Field evaluation of HIV point-of-care testing for early infant diagnosis in Cape Town, South Africa

The timely commencement of treatment within the first 12 weeks of life in children reduces the HIV disease progression by 75% and mortality by 76%. For all children infected with HIV to receive essential treatment and care, few things are more important than early and accurate HIV diagnosis. Traditional methods of providing Early Infant Diagnosis (EID) have been bedeviled with several challenges. Point of Care (POC) testing for EID has been recommended as a game-changer. A field evaluation was conducted across 6 healthcare facilities between February 2017 and August 2018 to determine the accuracy and operational feasibility of POC testing for EID in Nigeria. The conceptual framework rides on the WHO SDI ASSURED criteria. Participants were infants aged between 4 weeks and 18 months born to HIV-positive mothers and visiting the clinic for the first time for EID. Results obtained from the POC was compared with the Standard of Care (SOC) to determine accuracy and feasibility. A total of 245 participants took part in the study, with 76% visiting the clinic for EID within 2 months of life. The average turnaround time for EID test using the SOC was 67 days. Analysis of the 10.4% error rate indicate significant correlation by personnel (r= 0.01122, P=0.841706). An average concordance percentage of 99.6%, sensitivity of 91.7% and specificity of 100.0% was observed. Operator’s assessment indicates that the equipment is very good and acceptable. The POC testing for EID is acceptable, rapid, and robust; hence, viable for use in Nigeria.

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Field evaluation of near point of care Cepheid GeneXpert HIV-1 Qual for early infant diagnosis

PLoS ONE ◽

10.1371/journal.pone.0209778 ◽

2018 ◽

Vol 13 (12) ◽

pp. e0209778 ◽

Cited By ~ 5

Author(s):

Valarie Sarah Opollo ◽

Alliance Nikuze ◽

Jihane Ben-Farhat ◽

Emily Anyango ◽

Felix Humwa ◽

...

Keyword(s):

Point Of Care ◽

Field Evaluation ◽

Early Infant Diagnosis ◽

Early Infant ◽

Hiv 1

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Testing the specificity, operational feasibility and acceptability of point-of-care (POC) HIV testing compared to conventional laboratory testing for early infant diagnosis (EID) in Durban, South Africa

http://isrctn.com/ ◽

10.1186/isrctn38911104 ◽

2018 ◽

Author(s):

Elizabeth Spooner

Keyword(s):

South Africa ◽

Hiv Testing ◽

Laboratory Testing ◽

Point Of Care ◽

Early Infant Diagnosis ◽

Early Infant

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The NSEBA Demonstration Project: Implementation of a point‐of‐care platform for early infant diagnosis of HIV in rural Zambia

Tropical Medicine & International Health ◽

10.1111/tmi.13627 ◽

2021 ◽

Author(s):

Catherine G. Sutcliffe ◽

Nkumbula Moyo ◽

Jessica L. Schue ◽

Jane N. Mutanga ◽

Mutinta Hamahuwa ◽

...

Keyword(s):

Point Of Care ◽

Demonstration Project ◽

Early Infant Diagnosis ◽

Project Implementation ◽

Early Infant ◽

Rural Zambia

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Feasibility and acceptability of implementing early infant diagnosis of HIV in Papua New Guinea at the point of care: a qualitative exploration of health worker and key informant perspectives

BMJ Open ◽

10.1136/bmjopen-2020-043679 ◽

2020 ◽

Vol 10 (11) ◽

pp. e043679

Author(s):

Yasmin Mohamed ◽

Martha Kupul ◽

Janet Gare ◽

Steven G Badman ◽

Selina Silim ◽

...

Keyword(s):

Papua New Guinea ◽

Standard Care ◽

Health Workers ◽

Point Of Care ◽

Hiv Positive ◽

Early Infant Diagnosis ◽

Pmtct Programme ◽

Early Infant ◽

Qualitative Exploration ◽

Hiv 1

IntroductionEarly infant diagnosis (EID) of HIV and timely initiation of antiretroviral therapy can significantly reduce morbidity and mortality among HIV-positive infants. Access to EID is limited in many low-income and middle-income settings, particularly those in which standard care involves dried blood spots (DBS) sent to centralised laboratories, such as in Papua New Guinea (PNG). We conducted a qualitative exploration of the feasibility and acceptability of implementing a point-of-care (POC) EID test (Xpert HIV-1 Qualitative assay) among health workers and key stakeholders working within the prevention of mother-to-child transmission of HIV (PMTCT) programme in PNG.MethodsThis qualitative substudy was conducted as part of a pragmatic trial to investigate the effectiveness of the Xpert HIV-1 Qualitative test for EID in PNG and Myanmar. Semistructured interviews were undertaken with 5 health workers and 13 key informants to explore current services, experiences of EID testing, perspectives on the Xpert test and the feasibility of integrating and scaling up POC EID in PNG. Coding was undertaken using inductive and deductive approaches, drawing on existing acceptability and feasibility frameworks.ResultsHealth workers and key informants (N=18) felt EID at POC was feasible to implement and beneficial to HIV-exposed infants and their families, staff and the PMTCT programme more broadly. All study participants highlighted starting HIV-positive infants on treatment immediately as the main advantage of POC EID compared with standard care DBS testing. Health workers identified insufficient resources to follow up infants and caregivers and space constraints in hospitals as barriers to implementation. Participants emphasised the importance of adequate human resources, ongoing training and support, appropriate coordination and a sustainable supply of consumables to ensure effective scale-up of the test throughout PNG.ConclusionsImplementation of POC EID in a low HIV prevalence setting such as PNG is likely to be both feasible and beneficial with careful planning and adequate resources.Trial registration number12616000734460.

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