scholarly journals Feasibility and Success of Hiv Point-of-Care Testing in an Emergency Department in an Urban Canadian Setting

2013 ◽  
Vol 24 (1) ◽  
pp. 27-31 ◽  
Author(s):  
Marissa L Becker ◽  
Laura H Thompson ◽  
Carla Pindera ◽  
Natalie Bridger ◽  
Carmen Lopez ◽  
...  

BACKGROUND: Approximately 26% of Canadians living with HIV are unaware of their status. Point-of-care (POC) HIV tests have been introduced to simplify and expand HIV testing.OBJECTIVE: To evaluate the feasibility and acceptability of POC testing in an emergency department (ED) setting in Winnipeg, Manitoba.METHODS: A cross-sectional study of unselected adults presenting to the ED at the Health Sciences Centre Hospital (Winnipeg, Manitoba) was performed. Study procedures included pre- and post-test counselling, administration of the INSTI HIV-1/HIV-2 Antibody Test (bioLytical Laboratories, Canada) and a brief questionnaire. Venous blood samples were collected from participants for confirmatory testing on all reactive and indeterminate specimens.RESULTS: In total, 501 adults participated in the study. The majority of participants were younger than 40 years of age, approximately one-half (48.5%) were women and 53% self-identified as Aboriginal. Nearly one-half (49.1%) of the participants had undergone previous HIV testing, although 63% of these tests were performed more than a year earlier. A total of seven individuals tested reactive with the POC test, all of whom were confirmed positive using serological testing (1.4%) and were linked to an HIV specialist within 24 h. Nearly all of the participants (96%) reported satisfaction with the test and believed it belonged in the ED (93%).CONCLUSIONS: Of the participants tested, 1.4% tested reactive for HIV, which is significantly higher than the reported prevalence in Manitoba and in other similar studies conducted in North America. Furthermore, all individuals were linked to timely care. The present study demonstrated that this particular busy tertiary care ED is an important and feasible location for HIV POC testing.

2019 ◽  
Author(s):  
Ucheoma Nwaozuru ◽  
iwelunmor juliet ◽  
Jason J. Ong ◽  
Sawsan Salah ◽  
Chisom Obiezu-Umeh ◽  
...  

Abstract Background Despite high HIV incidence rates among young people in Nigeria, less than 24% of this population have ever tested for HIV. These low HIV testing rates suggest that current testing services may not align with their testing preferences. To address this gap, the objective of this study was to assess preferences for HIV testing options among young people in Nigeria.Methods We conducted a cross-sectional study using survey to assess preferences for HIV testing options among 113 youth aged 14-24 years residing in Nigeria. The survey included a series of hypothetical HIV testing options, comprised of six characteristics centered around HIV testing service (i.e. location of testing, test administrator, mode of pre-test, mode of post-test counseling, type of HIV test, and cost of HIV test). For each characteristic, participants were asked to select one of the options that they prefer or indicate none of the above. A descriptive analysis of the preferences made by participants was conducted, summarizing proportions of participants who selected different options for HIV testing.Results The mean age of study participants was 19.5 years old (SD=2.7). Most youth (73, 64.6%) had at least a secondary school degree. There was pronounced heterogeneity in HIV testing preferences among young people. Although most youth preferred free HIV testing, 14 (16.7%) reported preferring paying a small amount compared to free testing. More youth preferred blood-based HIV self-testing 39(48.8%) compared to facility-based HIV testing and oral HIV self-testing.Conclusions Our finding suggest that young people have a range of HIV testing preferences in Nigeria. This suggests that a “one-size-fits-all” approach to delivering services to youth may be challenging in this context. HIV testing services can be optimized to reach young people if a variety options are provided to meet their unique preferences.


2019 ◽  
Author(s):  
Ucheoma Nwaozuru ◽  
iwelunmor juliet ◽  
Jason J. Ong ◽  
Sawsan Salah ◽  
Chisom Obiezu-Umeh ◽  
...  

Abstract Background Despite high HIV incidence rates among young people in Nigeria, less than 24% of this population have ever tested for HIV. These low HIV testing rates suggest that current testing services may not align with their testing preferences. To address this gap, the objective of this study was to assess preferences for HIV testing options among young people in Nigeria.Methods We conducted a cross-sectional study using survey to assess preferences for HIV testing options among 113 youth aged 14-24 years residing in Nigeria. The survey included a series of hypothetical HIV testing options, comprised of six characteristics centered around HIV testing service (i.e. location of testing, test administrator, mode of pre-test, mode of post-test counseling, type of HIV test, and cost of HIV test). For each characteristic, participants were asked to select one of the options that they prefer or indicate none of the above. A descriptive analysis of the preferences made by participants was conducted, summarizing proportions of participants who selected different options for HIV testing.Results The mean age of study participants was 19.5 years old (SD=2.7). Most youth (73, 64.6%) had at least a secondary school degree. There was pronounced heterogeneity in HIV testing preferences among young people. Although most youth preferred free HIV testing, 14 (16.7%) reported preferring paying a small amount compared to free testing. More youth preferred blood-based HIV self-testing 39(48.8%) compared to facility-based HIV testing and oral HIV self-testing.Conclusions Our finding suggest that young people have a range of HIV testing preferences in Nigeria. This suggests that a “one-size-fits-all” approach to delivering services to youth may be challenging in this context. HIV testing services can be optimized to reach young people if a variety options are provided to meet their unique preferences.


Author(s):  
Vani Srinivas ◽  
Rajesh T. Patil ◽  
M. Chandrakantha ◽  
T. L. N. Prasad ◽  
Sunil D. Khaparde

Background: This paper presents the prevalence of human immuno deficiency virus (HIV) infection among men who have sex with men (MSM) attending integrated counselling and testing Centres (ICTC) in selected districts of Karnataka.Methods: A cross sectional study was done at ICTCs. Men and transgenders coming with referral slips from targeted intervention (TI), non-government organizations (NGOs) were considered as MSMs. The basic demographic data, HIV test result and details of post- test counselling were collected in specific format. Data from 13 districts was obtained from April 2009 to March 2010 and comparing the prevalence of HIV among MSM in HIV sentinel surveillance (HSS).Results: Out of 8,276 MSMs in 13 districts, 2808 (33.9%) visited ICTCs with TI NGOs referral slips and were tested for HIV once in a year. The overall prevalence of HIV was 8.6%. Prevalence was highest (17.3%) among men in the age group of 41 to 45 years, illiterates (11.5%), unemployed (11.2%) and divorced and separated (13.3%) and widowed (13.6%) MSMs. Among those tested, 97.7% of MSM underwent post-test counselling and collected their report. The highest HIV prevalence was among MSMs from Mysore district (20.1%), followed by Udupi (19.9%) and Bagalkot (10.6%). Rest of all the other districts had less than 10% of HIV prevalence.Conclusions: The uptake of HIV testing among the MSM with referral slips was low in Karnataka. The prevalence level differs in various districts. There is need for more focused and effective counselling by peer educators for correct and consistent condom usage among illiterate, widowed and unemployed MSMs.


2021 ◽  
Vol 15 (9) ◽  
pp. 2311-2313
Author(s):  
Zulfiqar Ali Buzdar ◽  
Kanwal Zahra ◽  
Maryam Shahid ◽  
Muhammad Anwar Sibtain Fazli ◽  
Javaid Munir ◽  
...  

Background: The burns resulting from heating mechanisms or hot sources are inevitable as such a scheme is an integral part of human’s life. It though benefits on one hand but unfortunately it harms as well especially if due care is not rendered in this regard. Aim: To assess the seasonal effects on presentation of victims of burns. Methods: An analytical cross-sectional study was conducted on the medicolegal cases of burns filtered at medicolegal clinic of Mayo Hospital Lahore, Accident and Emergency Department from December 2017 to August 2018. A total of 250 cases were studied presenting in the above setting. Result: The study revealed the seasonality as a quiet common and impressive factor in reporting of victims of burns in the medicolegal clinic of Mayo Hospital/King Edward Medical University Lahore. The winter months of December, January and February were the most common reporting months of study showing maximum peaks. Keywords: Burns, Season, Variation, Factors


Diagnostics ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. 226
Author(s):  
Tomasz Gołębiowski ◽  
Mariusz Kusztal ◽  
Andrzej Konieczny ◽  
Magdalena Kuriata-Kordek ◽  
Ada Gawryś ◽  
...  

Background: Metabolic acidosis in patients with chronic kidney disease (CKD) is a common complication. A bicarbonate concentration in venous blood (V-HCO3−) is a key index for diagnosis and treatment initiation. The aim of our study is to evaluate usability of acid–base balance parameters of in blood taken simultaneously from peripheral artery and the vein. Methods: A total of 49 patients (median age 66 years [interquartile range IQR 45–75]), with CKD stage G4 or G5 were enrolled in this cross-sectional study. All patients were qualified for arteriovenous fistula creation in pre-dialysis period. The samples were taken during surgery, directly after dissection, and evaluated in a point of care testing analyzer. The arteriovenous difference in bicarbonate levels (Δ-HCO3−) was calculated. According to glomerular filtration rate (eGFR) the group was divided into Group A eGFR ≥ 10 mL/min/1.73 m2) and Group B eGFR < 10 mL/min/1.73 m2). Results: In Group A Δ-HCO3− was significantly higher compared to Group B. No such differences were observed in the case of V-HCO3−. Δ-HCO3− positively correlated with eGFR. The discriminative power of Δ-HCO3− for predicting eGFR < 10 mL/min/1.73 m2 was 0.72 (95% confidence interval [CI] = 0.551–0.88; p = 0.01) which provided 67% sensitivity and 75% specificity. The best cut-off was 0.5 mmol/L. Conclusions: The Δ-HCO3− lower than 0.5 mmol/L may be used as predictor of exhaust buffer capacity. The value of this tool should be tested in larger population.


Author(s):  
Bhakti Hansoti ◽  
Sarah E. Hill ◽  
Madeleine Whalen ◽  
David Stead ◽  
Andy Parrish ◽  
...  

Background: The national South African HIV Counselling and Testing (HCT) guidelines mandate that voluntary counselling and testing (VCT) should be offered in all healthcare facilities. Emergency departments (EDs) are at the forefront of many healthcare facilities, yet VCT is not routinely implemented in this setting.Methods: We conducted a cross-sectional study that surveyed patients and healthcare providers at a tertiary care ED in the spring and summer of 2016 to ascertain their attitudes to VCT in the ED. We also used two previously validated survey instruments to gather data on patients’ HIV knowledge and providers’ stigma against patients living with HIV, as we anticipated that these may have an impact on providers’ and patients’ attitudes to the provision of HIV testing within the ED, and may offer insights for future intervention development.Results: A total of 104 patients and 26 providers were enrolled in the study. Overall, patients responded more favourably to ED-based HIV testing (92.3%) compared to providers (only 40% responded favourably). When asked about potential barriers to receiving or providing HIV testing, 16.4% of patients and 24% of providers felt that the subject of HIV was too sensitive and 58.7% of patients and 80% of providers indicated that privacy and confidentiality issues would pose major barriers to implementing ED-based HIV testing.Conclusion: This study shows that while ED-based HIV testing is overall highly acceptable to patients, providers seem less willing to provide this service. The survey data also suggest that future development of ED-based testing strategies should take into consideration privacy and confidentiality concerns that may arise within a busy emergency care setting. Furthermore, every effort should be made to tackle HIV stigma among providers to improve overall attitudes towards HIV-positive individuals that present for care in the ED.


Author(s):  
Chattar Kanchan ◽  
Dabhade Sangeeta ◽  
Ghongane Balasaheb

Objective: The study was carried out to find the knowledge and awareness of medical and surgical section nurses about the use of antiseptic and disinfectants and the immediate and late impact of an educational intervention like seminar and workshop in the knowledge of nurses.Method: This is a questionnaire-based pre- and post-test cross-sectional study.  200 nurses [100 working in medical wards and 100 working in surgical wards and Operation theatre (O.T.)] were selected using random number sampling method.  First a pre-test was given. Then an educational intervention in the form of power point presentation was carried out and post-test was given. One more test was carried out 1 month after post-test to check retention of knowledge by nurses.Result: In both medical and surgical pre-test, most of the questions answered correctly were in below 25% response. While in post-test number of the questions answered correctly was increased and maximum number of number of the questions solved correctly were between 50-75% and 75-100 percent. Individual response in the pre-test both medical and surgical nurses showed that maximum number of nurses have responses between 25-50% and 50-75% while response rate has increased in post-test where maximum number of responses were between 75-100%.Conclusion: Our study suggests that educational intervention has positive impact on the knowledge of nurses. There is a need to carry out such educational interventions periodically which will be helpful for better retention of knowledge by nurses. 


2020 ◽  
Vol 58 (229) ◽  
Author(s):  
Sameer Thapa ◽  
Anup Raj Upreti ◽  
Bishow Raj Dawadi

Introduction: Injury is one of the major global public health problems causing significant number of death and disability. The study aims to study the epidemiological and clinical profile of patients presented in emergency department with injury. Methods: This was a descriptive cross-sectional study conducted in a tertiary care hospital from September 2019 to February 2020 after obtaining ethical approval from Institutional review board (reference number 007-076/077). A convenient sampling method was applied. Epidemiological factors, chronological factors, causes of injury, anatomical distribution, pattern of injury were studied. Statistical analysis was done using statistical package for the social sciences version 20. Point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data. Results: Out of 197 patients, 72 (36.5%) patients had fall followed by road traffic accident 57 (28.9%). Of total, 80 (40.6%) had injury at home and 80 (40.6%) had cut injury. Head and neck accounted for 66 (33.5%) of total injury followed by upper Extremities 50 (25.4%) and lower extremities 47 (23.9%). Eighty-seven (44.2%) of the patients visited emergency within 30 minutes of sustained injury. Conclusions: The top three leading causes of injuries visiting emergency department were: fall, Road Traffic Accident and physical assaults respectively. The most common mode was fall being cut as most common pattern. Head and neck was the most commonest site of injury. The common place of injury was home.


2020 ◽  
Vol 58 (227) ◽  
Author(s):  
Sameer Thapa ◽  
Bishwa Raj Dawadi ◽  
Anup Raj Upreti

Introduction: Acute poisoning is a major global public health problem contributing to one of theleading causes for a visit to an emergency department. This study aims to analyse the demographicand psychosocial characteristics of patients with acute poisoning presented to the emergencydepartment. Methods: This was a descriptive cross-sectional study conducted in a tertiary care hospital fromJune to December 2019 after obtaining ethical approval from Institutional review board (referencenumber. 041-075/0760). A convenient sampling method was applied. Epidemiological factors, typesof poison consumed, reason, motive, and place to take poison, time elapse in the presentation to thehospital were studied. Statistical analysis was done using statistical package for the social sciencesversion 20. Point estimate at 95% Confidence Interval was calculated along with frequency andproportion for binary data. Results: Out of 76 cases of acute poisoning, the organophosphorus poisoning was 18 (23.7%) followedby unknown 12 (15.8). Of total, 28 (36.8%) had quarrel before taking poison and 41 (53.9 %) hadintention to commit suicide. Sixty-seven (88.2%) took a poison at home. The average elapsed time tothe visit of the emergency department was 110±80 minutes.   Conclusions: The most common poisoning was organophosphorus with a suicide being the mostcommon intention. Quarrel was the most frequent reason to take poison and the home was the mostcommon place to take poison.


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