Efficacy and Acceptability of Rapid, Point-of-Care HIV Testing in Two Clinical Settings in Ghana

Abstract

This study assessed the efficacy and acceptability of two rapid point-of-care HIV assays used in a voluntary counseling and testing (VCT) and a tuberculosis (TB) clinic in Kumasi, Ghana. Over a 4-week period in 2007, 95 individuals attending the VCT clinic and 35 patients with newly diagnosed TB were offered a rapid HIV test. Rates of return for positive results and attendance at the HIV clinic were compared with 471 individuals (395 attending the VCT clinic and 76 patients with TB), tested during an 8-week period 6 months earlier using standard testing procedures. All patients offered a rapid test in each clinic underwent testing, compared to 93% of VCT clients and 40% of TB patients offered a test 6 months earlier. In the rapid testing period, 37%, 60%, and 3% of the VCT clients and 26%, 74% and 0% of the TB patients had positive, negative, or indeterminate serology, respectively. There were no discordant results following retesting of patients with a positive test. All patients attending either the VCT or TB clinics who tested positive for HIV with the point-of-care test returned to the HIV clinic for care, while only 64% and 95%, respectively, of the patients previously testing positive had returned for follow-up. Both clients and staff showed high levels of satisfaction with the rapid testing procedure. In conclusion, rapid point-of-care testing in both of these settings was successful in improving diagnosis of HIV infection and engaging those testing positive in a clinical care program.

Point-of-Care Testing

“…Tests must be simple to perform and to interpret, by personnel with no/minimal scientific training, with all components included in the individual test package or box of tests. This should preferably include quality control reagents and appropriate, single-use lancets for fingerprick blood collection where required [3]. Tests should be robust, with low rates of "invalid" results across a wide range of acceptable operating temperatures, to facilitate use outside temperature-controlled laboratories [4•].…”

“…This has been especially important in remote areas and resource-constrained countries (RCCs) that may lack the infrastructure for laboratory-based screening tests. POC tests for HIV diagnosis allow rapid diagnosis in the settings of antenatal clinics and labor wards, where timely provision of results can facilitate effective programs for prevention of mother-to-child transmission (PMTCT) [1,2], and in community-based clinics and voluntary counseling and testing services, where the availability of rapid test results contributes to better uptake of voluntary testing, reduced loss of patients to follow-up, and thus increased access to appropriate care [3]. However, there are no commercially available POC tests for the diagnosis of HIV infection in neonates, where the presence of maternal antibody precludes the use of antibody-based tests, or for viral load in the management of patients on antiretroviral therapy (ART).…”

Development of a Point-of-Care HIV/Aids Medication Dosing Support System Using the Android Mobile Platform

“…The Android platform is a software stack that includes a Linux-based operating system, middleware, and key applications empowering developers to build a wide range of sophisticated mobile applications [10]. Android is backed by both Google and the Open Handset Alliance and builds on open standards of development [17].…”

“…Provider-facing point-of-care (POC) applications that provide decision support at the point-of-need, show promise in improving the overall quality of care, especially for remote and underserved populations [8][9][10]. Improved access to medical decision support will likely lead to improvement in the quality of care provided, and ultimately improvements in treatment outcomes [11].…”

Adaptação e validação para português da HIV Antibody Testing Attitude Scale

“…(1) The group of activities involving rapid tests is commonly referred to as Voluntary Counselling and Testing (VCT). (1,2) The World Health Organization (WHO) recommends it to health centers, programs or campaigns. (3) In Portugal, rapid tests are conducted under the National Program of HIV/AIDS Infection Control and Prevention 2012-2016.…”