Evaluation of a rapid point-of-care HIV screening program in an emergency department setting in Detroit, Michigan

2018 ◽  
Vol 106 ◽  
pp. 11-12 ◽  
Author(s):  
Weiming Zhu ◽  
Kimberly Mumby ◽  
Doreen Dankerlui ◽  
Jake Manteuffel ◽  
Cal Ham ◽  
...  
Keyword(s):  
Emergency Department ◽  
Screening Program ◽  
Point Of Care ◽  
Hiv Screening ◽  
Emergency Department Setting

scholarly journals 845. Impact of the COVID-19 Pandemic on Routine HIV Screening in an Emergency Department

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S513-S513
Author(s):  
Elizabeth A Aguilera ◽  
Gilhen Rodriguez ◽  
Gabriela P Del Bianco ◽  
Gloria Heresi ◽  
James Murphy ◽  
...  
Keyword(s):  
Emergency Department ◽  
Screening Program ◽  
Medical Center ◽  
Hiv Infections ◽  
Hiv Screening ◽  
Opt Out ◽  
Number Of Patients ◽  
Confirmatory Tests ◽  
Routine Hiv Screening ◽  
The Impact

Abstract Background The Emergency Department (ED) at Memorial Hermann Hospital (MHH) - Texas Medical Center (TMC), Houston, Texas has a long established screening program targeted at detection of HIV infections. The impact of the COVID-19 pandemic on this screening program is unknown. Methods The Routine HIV screening program includes opt-out testing of all adults 18 years and older with Glasgow score > 9. HIV 4th generation Ag/Ab screening, with reflex to Gennius confirmatory tests are used. Pre-pandemic (March 2019 to February 2020) to Pandemic period (March 2020 to February 2021) intervals were compared. Results 72,929 patients visited MHH_ED during the pre-pandemic period and 57,128 in the pandemic period, a 22% decline. The number of patients tested for HIV pre-pandemic was 9433 and 6718 pandemic, a 29% decline. When the pandemic year was parsed into first and last 6 months interval and compared to similar intervals in the year pre pandemic, 39% followed by 16% declines in HIV testing were found. In total, 354 patients were HIV positives, 209, (59%) in the pre-pandemic and 145 (41%) in the pandemic period.The reduction in new HIV infections found was directly proportional to the decline in patients visiting the MHH-ED where the percent of patients HIV positive was constant across intervals (2.21% vs 2.26%). Demographic and outcome characteristics were constant across the compared intervals. Conclusion The COVID -19 pandemic reduced detection of new HIV infections by screening in direct proportion to the reduction in MHH-ED patient visits. The impact of COVID-19 pandemic decreased with duration of the pandemic. Disclosures All Authors: No reported disclosures

The Use of a Computer Reminder System in an Emergency Department Universal HIV Screening Program

2011 ◽  
Vol 58 (1) ◽  
pp. S71-S73.e1 ◽  
Author(s):  
Lee Wilbur ◽  
Gretchen Huffman ◽  
Stephanie Lofton ◽  
John T. Finnell
Keyword(s):  
Emergency Department ◽  
Screening Program ◽  
Hiv Screening ◽  
Reminder System ◽  
Computer Reminder

scholarly journals High burden of cryptococcal antigenemia and meningitis among patients presenting at an emergency department in Maputo, Mozambique

PLoS ONE ◽  
2021 ◽  
Vol 16 (4) ◽  
pp. e0250195
Author(s):  
Robert Deiss ◽  
Carolina V. Loreti ◽  
Ana G. Gutierrez ◽  
Eudoxia Filipe ◽  
Milton Tatia ◽  
...  
Keyword(s):  
Emergency Department ◽  
Cryptococcal Meningitis ◽  
Screening Program ◽  
Point Of Care ◽  
Rapid Assessment ◽  
Vital Signs ◽  
Cd4 Count ◽  
Sub Saharan Africa ◽  
Induction Treatment ◽  
Cryptococcal Antigen

Background Cryptococcal meningitis is a leading cause of HIV-related mortality in sub-Saharan Africa, however, screening for cryptococcal antigenemia has not been universally implemented. As a result, data concerning cryptococcal meningitis and antigenemia are sparse, and in Mozambique, the prevalence of both are unknown. Methods We performed a retrospective analysis of routinely collected data from a point-of-care cryptococcal antigen screening program at a public hospital in Maputo, Mozambique. HIV-positive patients admitted to the emergency department underwent CD4 count testing; those with pre-defined abnormal vital signs or CD4 count ≤ 200 cells/μL received cryptococcal antigen testing and lumbar punctures if indicated. Patients with CM were admitted to the hospital and treated with liposomal amphotericin B and flucytosine; their 12-week outcomes were ascertained through review of medical records or telephone contact by program staff made in the routine course of service delivery. Results Among 1,795 patients screened for cryptococcal antigenemia between March 2018—March 2019, 134 (7.5%) were positive. Of patients with cryptococcal antigenemia, 96 (71.6%) were diagnosed with CM, representing 5.4% of all screened patients. Treatment outcomes were available for 87 CM patients: 24 patients (27.6%) died during induction treatment and 63 (72.4%) survived until discharge; of these, 38 (60.3%) remained in care, 9 (14.3%) died, and 16 (25.3%) were lost-to follow-up at 12 weeks. Conclusions We found a high prevalence of cryptococcal antigenemia and meningitis among patients screened at an emergency department in Maputo, Mozambique. High mortality during and after induction therapy demonstrate missed opportunities for earlier detection of cryptococcal antigenemia, even as point-of-care screening and rapid assessment in an emergency room offer potential to improve outcomes.

Missed Opportunities for Earlier HIV Diagnosis in an Emergency Department Despite an HIV Screening Program

2009 ◽  
Vol 23 (4) ◽  
pp. 245-250 ◽  
Author(s):  
Douglas A.E. White ◽  
Otis U. Warren ◽  
Alicia N. Scribner ◽  
Bradley W. Frazee
Keyword(s):  
Emergency Department ◽  
Screening Program ◽  
Hiv Screening ◽  
Hiv Diagnosis ◽  
Missed Opportunities

scholarly journals Resource Utilization and Cost-Effectiveness of Counselor- vs. Provider-Based Rapid Point-of-Care HIV Screening in the Emergency Department

PLoS ONE ◽  
2011 ◽  
Vol 6 (10) ◽  
pp. e25575 ◽  
Author(s):  
Rochelle P. Walensky ◽  
Bethany L. Morris ◽  
William M. Reichmann ◽  
A. David Paltiel ◽  
Christian Arbelaez ◽  
...  
Keyword(s):  
Emergency Department ◽  
Cost Effectiveness ◽  
Resource Utilization ◽  
Point Of Care ◽  
Hiv Screening

scholarly journals Clinical value of drugs of abuse point of care testing in an emergency department setting

2018 ◽  
Vol 5 ◽  
pp. 12-17 ◽  
Author(s):  
P.S. Lager ◽  
M.E. Attema-de Jonge ◽  
M.P. Gorzeman ◽  
L.E. Kerkvliet ◽  
E.J.F. Franssen
Keyword(s):  
Emergency Department ◽  
Drugs Of Abuse ◽  
Point Of Care ◽  
Point Of Care Testing ◽  
Clinical Value ◽  
Emergency Department Setting

scholarly journals Costs and Consequences of Eliminating a Routine, Point-Of-Care HIV Screening Program in a High-Prevalence Jail

2021 ◽  
Vol 61 (5) ◽  
pp. S32-S38
Author(s):  
Angela B. Hutchinson ◽  
Robin J. MacGowan ◽  
Andrew D. Margolis ◽  
Madeline G. Adee ◽  
Wendy Wen ◽  
...  
Keyword(s):  
Screening Program ◽  
Point Of Care ◽  
Hiv Screening ◽  
High Prevalence

scholarly journals Factors associated with patients who prefer HIV self-testing over health professional testing in an emergency department-based rapid HIV screening program

2017 ◽  
Vol 28 (11) ◽  
pp. 1124-1129 ◽  
Author(s):  
Yu-Hsiang Hsieh ◽  
Kaylin J Beck ◽  
Richard E Rothman ◽  
Megan Gauvey-Kern ◽  
Alonzo Woodfield ◽  
...  
Keyword(s):  
Emergency Department ◽  
Screening Program ◽  
Standard Of Care ◽  
Hiv Screening ◽  
Factors Associated ◽  
Self Testing ◽  
Chi Squared ◽  
Conventional Modality ◽  
Stage System ◽  
English Speaking

Kiosk-facilitated HIV self-testing has been shown to be accurate and well accepted by emergency department (ED) patients. We investigated factors associated with patients who preferred self-testing over testing performed by health professionals in an ED-based HIV screening program. This opt-in program evaluation studied 332 patients in an inner-city academic ED from February 2012 to April 2012, when a kiosk-based HIV self-testing program was standard of care. The first kiosk in the 2-stage system registered patients and assessed their interest in screening, while the second kiosk gathered demographic and risk factor information and also provided self-testing instructions. Patients who declined to self-test were offered testing by staff. Broad eligibility included patients aged 18–64 years who were not critically ill, English-speaking, able to provide informed consent, and registered during HIV program operational hours. Data were analyzed using descriptive statistical analysis and Chi squared tests; 160 (48.2%) of 332 patients consenting to testing chose to use a kiosk to guide them performing self-testing. Patients aged 25–29 years and those whose primary ED diagnosis was not infectious disease-related were more likely to prefer HIV self-testing (OR = 2.19, 95% CI: 1.17–4.10; OR = 1.79, 95% CI: 1.03–3.12). HIV self-testing in the ED could serve as a complementary testing approach to the conventional modality.

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