Point-of-care HIV testing at antenatal care and maternity sites: experience in Battambang Province, Cambodia

Heller, Thomas; Kunthea, Soch; Bunthoeun, E; Sok, K; Seuth, C; Killam, W P; Tuon, Sovanna; Sathiarany, V; Kanal, Koum

doi:10.1258/ijsa.2011.011262

Cited by 12 publications

(23 citation statements)

References 10 publications

(6 reference statements)

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“…Human immunodeficiency virus (HIV) rapid tests have been a successful intervention to improve healthcare access and outcomes of pregnant women. 3,4,5,6,7,8 HIV rapid testing can allow timely initiation of antiretroviral therapy (ART) and facilitate linkages to care for HIV-infected women. 3,4,5,6,7,8 However, to ensure sustainability and accuracy of HIV testing services, HIV rapid tests must meet certain standards.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of antenatal rapid human immunodeficiency virus testing in rural South Africa

Mashamba-Thompson

Moodley

Sartorius

et al. 2018

South. Afr. j. HIV med.

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Introduction: South African guidelines recommend two rapid tests for diagnosing human immunodeficiency virus (HIV) using the serial HIV testing algorithm, but the accuracy and compliance to this algorithm is unknown in rural clinics. We evaluated the accuracy of HIV rapid testing and the time to receiving test results among pregnant women in rural KwaZulu-Natal (KZN).Method: We observed the accuracy of rapid HIV testing algorithms for 208 consenting antenatal patients accessing voluntary HIV testing services in nine rural primary healthcare (PHC) clinics in KZN. A PHC-based HIV counsellor obtained finger-prick whole blood from each participant to perform rapid testing using the Advanced Quality™ One Step anti-HIV (1&2) and/or ABON™ HIV 1/2/O Tri-Line HIV test. A research nurse obtained venous blood for an enzyme-linked immunosorbent assay (ELISA) HIV test, which is the gold standard diagnostic test. We recorded the time of receipt of HIV test results for each test.Results: Among 208 pregnant women with a mean age of 26 years, 72 women from nine rural PHC clinics were identified as HIV-positive by two rapid tests with an HIV-prevalence of 35% (95% Bayesian credibility intervals [BCI]: 28% – 41%). Of the 208 patients, 135 patients from six clinics were tested with the serial HIV testing algorithm. The estimated sensitivity and specificity for the 135 participants were 100% (95% confidence interval [CI]: 93% – 100%) and 99% (CI: 95% – 100%), respectively. The positive predictive value and negative predictive value were estimated at 98% (CI: 94% – 100%) and 95% (CI: 88% – 99%), respectively. All women received their HIV rapid test results within 20 min of testing. Test stock-out resulted in poor test availability at point-of-care, preventing performance of a second HIV test in three out of nine PHC clinics in rural KZN.Conclusion: Despite the poor compliance with national guidelines for HIV rapid testing services, HIV rapid test results provided to pregnant women in rural PHC clinics in KZN were generally accurate and timely. Test stock-out was shown to be one of the barriers to test availability in rural PHC clinics, resulting in poor compliance with guidelines. We recommend a compulsory confirmation HIV rapid test for all HIV-negative test results obtained from pregnant patients in rural and resource-limited settings.

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Section: Introductionmentioning

confidence: 99%

Evaluation of antenatal rapid human immunodeficiency virus testing in rural South Africa

Mashamba-Thompson

Moodley

Sartorius

et al. 2018

South. Afr. j. HIV med.

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“…Of the six studies eligible for data extraction, four were cross-sectional studies (41–44) and two were case-control studies (45, 46). All included studies were published between and 2001 and 2015 and included HIV-infected women with the objective of assessing the impact of HIV-related POC diagnostics on maternal outcomes.…”

Section: Resultsmentioning

confidence: 99%

“…Of those, 167 were HIV-infected women. Four out of the six of the included studies were carried out in urban areas (41, 42, 44, 46). Of the remaining two studies, one was carried out in a rural area (45) and the other in a semi-urban area (43).…”

Section: Resultsmentioning

confidence: 99%

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Effect of Point-of-Care Diagnostics on Maternal Outcomes in Human Immunodeficiency Virus–Infected Women

et al. 2017

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Introduction The World Health Organization advocates for increased accessibility of HIV-related point-of-care (POC) diagnostics in settings that lack laboratory infrastructure. The aim of this study is to assess the impact of POC diagnostics on maternal health outcomes in HIV-infected women. Methods A systematic literature review used multiple data sources as follows: Cochrane Infectious Disease Group Specialized Register; Cochrane Central Register of Control Trials, published in The Cochrane Library; PubMed; EBSCOhost and LILACS from January 2000 to October 2015. References of included studies were hand searched. Randomized controlled trials (RCTs) and observational studies examining health outcomes of HIV-infected women were eligible for inclusion in this review. The Cochrane Risk of Bias tool was used for bias assessment of the included studies. PRISMA guidelines were used for reporting. Results Of the 695 studies identified, six retrievable studies (five cross-sectional studies and one case control study) met the inclusion criteria and were included in this study. These studies examined a total of 167 HIV-infected women in different study settings. No studies reported evidence of CD4 count, viral load and TB, and the syphilis POC test impact on HIV-infected women was not found by this study. Included studies reported the impact of various HIV rapid tests across the following five maternal outcomes: timely receipt of results with pooled effect size (ES) = 1.00 (95% confidence interval [CI]: (0.98; 1.02); enabling partner testing, ES = 0.95 (0.85; 1.04); prevention of mother-to-child transmission of HIV, ES = 0.86 (0.79; 0.93); linkage to antiretroviral treatment (ART), ES = 0.76 (0.69; 0.84); and linkage to HIV care, ES = 0.50 (0.18; 0.82). No studies reported evidence of the impact of POC testing on maternal mortality or maternal and child morbidity of HIV-infected women. Conclusions The review provides an international overview of the impact of HIV POC diagnostics on maternal outcomes in HIV-infected women, showing the evidence that the HIV POC test is significantly associated with decreased mother-to-child transmission of HIV and increased linkage to ART and HIV care for HIV-infected women. It also revealed a gap in the literature aimed at assessing the impact of POC diagnostics on maternal morbidity and mortality in HIV-infected women.

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“…A study from Cambodia demonstrated that 95.4% and 99.4% of women in antenatal clinics and labour, respectively, accepted rapid HIV testing 30. In a study from Chiang Rai Province, Thailand, 96.8% of women in antenatal and postnatal settings were satisfied with the rapid testing process and 78.7% of women said they preferred this process to conventional HIV testing 36.…”

Section: Commentarymentioning

confidence: 99%

Should pregnant women with unknown HIV status be offered rapid HIV testing in labour?: Table 1

Downie

Mactier

Bland

2015

Arch Dis Child Fetal Neonatal Ed

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Point-of-care HIV testing at antenatal care and maternity sites: experience in Battambang Province, Cambodia

Cited by 12 publications

References 10 publications

Evaluation of antenatal rapid human immunodeficiency virus testing in rural South Africa

Evaluation of antenatal rapid human immunodeficiency virus testing in rural South Africa

Effect of Point-of-Care Diagnostics on Maternal Outcomes in Human Immunodeficiency Virus–Infected Women

Should pregnant women with unknown HIV status be offered rapid HIV testing in labour?: Table 1

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