Skip to content
Home
About Us
Resources
Profiles Metrics
Authors Directory
Institutions Directory
Top Authors
Top Institutions
Top Sponsors
AI Digest
Contact Us
Menu
Home
About Us
Resources
Profiles Metrics
Authors Directory
Institutions Directory
Top Authors
Top Institutions
Top Sponsors
AI Digest
Contact Us
Home
About Us
Resources
Profiles Metrics
Authors Directory
Institutions Directory
Top Authors
Top Institutions
Top Sponsors
AI Digest
Contact Us
Menu
Home
About Us
Resources
Profiles Metrics
Authors Directory
Institutions Directory
Top Authors
Top Institutions
Top Sponsors
AI Digest
Contact Us
Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
Feasibility of performing multiple point of care testing for HIV anti-retroviral treatment initiation and monitoring from multiple or single fingersticks
PLoS ONE, Volume 8, No. 12, Article e85265, Year 2013
Notification
URL copied to clipboard!
Description
Background: Point of Care testing (POCT) provides on-site, rapid, accessible results. With current South African anti-retroviral treatment guidelines, up to 4 fingersticks /patient/clinic visit could be required if utilizing POC. We determined the feasibility and accuracy of a nurse performing multiple POCT on multiple fingersticks followed by simplification of the process by performance of multiple POC on a single fingerstick. Method and Findings: Random HIV positive adult patients presenting at a HIV treatment clinic in South Africa, for ART initiation/ monitoring, were approached to participate in the study between April-June 2012. Phase I: n=150 patients approached for multiple POCT on multiple fingersticks. Phase II: n=150 patients approached for multiple POCT on a single fingerstick. The following POC tests were performed by a dedicated nurse: PIMA (CD4), HemoCue (hemoglobin), Reflotron (alanine aminotransferase, creatinine). A venepuncture specimen was taken for predicate laboratory methodology. Normal laboratory ranges and Royal College of Pathologists Australasia (RCPA) allowable differences were used as guidelines for comparison. In 67% of participants, ≥3 tests were requested per visit. All POCT were accurate but ranged in variability. Phase I: Hemoglobin was accurate (3.2%CV) while CD4, alanine aminotransferase and creatinine showed increased variability (16.3%CV; 9.3%CV; 12.9%CV respectively). PIMA generated a misclassification of 12.4%. Phase II: Hemoglobin, alanine aminotransferase and creatinine showed good accuracy (3.2%CV, 8.7%CV, 6.4%CV respectively) with increased variability on CD4 (12.4%CV) but low clinical misclassification (4.1%). No trends were observed for the sequence in which POC was performed on a single fingerstick. Overall, PIMA CD4 generated the highest error rate (16-19%). Conclusions: Multiple POCT for ART initiation and/or monitoring can be performed practically by a dedicated nurse on multiple fingersticks. The process is as accurate as predicate methodology and can be simplified using a single fingerstick. © 2013 Gous et al.
Authors & Co-Authors
Gous, Natasha M.
South Africa, Johannesburg
School of Pathology
Scott, Lesley Erica
South Africa, Johannesburg
School of Pathology
Potgieter, Joachim J.C.
South Africa, Pretoria
University of Pretoria
South Africa, Johannesburg
National Health Laboratory Service
Ntabeni, Lumka
South Africa, Pretoria
University of Pretoria
South Africa, Johannesburg
National Health Laboratory Service
Enslin, Sharon
South Africa, Pretoria
University of Pretoria
South Africa, Johannesburg
National Health Laboratory Service
Newman, Ronel
South Africa, Pretoria
University of Pretoria
South Africa, Johannesburg
National Health Laboratory Service
Stevens, Wendy Susan
South Africa, Johannesburg
School of Pathology
South Africa, Johannesburg
National Health Laboratory Service
Statistics
Citations: 31
Authors: 7
Affiliations: 3
Identifiers
Doi:
10.1371/journal.pone.0085265
e-ISSN:
19326203
Research Areas
Health System And Policy
Infectious Diseases
Study Locations
South Africa