Point-of-Care Testing

Abstract

The availability of rapid, point-of-care (POC) tests has significantly expanded the capacity of both developed and resource-constrained countries (RCCs) to diagnose HIV, with immunochromatographic tests most commonly used in these settings. This has been especially important in programs for prevention of mother-to-child transmission, in both RCCs and the developed world. However, suitable POC tests are not yet commercially available for diagnosis of neonatal HIV, where persistence of maternal antibody in the infant precludes the use of current antibody tests during the first 12 to 18 months. In addition, measurement of CD4+ T cells, CD4%, and HIV viral load still relies on sophisticated laboratory infrastructure, constraining the delivery of appropriate care to many HIV-infected patients. Continued effort is required in the development and validation of additional POC tests to support HIV patient care, and in quality assurance in manufacturing and in test performance in the field to ensure appropriate use of existing and new POC tests.

What Should the Ideal HIV Self-Test Look Like? A Usability Study of Test Prototypes in Unsupervised HIV Self-Testing in Kenya, Malawi, and South Africa

“…As with other rapid testing [19], both rapid tests using oral and fingerstick methods require significant adaptation of test instructions as well as clear labeling and numbering of all components to correspond with test instructions; instructions that specify more clearly how to handle the sample collection device and properly collect a sample may be helpful. In particular, instructions need to be developed and tested for understanding, including populations with low literacy levels [20,21]. Use of pictures is essential and, in some settings, additional local languages may be optimal.…”

Barriers, facilitators and recommendations for the early infant diagnosis and treatment (EIDT) cascade: A qualitative study in Malawi

“…Another study encourages initiation with point-of-care testing as the best solution to avoid issues of sample transport and hence fast delivery of results. [14] Recommendations indicate that if an appointment is scheduled with a woman to receive test results (step 4), it either needs to be kept or the woman needs to be contacted to reschedule the appointment. One study found that HIV-infected mothers enrolled in HIV care were less likely to fail to return for their infant's HIV test result (aRR 0.51; 95% CI (0.3 -0.9), [5] therefore providing ART to all pregnant women may lead to a better return.…”

Implementing early infant diagnosis of HIV infection at the primary care level: experiences and challenges in Malawi

“…However, by eliminating the need to transport samples or to return to a clinic to retrieve the test results, a rapid point-of-care test for infant HIV diagnosis 14 could still greatly enhance the operational feasibility of early infant diagnosis programmes in resource-poor settings.…”