Evaluation and implementation of rapid HIV tests: The experience in 11 African countries
Evaluation and implementation of rapid HIV tests: The experience in 11 African countries
复制标题
DOI：
10.1089/aid.2007.0020
复制
发表时间：
2007-12-01
影响因子：
1.5
通讯作者：
Gershy-Damet, G.
中科院分区：
文献类型：
--
作者：
Plate, David K.;Wiktor, S.;Gershy-Damet, G.
艾滋病毒快速检测使艾滋病毒预防和护理服务能够扩展到实验室基础设施有限的环境中。世界卫生组织建议，在实施艾滋病毒快速检测之前，首先在参考实验室进行评估，然后在服务点进行评估，并采取措施确保检测质量。我们描述了11个非洲国家利用这一进程实施艾滋病毒快速检测的经验。对11个非洲国家的卫生部、参考实验室和疾病控制和预防中心的工作人员进行了关于快速检测评估和质量保证措施的问卷调查。在参考实验室评估中，15项快速检测中有10项的敏感度中位数超过99%，而15项快速检测中有13项的特异度中位数超过99%。在服务点地点的评价中也观察到类似的结果。已在其中9个国家的600多个地点实施了快速测试算法。样本的服务点快速检测和参考实验室重新检测的符合率在95.7%到99.5%之间(中位数：98.7%)。即使由实验室经验有限的人进行，评价和实施艾滋病毒快速检测的系统办法也有助于确保准确、分散的检测。
Rapid HIV testing enables HIV prevention and care services to expand to settings with limited laboratory infrastructure. The World Health Organization recommends that prior to their implementation, rapid HIV tests first be evaluated at a reference laboratory and then at points-of-service, and that measures to ensure quality of testing be in place. We describe the experience of 11 African countries that implemented rapid HIV testing using this process. A questionnaire regarding rapid test evaluations and quality assurance measures was administered to personnel in ministries of health, reference laboratories, and Centers for Disease control and Prevention programs in 11 African countries. In reference laboratory evaluations, median sensitivity was above 99% for 10 of 15 rapid tests and median specificity was above 99% for 13 of 15 rapid tests. Similar results were observed in evaluations at point-of-service sites. Rapid testing algorithms have been implemented in over 600 sites in nine of the countries. Concordance between point-of-service rapid testing and reference laboratory retesting of samples ranged from 95.7% to 99.5% (median: 98.7%). A systematic approach to the evaluation and implementation of rapid HIV tests was useful in ensuring accurate, decentralized testing even when conducted by persons with limited laboratory experience.