Task-shifting point-of-care CD4+ testing to lay health workers in HIV care and treatment services in Namibia
Introduction: Access to CD4+ testing remains a common barrier to early initiation of antiretroviral therapy among persons living with HIV/AIDS in low- and middle-income countries. The feasibility of task-shifting of point-of-care (POC) CD4+ testing to lay health workers in Namibia has not been evalu...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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AOSIS
2017-09-01
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| Series: | African Journal of Laboratory Medicine |
| Subjects: | |
| Online Access: | https://ajlmonline.org/index.php/ajlm/article/view/643 |
| _version_ | 1818248066036137984 |
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| author | Francina Kaindjee-Tjituka Souleymane Sawadogo Graham Mutandi Andrew D. Maher Natanael Salomo Claudia Mbapaha Marytha Neo Anita Beukes Justice Gweshe Alexinah Muadinohamba David W. Lowrance |
| author_facet | Francina Kaindjee-Tjituka Souleymane Sawadogo Graham Mutandi Andrew D. Maher Natanael Salomo Claudia Mbapaha Marytha Neo Anita Beukes Justice Gweshe Alexinah Muadinohamba David W. Lowrance |
| author_sort | Francina Kaindjee-Tjituka |
| collection | DOAJ |
| description | Introduction: Access to CD4+ testing remains a common barrier to early initiation of antiretroviral therapy among persons living with HIV/AIDS in low- and middle-income countries. The feasibility of task-shifting of point-of-care (POC) CD4+ testing to lay health workers in Namibia has not been evaluated.
Methods: From July to August 2011, Pima CD4+ analysers were used to improve access to CD4+ testing at 10 selected public health facilities in Namibia. POC Pima CD4+ testing was performed by nurses or lay health workers. Venous blood samples were collected from 10% of patients and sent to centralised laboratories for CD4+ testing with standard methods. Outcomes for POC Pima CD4+ testing and patient receipt of results were compared between nurses and lay health workers and between the POC method and standard laboratory CD4+ testing methods.
Results: Overall, 1429 patients received a Pima CD4+ test; 500 (35.0%) tests were performed by nurses and 929 (65.0%) were performed by lay health workers. When Pima CD4+ testing was performed by a nurse or a lay health worker, 93.2% and 95.2% of results were valid (p = 0.1); 95.6% and 98.1% of results were received by the patient (p = 0.007); 96.2% and 94.0% of results were received by the patient on the same day (p = 0.08). Overall, 97.2% of Pima CD4+ results were received by patients, compared to 55.4% of standard laboratory CD4+ results (p < 0.001).
Conclusions: POC CD4+ testing was feasible and effective when task-shifted to lay health workers. Rollout of POC CD4+ testing via task-shifting can improve access to CD4+ testing and retention in care between HIV diagnosis and antiretroviral therapy initiation in low- and middle-income countries. |
| first_indexed | 2024-12-12T15:14:41Z |
| format | Article |
| id | doaj.art-cef8efbd1a0e47c39db9aaa53dff49c7 |
| institution | Directory Open Access Journal |
| issn | 2225-2002 2225-2010 |
| language | English |
| last_indexed | 2024-12-12T15:14:41Z |
| publishDate | 2017-09-01 |
| publisher | AOSIS |
| record_format | Article |
| series | African Journal of Laboratory Medicine |
| spelling | doaj.art-cef8efbd1a0e47c39db9aaa53dff49c72022-12-22T00:20:32ZengAOSISAfrican Journal of Laboratory Medicine2225-20022225-20102017-09-0161e1e510.4102/ajlm.v6i1.643175Task-shifting point-of-care CD4+ testing to lay health workers in HIV care and treatment services in NamibiaFrancina Kaindjee-Tjituka0Souleymane Sawadogo1Graham Mutandi2Andrew D. Maher3Natanael Salomo4Claudia Mbapaha5Marytha Neo6Anita Beukes7Justice Gweshe8Alexinah Muadinohamba9David W. Lowrance10Directorate of Special Programs, Ministry of Health and Social Services, WindhoekUS Centers for Disease Control and Prevention, WindhoekUS Centers for Disease Control and Prevention, WindhoekUS Centers for Disease Control and Prevention, WindhoekUS Centers for Disease Control and Prevention, WindhoekUS Centers for Disease Control and Prevention, WindhoekUS Centers for Disease Control and Prevention, WindhoekUS Centers for Disease Control and Prevention, WindhoekDirectorate of Special Programs, Ministry of Health and Social Services, WindhoekDirectorate of Special Programs, Ministry of Health and Social Services, WindhoekDirectorate of Special Programs, Ministry of Health and Social Services, WindhoekIntroduction: Access to CD4+ testing remains a common barrier to early initiation of antiretroviral therapy among persons living with HIV/AIDS in low- and middle-income countries. The feasibility of task-shifting of point-of-care (POC) CD4+ testing to lay health workers in Namibia has not been evaluated. Methods: From July to August 2011, Pima CD4+ analysers were used to improve access to CD4+ testing at 10 selected public health facilities in Namibia. POC Pima CD4+ testing was performed by nurses or lay health workers. Venous blood samples were collected from 10% of patients and sent to centralised laboratories for CD4+ testing with standard methods. Outcomes for POC Pima CD4+ testing and patient receipt of results were compared between nurses and lay health workers and between the POC method and standard laboratory CD4+ testing methods. Results: Overall, 1429 patients received a Pima CD4+ test; 500 (35.0%) tests were performed by nurses and 929 (65.0%) were performed by lay health workers. When Pima CD4+ testing was performed by a nurse or a lay health worker, 93.2% and 95.2% of results were valid (p = 0.1); 95.6% and 98.1% of results were received by the patient (p = 0.007); 96.2% and 94.0% of results were received by the patient on the same day (p = 0.08). Overall, 97.2% of Pima CD4+ results were received by patients, compared to 55.4% of standard laboratory CD4+ results (p < 0.001). Conclusions: POC CD4+ testing was feasible and effective when task-shifted to lay health workers. Rollout of POC CD4+ testing via task-shifting can improve access to CD4+ testing and retention in care between HIV diagnosis and antiretroviral therapy initiation in low- and middle-income countries.https://ajlmonline.org/index.php/ajlm/article/view/643Task-ShiftingPoint of care testingLay health care workers |
| spellingShingle | Francina Kaindjee-Tjituka Souleymane Sawadogo Graham Mutandi Andrew D. Maher Natanael Salomo Claudia Mbapaha Marytha Neo Anita Beukes Justice Gweshe Alexinah Muadinohamba David W. Lowrance Task-shifting point-of-care CD4+ testing to lay health workers in HIV care and treatment services in Namibia African Journal of Laboratory Medicine Task-Shifting Point of care testing Lay health care workers |
| title | Task-shifting point-of-care CD4+ testing to lay health workers in HIV care and treatment services in Namibia |
| title_full | Task-shifting point-of-care CD4+ testing to lay health workers in HIV care and treatment services in Namibia |
| title_fullStr | Task-shifting point-of-care CD4+ testing to lay health workers in HIV care and treatment services in Namibia |
| title_full_unstemmed | Task-shifting point-of-care CD4+ testing to lay health workers in HIV care and treatment services in Namibia |
| title_short | Task-shifting point-of-care CD4+ testing to lay health workers in HIV care and treatment services in Namibia |
| title_sort | task shifting point of care cd4 testing to lay health workers in hiv care and treatment services in namibia |
| topic | Task-Shifting Point of care testing Lay health care workers |
| url | https://ajlmonline.org/index.php/ajlm/article/view/643 |
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