Digitising HIV Testing Registers to Support National Scale-Up of Three-Test HIV Diagnostic Algorithm: A Case Study of an AI-Powered Monitoring and Evaluation System in Malawi

作者：Tiwonge Chimpandule, Hannock Tweya, Stone Mbiriyawanda, Tobias Masina, Khumbo Namachapa, Martha Muyaso, Elsie Kasambwe, Chimwemwe Mkandawire, William Ka Kei Wu, J Chen, Michał Łazowik, Maciej Pomykała, Watipa Nyangulu, Chatonda Ngwira, Maria Sanena, Joyce Mtambo, Molly Ndisale, Dominik Bilicki, Leah Goeke, Confidence Banda, Jeffrey W. Eaton, Cheryl Case Johnson, Andreas Jahn · 发表于：medRxiv · 年份：2026 · DOI：10.64898/2026.01.08.26343708 · 被引用次数：1 · 研究领域：HIV/AIDS Research and Interventions、HIV Research and Treatment、Viral Infections and Outbreaks Research

Abstract Background By November 2022, Malawi became one of the first countries to implement the 2019 World Health Organization (WHO) recommended three-test HIV algorithm nationally. To support the scale-up, a new monitoring and evaluation (M&E) system, ScanForm, was introduced to digitise individual-level records from paper-based HIV testing registers using artificial intelligence (AI). We describe the national scale-up of the ScanForm M&E system alongside the three-test algorithm and assess the performance of the M&E system in monitoring quality assurance and generating routine program reporting. Methods We conducted a descriptive study using routinely collected HIV testing data captured through ScanForm between November 2022 and September 2025. HIV testing providers photographed completed handwritten register pages, which were automatically transcribed using AI, validated and summarised into reports. The system performance was assessed by evaluating changes over time in numbers of recording errors and HIV testing services (HTS) protocol deviations detected in the first image submitted per register page, data completeness, and reporting timeliness. Trends in recording errors and protocol deviations were analysed among facilities with at least 24 months of follow-up, using each facility’s activation date as the baseline. Results By January 2023, 260 (30%) of 867 HTS facilities had adopted the M&E system and the three-test algorithm. By September 2024, 98% cove...