Implementation science: point-of-care diagnostics in HIV and tuberculosis.

Implementation science uses methods to promote the scaling up and use of evidence-based practices by health systems to improve quality and outcomes. Its use is vital to maximise the efficiency of limited resources for health care in tropical settings. HIV and tuberculosis (TB) are two of the major causes of morbidity and mortality in sub-Saharan Africa, and globally. Although effective treatments are widely available, lack of diagnosis remains a large barrier to accessing treatment, particularly in resource-limited settings. We explore HIV and TB diagnostics that can be used at point-of-care in any settings, and outline some important principles and applications of implementation science to aid their application and use. Despite robust evidence of diagnostic accuracy and efficacy in improving patient-centred outcomes, such interventions cannot be fully utilised without addressing operational barriers and knowledge gaps. © Royal College of Physicians 2019. All rights reserved.