIDS Research Institute, Badalona, Catalonia, Spain"},{"name":"Member of the European Laboratory Initiative on TB, HIV and Viral Hepatitis (ELI) core group. The additional members of the ELI core group are listed under Acknowledgements"}]},{"given":"Daniela Maria","family":"Cirillo","sequence":"additional","affiliation":[{"name":"IRCCS San Raffaele Scientific Institute, Milan Italy\u00a0"},{"name":"Member of the European Laboratory Initiative on TB, HIV and Viral Hepatitis (ELI) core group. The additional members of the ELI core group are listed under Acknowledgements"}]},{"given":"Ana","family":"Avellon","sequence":"additional","affiliation":[{"name":"Hepatitis Unit, National Center of Microbiology, Instituto de Salud Carlos III, CIBERESP, Madrid, Spain"},{"name":"Member of the European Laboratory Initiative on TB, HIV and Viral Hepatitis (ELI) core group. The additional members of the ELI core group are listed under Acknowledgements"}]},{"given":"Irina","family":"Felker","sequence":"additional","affiliation":[{"name":"Novosibirsk Tuberculosis Research Institute, Novosibirsk, Russia"},{"name":"Member of the European Laboratory Initiative on TB, HIV and Viral Hepatitis (ELI) core group. The additional members of the ELI core group are listed under Acknowledgements"}]},{"given":"Florian P","family":"Maurer","sequence":"additional","affiliation":[{"name":"University Medical Center Hamburg-Eppendorf, Hamburg, Germany"},{"name":"National and WHO Supranational Reference Laboratory for Mycobacteria, Research Center Borstel, Borstel, Germany"},{"name":"Member of the European Laboratory Initiative on TB, HIV and Viral Hepatitis (ELI) core group. The additional members of the ELI core group are listed under Acknowledgements"}]},{"given":"Askar","family":"Yedilbayev","sequence":"additional","affiliation":[{"name":"WHO Regional Office for Europe, Copenhagen, Denmark"}]},{"given":"Francis","family":"Drobniewski","sequence":"additional","affiliation":[{"name":"Infectious Diseases, Faculty of Medicine, Imperial College, London, United Kingdom"},{"name":"Member of the European Laboratory Initiative on TB, HIV and Viral Hepatitis (ELI) core group. The additional members of the ELI core group are listed under Acknowledgements"}]},{"given":"Lara","family":"Vojnov","sequence":"additional","affiliation":[{"name":"WHO Headquarters, Geneva, Switzerland"}]},{"given":"Anne S","family":"Johansen","sequence":"additional","affiliation":[{"name":"WHO Regional Office for Europe, Copenhagen, Denmark"}]},{"given":"Nicole","family":"Seguy","sequence":"additional","affiliation":[{"name":"WHO Regional Office for Europe, Copenhagen, Denmark"}]},{"given":"Masoud","family":"Dara","sequence":"additional","affiliation":[{"name":"WHO Regional Office for Europe, Copenhagen, Denmark"}]},{"name":"on behalf of the European Laboratory Initiative on TB, HIV and viral hepatitis core group members","sequence":"additional","affiliation":[]}],"member":"7995","reference":[{"key":"r1","unstructured":"World Health Organization (WHO). WHO Coronavirus Disease (COVID-19) Dashboard | WHO Coronavirus Disease (COVID-19) Dashboard. Geneva: WHO. [Accessed: 24 Jan 2021]. Available from: https:\/\/covid19.who.int\/"},{"key":"r2","unstructured":"MRC Centre for Global Infectious Disease Analysis, Imperial College London. Forecasting the healthcare burden of COVID-19 in LMICs. London: Imperial College London. [Accessed: 24 Jan 2021]. Available from: https:\/\/mrc-ide.github.io\/global-lmic-reports\/"},{"issue":"24","key":"r3","doi-asserted-by":"crossref","DOI":"10.2807\/1560-7917.ES.2021.26.24.2100426","article-title":"Impact of the COVID-19 pandemic on tuberculosis national reference laboratory services in the WHO European Region, March to November 2020.","volume":"26","author":"Maurer","year":"2021","journal-title":"Euro Surveill"},{"key":"r4","unstructured":"European Commission. COVID-19 Clearing House for medical equipment. Brussels: European Commission. [Accessed: 23 Jan 2021]. Available from: https:\/\/ec.europa.eu\/info\/live-work-travel-eu\/coronavirus-response\/emergency-support-instrument\/covid-19-clearing-house-medical-equipment_en."},{"key":"r5","unstructured":"European Centre for Disease Prevention and Control (ECDC). Laboratory support for COVID-19 in the EU\/EEA. Stockholm: ECDC. [Accessed: 24 Jan 2021]. Available from: https:\/\/www.ecdc.europa.eu\/en\/novel-coronavirus\/laboratory-support"},{"key":"r6","doi-asserted-by":"crossref","DOI":"10.1016\/j.eclinm.2020.100603","article-title":"The potential impact of the COVID-19 pandemic on the tuberculosis epidemic a modelling analysis.","volume":"28","author":"Cilloni","year":"2020","journal-title":"EClinicalMedicine"},{"key":"r7","unstructured":"World Health Organization (WHO). The end TB strategy and targets for tuberculosis prevention, care and control after. Geneva: WHO; 2015. Available from: https:\/\/www.who.int\/publications\/i\/item\/WHO-HTM-TB-2015.19"},{"key":"r8","unstructured":"World Health Organization (WHO) - Department of Reproductive Health and Research. Global Health Sector Strategy on Sexually Transmitted Infections 2016-2021 Towards Ending STIs. Geneva: WHO; 2016. Available from: https:\/\/apps.who.int\/iris\/bitstream\/handle\/10665\/246296\/WHO-RHR-16.09-eng.pdf"},{"key":"r9","unstructured":"World Health Organization (WHO). Global Health Sector Strategy on Viral Hepatitis 2016-2021. Geneva: WHO; 2016. [Accessed: 24 Jan 2021]. Available from: https:\/\/apps.who.int\/iris\/bitstream\/handle\/10665\/246177\/WHO-HIV-2016.06-eng.pdf?sequence=1"},{"key":"r10","unstructured":"World Health Organization (WHO). Global Health Sector Strategy on HIV 2016-2021. Geneva: WHO; 2016. [Accessed: 24 Jan 2021]. Available from: https:\/\/apps.who.int\/iris\/bitstream\/handle\/10665\/246178\/WHO-HIV-2016.05-eng.pdf?sequence=1"},{"key":"r11","unstructured":"World Health Organization (WHO) Regional Office for Europe. Tuberculosis action plan for the WHO European Region 2016-2020. Copenhagen: WHO Regional Office for Europe; 2015."},{"key":"r12","unstructured":"World Health Organization (WHO) Regional Office for Europe. Action plan for the health sector response to viral hepatitis in the WHO European Region. Copenhagen: WHO Regional Office for Europe; 2016."},{"key":"r13"},{"key":"r14","unstructured":"World Health Organization (WHO). Progress report on HIV, viral hepatitis and sexually transmitted infections, 2019. Geneva: WHO; 2019. [Accessed: 24 Jan 2021]. Available from: https:\/\/www.who.int\/hiv\/strategy2016-2021\/progress-report-2019\/en\/"},{"issue":"2","key":"r15","doi-asserted-by":"crossref","first-page":"e47","DOI":"10.1016\/S1473-3099(19)30524-9","article-title":"Tuberculosis, HIV, and viral hepatitis diagnostics in eastern Europe and central Asia: high time for integrated and people-centred services.","volume":"20","author":"Dara","year":"2020","journal-title":"Lancet Infect Dis"},{"issue":"3","key":"r16","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0193577","article-title":"Multidisease testing for HIV and TB using the GeneXpert platform: A feasibility study in rural Zimbabwe.","volume":"13","author":"Ndlovu","year":"2018","journal-title":"PLoS One"},{"key":"r17","unstructured":"World Health Organization (WHO). Molecular diagnostics Integration Global Meeting Report. Geneva: WHO; 2019. [Accessed: 24 Jan 2021]. Available from: https:\/\/www.who.int\/publications\/i\/item\/molecular-diagnostics-integration-global-meeting-report"},{"key":"r18","unstructured":"World Health Organization (WHO). Considerations for adoption and use of multidisease testing devices in integrated laboratory networks. Geneva: WHO; 2018. [Accessed: 24 Jan 2021]. Available from: http:\/\/www.who.int\/tb\/publications\/2017\/considerations_multidisease_testing_devices_2017\/en\/"},{"key":"r19","doi-asserted-by":"crossref","unstructured":"Drobnik A, Pinchoff J, Bushnell G, Terranova E, Fuld J. Matching New York City Viral Hepatitis, Tuberculosis, Sexually Transmitted Diseases and HIV Surveillance Data, 2000-2010. New York City Department of Health and Mental Hygiene: Epi Research Report, October 2013; 1-12.","DOI":"10.1097\/PHH.0b013e3182a95607"},{"key":"r20","unstructured":"World Health Organization (WHO). 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Available from: https:\/\/voxeu.org\/article\/economic-consequences-covid-19-multi-country-analysis"},{"key":"r33","doi-asserted-by":"crossref","first-page":"i4","DOI":"10.1093\/heapol\/czq060","article-title":"Health systems, communicable diseases and integration.","volume":"25","author":"Shigayeva","year":"2010","journal-title":"Health Policy Plan"},{"key":"r34","unstructured":"World Health Organization (WHO) Regional Office for Europe and Public Health Institutes of the World. (IANPHI). A guide to establishing national public health institutes through mergers. Geneva: WHO; 2020."},{"issue":"6","key":"r35","doi-asserted-by":"crossref","first-page":"796","DOI":"10.1093\/cid\/ciw817","article-title":"Combatting Global Infectious Diseases: A Network Effect of Specimen Referral Systems.","volume":"64","author":"Fonjungo","year":"2017","journal-title":"Clin Infect Dis"},{"key":"r36","unstructured":"World Health Organization (WHO). Roadmap to implement the Tuberculosis Action Plan for the WHO European Region 2016-2020. Geneva: WHO; 2016."},{"key":"r37","unstructured":"Unitaid. Multi-disease diagnostic landscape for integrated management of HIV, HCV, TB and other coinfections. Geneva: WHO; 2018. [Accessed: 24 Jan 2021]. Available at: https:\/\/unitaid.org\/assets\/multi-disease-diagnostics-landscape-for-integrated-management-of-HIV-HCV-TB-and-other-coinfections-january-2018.pdf"},{"issue":"13","key":"r38","doi-asserted-by":"crossref","first-page":"7595","DOI":"10.3390\/ijerph19137595","article-title":"The Management of HIV Care Services in Central and Eastern Europe: Data from the Euroguidelines in Central and Eastern Europe Network Group.","volume":"19","author":"Skrzat-Klapaczy\u0144ska","year":"2022","journal-title":"Int J Environ Res Public Health"},{"key":"r39","unstructured":"World Health Organization (WHO) Regional Office for Europe. 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