Acceptability of Routine Point-of-Care Early Infant Diagnosis in Eight African Countries: Findings From a Qualitative Assessment of Clinical and Laboratory Personnel
Acceptability of Routine Point-of-Care Early Infant Diagnosis in Eight African Countries: Findings From a Qualitative Assessment of Clinical and Laboratory Personnel
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DOI：
10.1097/qai.0000000000002372
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发表时间：
2020-07-01
影响因子：
3.6
通讯作者：
Cohn, Jennifer
中科院分区：
文献类型：
--
作者：
Bianchi, Flavia;Clemens, Sara;Cohn, Jennifer
背景：伊丽莎白·格拉泽儿童艾滋病基金会在8个非洲国家引入了用于早期婴儿艾滋病毒诊断（EID）的护理点（POC）检测。了解用户的经验和意见，可以帮助促进引进和sustainable.Setting：喀麦隆，科特迪瓦，斯威士兰，肯尼亚，莱索托，莫桑比克，卢旺达和Zimbabwe.Methods：结构化的采访与卫生保健工作者（HCWs）提供EID服务和半结构化的采访与国家和地区的实验室经理或EID程序经理进行之前和之后的POC EID的实施。调查的反应进行了分析和比较;开放式的反应进行了分析theme.Results：在总数，234和175与HCWs和28和14与实验室或项目经理的访谈前和后引入POC EID，分别进行。在干预前的访谈中，基于实验室的EID检测所面临的挑战包括从患者住所到卫生设施的距离，耗时的样本运输到中心实验室，检测试剂盒缺货，以及等待结果的时间长。干预后的数据显示，保健工作者发现POC EID易于使用，并对快速周转时间和能够更快地开始治疗艾滋病毒感染的婴儿感到非常满意。实验室管理人员也支持扩大POC检测的规模，但对操作平台所需的可靠基础设施持谨慎态度。建议是，POC EID被纳入国家诊断测试network.Conclusions：支持POC EID从关键利益相关者的可持续性是必不可少的。总体而言，与会者支持为EID推出POC测试，指出扩大POC EID的挑战和机遇，并建议将其纳入整个EID系统。
Background:The Elizabeth Glaser Pediatric AIDS Foundation introduced point-of-care (POC) testing for early infant diagnosis (EID) of HIV in 8 African countries. Understanding experiences and opinions of users can help facilitate introduction and sustainability.Setting:Cameroon, Côte d'Ivoire, Eswatini, Kenya, Lesotho, Mozambique, Rwanda, and Zimbabwe.Methods:Structured interviews with health care workers (HCWs) providing EID services and semistructured interviews with national and regional laboratory managers or EID program managers were conducted before and after the implementation of POC EID. Survey responses were analyzed and compared; open-ended responses were analyzed by theme.Results:In total, 234 and 175 interviews with HCWs and 28 and 14 interviews with laboratory or program managers were conducted before and after the introduction of POC EID, respectively. In preintervention interviews, challenges identified with laboratory-based EID testing included distance from patients' residence to the health facility, time-consuming sample transportation to central laboratories, stockout of testing kits, and long wait times for results. Postintervention data revealed that HCWs found POC EID easy to use and were very satisfied with the fast turnaround time and ability to initiate treatment for HIV-infected infants sooner. Laboratory managers were also supportive of scaling-up POC testing although cautious of the need for reliable infrastructure to operate platforms. The recommendation was that POC EID be integrated within the national diagnostic testing network.Conclusions:Support for POC EID from key stakeholders is essential for sustainability. Overall, participants supported the rollout of POC testing for EID, noting challenges and opportunities for scaling-up POC EID and recommending integration into the overall EID system.