학술논문
Accuracy of point-of-care HIV and CD4 field testing by lay healthcare workers in the Botswana Combination Prevention Project.
Document Type
Academic Journal
Author
Bile EC; US Centers for Disease Control and Prevention Botswana (CDC Botswana), Gaborone, Botswana.; Bachanas PJ; US Centers for Disease Control and Prevention Atlanta, United States.; Jarvis JN; Botswana Harvard AIDS Institute Partnership, Gaborone, Botswana; Department of Clinical Research, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK.; Maurice F; US Centers for Disease Control and Prevention Botswana (CDC Botswana), Gaborone, Botswana.; Makovore V; US Centers for Disease Control and Prevention Botswana (CDC Botswana), Gaborone, Botswana.; Chebani L; US Centers for Disease Control and Prevention Botswana (CDC Botswana), Gaborone, Botswana.; Jackson KG; US Centers for Disease Control and Prevention Atlanta, United States.; Birhanu S; US Centers for Disease Control and Prevention Atlanta, United States.; Maphorisa C; Botswana Harvard AIDS Institute Partnership, Gaborone, Botswana.; Mbulawa MB; US Centers for Disease Control and Prevention Botswana (CDC Botswana), Gaborone, Botswana.; Alwano MG; US Centers for Disease Control and Prevention Botswana (CDC Botswana), Gaborone, Botswana.; Sexton C; US Centers for Disease Control and Prevention Atlanta, United States.; Modise SK; Ministry of Health Gaborone, Botswana.; Bapati W; Tebelopele Counseling and Testing Center, Gaborone, Botswana.; Segolodi T; US Centers for Disease Control and Prevention Botswana (CDC Botswana), Gaborone, Botswana.; Moore J; US Centers for Disease Control and Prevention Atlanta, United States.; Fonjungo PN; US Centers for Disease Control and Prevention Atlanta, United States. Electronic address: Pdf4@cdc.gov.
Source
Publisher: Elsevier/North-Holland Biomedical Press Country of Publication: Netherlands NLM ID: 8005839 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1879-0984 (Electronic) Linking ISSN: 01660934 NLM ISO Abbreviation: J Virol Methods Subsets: MEDLINE
Subject
Language
English
Abstract
Accurate HIV and CD4 testing are critical in program implementation, with HIV misdiagnosis having serious consequences at both the client and/or community level. We implemented a comprehensive training and Quality Assurance (QA) program to ensure accuracy of point-of-care HIV and CD4 count testing by lay counsellors during the Botswana Combination Prevention Project (BCPP). We compared the performance of field testing by lay counsellors to results from an accredited laboratory to ascertain accuracy of testing. All trained lay counsellors passed competency assessments and performed satisfactorily in proficiency testing panel evaluations in 2013, 2014, and 2015. There was excellent agreement (99.6 %) between field and laboratory-based HIV test results; of the 3002 samples tested, 960 and 2030 were concordantly positive and negative respectively, with 12 misclassifications (kappa score 0.99, p < 0.0001). Of the 149 HIV-positive samples enumerated for CD4 count in the field using PIMA at a threshold of ≤ 350 cells/µl; there was 86 % agreement with laboratory testing, with only 21 misclassified. The mean difference between field and lab CD4 testing was - 16.16 cells/µl (95 % CI -5.4 to 26.9). Overall, there was excellent agreement between field and laboratory results for both HIV rapid test and PIMA CD4 results. A standard training package to train lay counsellors to accurately perform HIV and CD4 point-of-care testing in field settings was feasible, with point-of-care results obtained by lay counsellors comparable to laboratory-based testing.
Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
(Copyright © 2022. Published by Elsevier B.V.)
Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
(Copyright © 2022. Published by Elsevier B.V.)