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[PMID]:28461133
[Au] Autor:Chen DJ; Yao JD
[Ad] Endereço:Division of Clinical Microbiology, Department of Laboratory Medicine and Pathology, Mayo Clinic, 200 First St SW, Rochester, MN 55905, USA. Electronic address: dchen@uwhealth.org.
[Ti] Título:Comparison of turnaround time and total cost of HIV testing before and after implementation of the 2014 CDC/APHL Laboratory Testing Algorithm for diagnosis of HIV infection.
[So] Source:J Clin Virol;91:69-72, 2017 06.
[Is] ISSN:1873-5967
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Updated recommendations for HIV diagnostic laboratory testing published by the Centers for Disease Control and Prevention and the Association of Public Health Laboratories incorporate 4th generation HIV immunoassays, which are capable of identifying HIV infection prior to seroconversion. OBJECTIVES: The purpose of this study was to compare turnaround time and cost between 3rd and 4th generation HIV immunoassay-based testing algorithms for initially reactive results. STUDY DESIGN: The clinical microbiology laboratory database at Mayo Clinic, Rochester, MN was queried for 3rd generation (from November 2012 to May 2014) and 4th generation (from May 2014 to November 2015) HIV immunoassay results. All results from downstream supplemental testing were recorded. Turnaround time (defined as the time of initial sample receipt in the laboratory to the time the final supplemental test in the algorithm was resulted) and cost (based on 2016 Medicare reimbursement rates) were assessed. RESULTS: A total of 76,454 and 78,998 initial tests were performed during the study period using the 3rd generation and 4th generation HIV immunoassays, respectively. There were 516 (0.7%) and 581 (0.7%) total initially reactive results, respectively. Of these, 304 (58.9%) and 457 (78.7%) were positive by supplemental testing. There were 10 (0.01%) cases of acute HIV infection identified with the 4th generation algorithm. The most frequent tests performed to confirm an HIV-positive case using the 3rd generation algorithm, which were reactive initial immunoassay and positive HIV-1 Western blot, took a median time of 1.1 days to complete at a cost of $45.00. In contrast, the most frequent tests performed to confirm an HIV-positive case using the 4th generation algorithm, which included a reactive initial immunoassay and positive HIV-1/-2 antibody differentiation immunoassay for HIV-1, took a median time of 0.4 days and cost $63.25. Overall median turnaround time was 2.2 and 1.5 days, and overall median cost was $63.90 and $72.50 for 3rd and 4th generation algorithms, respectively. CONCLUSIONS: Both 3rd and 4th generation HIV immunoassays had similar total numbers of tests performed and positivity rates during the study period. A greater proportion of reactive 4th generation immunoassays were confirmed to be positive, and the 4th generation algorithm identified several cases of acute HIV infection that would have been missed by the 3rd generation algorithm. The 4th generation algorithm had a more rapid turnaround time but higher cost for confirmed positive HIV infections and overall, compared to the 3rd generation algorithm.
[Mh] Termos MeSH primário: Sorodiagnóstico da AIDS
Algoritmos
Infecções por HIV/diagnóstico
Imunoensaio
[Mh] Termos MeSH secundário: Sorodiagnóstico da AIDS/economia
Centers for Disease Control and Prevention (U.S.)
Custos e Análise de Custo
Anticorpos Anti-HIV/sangue
Infecções por HIV/economia
Infecções por HIV/virologia
HIV-1/genética
HIV-1/imunologia
HIV-2/genética
HIV-2/imunologia
Seres Humanos
Imunoensaio/economia
Imunoensaio/métodos
Programas de Rastreamento/economia
Programas de Rastreamento/legislação & jurisprudência
Programas de Rastreamento/métodos
Técnicas de Amplificação de Ácido Nucleico/economia
Técnicas de Amplificação de Ácido Nucleico/métodos
Sensibilidade e Especificidade
Estados Unidos
Adulto Jovem
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (HIV Antibodies)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180311
[Lr] Data última revisão:
180311
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170503
[St] Status:MEDLINE


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[PMID]:28746168
[Au] Autor:Pittalis S; Orchi N; De Carli G; Navarra A; Chiaradia G; Puro V; Girardi E
[Ad] Endereço:*Clinical Epidemiology Unit, National Institute for Infectious Disease "L. Spallanzani"-IRCCS, Rome, Italy †Infectious Disease Epidemiology Unit, AIDS Reference Centre, National Institute for Infectious Disease "L. Spallanzani"-IRCCS, Rome, Italy.
[Ti] Título:HIV Self-Testing in Italy.
[So] Source:J Acquir Immune Defic Syndr;76(3):e84-e85, 2017 11 01.
[Is] ISSN:1944-7884
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Sorodiagnóstico da AIDS
Infecções por HIV/diagnóstico
Acesso aos Serviços de Saúde/estatística & dados numéricos
Kit de Reagentes para Diagnóstico/utilização
Autocuidado
[Mh] Termos MeSH secundário: Sorodiagnóstico da AIDS/utilização
Adulto
Aconselhamento Diretivo
Infecções por HIV/epidemiologia
Conhecimentos, Atitudes e Prática em Saúde
Promoção da Saúde
Homossexualidade Masculina
Seres Humanos
Itália/epidemiologia
Masculino
Estudos Prospectivos
Adulto Jovem
[Pt] Tipo de publicação:LETTER; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Nome de substância:
0 (Reagent Kits, Diagnostic)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180308
[Lr] Data última revisão:
180308
[Sb] Subgrupo de revista:IM; X
[Da] Data de entrada para processamento:170727
[St] Status:MEDLINE
[do] DOI:10.1097/QAI.0000000000001507


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[PMID]:28746166
[Au] Autor:Schaffer EM; Agot K; Thirumurthy H
[Ad] Endereço:*Department of Health Policy and Management, University of North Carolina at Chapel Hill, Chapel Hill, NC †Impact Research and Development Organization, Kisumu, Kenya ‡Carolina Population Center, Chapel Hill, NC.
[Ti] Título:The Association Between Intimate Partner Violence and Women's Distribution and Use of HIV Self-Tests With Male Partners: Evidence From a Cohort Study in Kenya.
[So] Source:J Acquir Immune Defic Syndr;76(3):e85-e87, 2017 11 01.
[Is] ISSN:1944-7884
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Sorodiagnóstico da AIDS/utilização
Infecções por HIV/diagnóstico
Violência por Parceiro Íntimo/estatística & dados numéricos
Programas de Rastreamento/métodos
Kit de Reagentes para Diagnóstico/utilização
Serviços de Saúde Reprodutiva
Parceiros Sexuais/psicologia
[Mh] Termos MeSH secundário: Adulto
Feminino
Infecções por HIV/psicologia
Acesso aos Serviços de Saúde
Seres Humanos
Quênia
Masculino
Programas de Rastreamento/psicologia
Ensaios Clínicos Controlados Aleatórios como Assunto
Estigma Social
Adulto Jovem
[Pt] Tipo de publicação:LETTER; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Nome de substância:
0 (Reagent Kits, Diagnostic)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180308
[Lr] Data última revisão:
180308
[Sb] Subgrupo de revista:IM; X
[Da] Data de entrada para processamento:170727
[St] Status:MEDLINE
[do] DOI:10.1097/QAI.0000000000001502


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[PMID]:29320504
[Au] Autor:Tonen-Wolyec S; Batina-Agasa S; Muwonga J; Fwamba N'kulu F; Mboumba Bouassa RS; Bélec L
[Ad] Endereço:Ecole Doctorale Régionale D'Afrique Centrale en Infectiologie Tropicale, Franceville, Gabon.
[Ti] Título:Evaluation of the practicability and virological performance of finger-stick whole-blood HIV self-testing in French-speaking sub-Saharan Africa.
[So] Source:PLoS One;13(1):e0189475, 2018.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Opportunities for HIV testing could be enhanced by offering HIV self-testing (HIVST) in populations that fear stigma and discrimination when accessing conventional HIV counselling and testing in health care facilities. Field experience with HIVST has not yet been reported in French-speaking African countries. METHODS: The practicability of HIVST was assessed using the prototype the Exacto® Test HIV (Biosynex, Strasbourg, France) self-test in 322 adults living in Kisangani and Bunia, Democratic Republic of the Congo, according to World Health Organization's recommendations. Simplified and easy-to-read leaflet was translated in French, Lingala and Swahili. RESULTS: Forty-nine percent of participants read the instructions for use in French, while 17.1% and 33.9% read the instructions in Lingala and Swahili, respectively. The instructions for use were correctly understood in 79.5% of cases. The majority (98.4%) correctly performed the HIV self-test; however, 20.8% asked for oral assistance. Most of the participants (95.3%) found that performing the self-test was easy, while 4.7% found it difficult. Overall, the results were correctly interpreted in 90.2% of cases. Among the positive, negative, and invalid self-tests, misinterpretation occurred in 6.5%, 11.2%, and 16.0% of cases, respectively (P<0.0001). The Cohen's κ coefficient was 0.84. The main obstacle for HIVST was educational level, with execution and interpretation difficulties occurring among poorly educated people. The Exacto® Test HIV self-test showed 100.0% (95% CI; 98.8-100.0) sensitivity and 99.2% (95% CI; 97.5-99.8) specificity. CONCLUSIONS: Our field observations demonstrate: (i) the need to adapt the instructions for use to the Congolese general public, including adding educational pictograms as well as instructions for use in the local vernacular language(s); (ii) frequent difficulties understanding the instructions for use in addition to frequent misinterpretation of test results; and (iii) the generally good practicability of the HIV self-test despite some limitations. Supervised use of HIVST is recommended among poorly-educated people.
[Mh] Termos MeSH primário: Sorodiagnóstico da AIDS/métodos
Dedos
Infecções por HIV/diagnóstico
Autocuidado
[Mh] Termos MeSH secundário: Adolescente
Adulto
República Democrática do Congo
Feminino
Infecções por HIV/sangue
Seres Humanos
Masculino
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180129
[Lr] Data última revisão:
180129
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180111
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0189475


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[PMID]:29267347
[Au] Autor:Limousi F; Lert F; Desgrées du Loû A; Dray-Spira R; Lydié N; PARCOURS Study Group
[Ad] Endereço:Santé publique France, Saint-Maurice, France.
[Ti] Título:Dynamic of HIV-testing after arrival in France for migrants from sub-Saharan Africa: The role of both health and social care systems.
[So] Source:PLoS One;12(12):e0188751, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: HIV testing is an important tool in the management of the HIV epidemic among key populations. We aimed to explore the dynamic of first-time HIV testing in France for sub-Saharan migrants after their arrival. METHODS: ANRS-Parcours is a retrospective life-event survey conducted from 2012 to 2013 in healthcare facilities in the Paris region, among 926 sub-Saharan HIV-infected migrants and 763 non-infected migrants. After describing the time to first HIV test in France and associated circumstances, we performed a discrete-time logistic regression to analyze the influence of socioeconomic position, contact with the healthcare system and sexual behaviors, on first-time HIV testing in France in migrants who arrived after 2000. RESULTS: Median first-time HIV testing occurred during the second year spent in France for non-infected men and women in both groups, and during the first year for men of the HIV group. The probability of testing increased with hospitalization and pregnancy for women of both groups. For non-infected men unemployment and absence of a residence permit were associated with an increased probability of HIV testing [respectively, OR = 2.2 (1.2-4.1) and OR = 2.0 (1.1-3.5)]. Unemployment was also associated with an increased probability of first-time HIV-testing for women of the HIV group [OR: 1.7 (1.0-2.7)]. Occasional and multiple sexual relationships were associated with an increased probability of first-time testing only for HIV-infected women [OR: 2.2 (1.2-4.0) and OR = 2.4 (1.3-4.6)]. CONCLUSION: Access to first HIV testing in France is promoted by contact with the health care system and is facilitated for unemployed and undocumented migrants after arrival.However, testing should be offered more systematically and repeated in order to reduce time between HIV infection and diagnosis, especially for deprived people which are particularly vulnerable regarding HIV infection.
[Mh] Termos MeSH primário: Sorodiagnóstico da AIDS/utilização
Assistência à Saúde/organização & administração
Emigrantes e Imigrantes
Infecções por HIV/diagnóstico
[Mh] Termos MeSH secundário: Adulto
África ao Sul do Saara/epidemiologia
África ao Sul do Saara/etnologia
Feminino
França
Infecções por HIV/epidemiologia
Seres Humanos
Masculino
Estudos Retrospectivos
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180116
[Lr] Data última revisão:
180116
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171222
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0188751


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[PMID]:29261707
[Au] Autor:Dunning L; Kroon M; Hsiao NY; Myer L
[Ad] Endereço:Division of Epidemiology and Biostatistics, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa.
[Ti] Título:Field evaluation of HIV point-of-care testing for early infant diagnosis in Cape Town, South Africa.
[So] Source:PLoS One;12(12):e0189226, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Early infant HIV diagnosis (EID) coverage and uptake remains challenging. Point-of-care (POC) testing may improve access and turn-around-times, but, while several POC technologies are in development there are few data on their implementation in the field. METHODS: We conducted an implementation study of the Alere q Detect POC system for EID at two public sector health facilities in Cape Town. HIV-exposed neonates undergoing routine EID testing at a large maternity hospital and a primary care clinic received both laboratory-based HIV PCR testing per local protocols and a POC test. We analysed the performance of POC versus laboratory testing, and conducted semi-structured interviews with providers to assess acceptability and implementation issues. RESULTS: Overall 478 specimens were taken: 311 tests were performed at the obstetric hospital (median child age, 1 days) and 167 six-week tests in primary care (median child age, 42 days). 9.0% of all tests resulted in an error with no differences by site; most errors resolved with retesting. POC was more sensitive (100%; lower 95% CI, 39.8%) and specific (100%, lower 95% CI, 98%) among older children tested in primary care compared with birth testing in hospital (90.0%, 95% CI, 55.5-99.8% and 100.0%, lower 95% CI, 98.4%, respectively). Negative predictive value was high (>99%) at both sites. In interviews, providers felt the device was simple to use and facilitated decision-making in the management of infants. However, many wanted clarity on the cause of errors on the POC device to help guide repeat testing. CONCLUSIONS: POC EID testing performs well in field implementation in health care facilities and appears highly acceptable to health care providers.
[Mh] Termos MeSH primário: Sorodiagnóstico da AIDS/utilização
Infecções por HIV/diagnóstico
Sistemas Automatizados de Assistência Junto ao Leito
[Mh] Termos MeSH secundário: Feminino
Seres Humanos
Lactente
Recém-Nascido
Masculino
África do Sul
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180116
[Lr] Data última revisão:
180116
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171221
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0189226


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[PMID]:29190791
[Au] Autor:Zhang C; Li X; Brecht ML; Koniak-Griffin D
[Ad] Endereço:Xiangya Nursing School of Central South University, Changsha, Hunan, China.
[Ti] Título:Can self-testing increase HIV testing among men who have sex with men: A systematic review and meta-analysis.
[So] Source:PLoS One;12(11):e0188890, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Globally, four out of ten individuals living with HIV have not been tested for HIV. Testing is especially important for men who have sex with men (MSM), among whom an increasing HIV epidemic has been identified in many regions of the world. As a supplement to site-based HIV testing services, HIV self-testing (HIVST) provides a promising approach to promote HIV testing. However, evidence is scattered and not well-summarized on the effect of HIVST to improve HIV testing behaviors, especially for MSM. METHODS: Seven databases (PubMed, Web of Science, Cochrane Library, PsycINFO, CINAHL Plus, WanFang, and China National Knowledge Internet) and conference abstracts from six HIV/sexually transmitted infections conferences were searched from January 2000-April 2017. RESULTS: Of 1,694 records retrieved, 23 studies were identified, 9 conducted in resource-limited countries and 14 in high-income countries. The pooled results showed that HIVST increased HIV test frequency for MSM by one additional test in a 6-month period (mean difference = 0.88 [95% CI 0.52-1.24]). The pooled proportion of first-time testers among those who took HIVST was 18.7% (95% CI: 9.9-32.4) globally, with a rate 3.32 times higher in resource-limited country settings (32.9% [95% CI: 21.3-47.6]) than in high-income countries (9.9% [95% CI: 7.4-13.8]). The pooled proportions included non-recent testers, 32.9% (95% CI: 28.1-38.3); ever or currently married MSM, 16.7% (95% CI: 14.5-19.4); and HIV positive men, 3.8% (95% CI: 2.0-5.7) globally; 6.5% [95% CI: 0.38-12.3] in resource-limited country settings; and 2.9% [95% CI: 2.0-5.0] in high-income countries). The rates reported for linkage to care ranged from 31.3% to 100%. CONCLUSIONS: HIVST could increase HIV testing frequency and potentially have capacity equivalent to that of site-based HIV testing services to reach first-time, delayed, married, and HIV-infected testers among MSM and link them to medical care. However, more rigorous study designs are needed to explore the specific self-testing approach (oral-fluid based or finger-prick based) on improving HIV testing for MSM in different social and economic settings.
[Mh] Termos MeSH primário: Sorodiagnóstico da AIDS/métodos
Infecções por HIV/psicologia
Homossexualidade Masculina
Autocuidado
[Mh] Termos MeSH secundário: Seres Humanos
Masculino
[Pt] Tipo de publicação:JOURNAL ARTICLE; META-ANALYSIS
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171226
[Lr] Data última revisão:
171226
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171201
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0188890


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[PMID]:28977006
[Au] Autor:Inghels M; Niangoran S; Minga A; Yoboue JM; Dohoun L; Yao A; Eholié S; Anglaret X; Danel C
[Ad] Endereço:Centre Population et Développement (CEPED), UMR 196 Paris Descartes-Institut de Recherche et Développement (IRD), France.
[Ti] Título:Missed opportunities for HIV testing among newly diagnosed HIV-infected adults in Abidjan, Côte d'Ivoire.
[So] Source:PLoS One;12(10):e0185117, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: HIV testing is crucial for starting ART earlier in HIV-infected people. We describe Missed Opportunities (MO) for HIV testing among adults newly diagnosed with HIV in Abidjan, Côte d'Ivoire. METHODS: Between april,2nd 2013 and april 1st 2014, a cross-sectional study was conducted among all adults newly diagnosed (< 1year) for HIV at the Blood Donors Medical Center of Abidjan with face to face questionnaire. An MO for HIV testing was defined as a medical consultation for a clinical indicator (e.g. symptoms, hospitalization, and pregnancy) or a non-clinical indicator (e.g. high-risk sexual behavior, HIV-infected partner) potentially related to an HIV infection but did not lead to HIV test proposal by a health care professional. RESULTS: Of the 341 patients who attended the center suring this period, 273 (157 women and 116 men) were included in this analysis. 130 (47.6%) reported at least one medical consultation for an indicator relevant for a test proposal between 1 month and five years prior to their diagnosis. Among them, 92 (77.3%) experienced at least one MO for testing. The 273 included patients reported a total of 216 indicators; 146 (67.6%) were reported without test proposal and thus were MO. Hospitalization, extreme lose of weight, chronic or repeat fever and herpes zoster were the indicators with the largest number of MO. While 66 (24.2%) patients experienced non-clinical indicators relevant to risk of HIV infection, only 11 (4.0%) mentioned it to a health professional. CONCLUSION: MO for HIV testing are frequent, even in situations for which testing is clearly recommended. Better train healthcare professionals and creating new opportunities of testing inside and, outside of medical settings are crucial to improve HIV control.
[Mh] Termos MeSH primário: Sorodiagnóstico da AIDS/utilização
Infecções por HIV/diagnóstico
[Mh] Termos MeSH secundário: Adulto
Contagem de Linfócito CD4
Costa do Marfim
Feminino
Seres Humanos
Masculino
Meia-Idade
Inquéritos e Questionários
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171031
[Lr] Data última revisão:
171031
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171005
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0185117


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[PMID]:28829801
[Au] Autor:Jaya Z; Drain PK; Mashamba-Thompson TP
[Ad] Endereço:Discipline of Public Health Medicine, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa.
[Ti] Título:Evaluating quality management systems for HIV rapid testing services in primary healthcare clinics in rural KwaZulu-Natal, South Africa.
[So] Source:PLoS One;12(8):e0183044, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:INTRODUCTION: Rapid HIV tests have improved access to HIV diagnosis and treatment by providing quick and convenient testing in rural clinics and resource-limited settings. In this study, we evaluated the quality management system for voluntary and provider-initiated point-of-care HIV testing in primary healthcare (PHC) clinics in rural KwaZulu-Natal (KZN), South Africa. MATERIAL AND METHODS: We conducted a quality assessment audit in eleven PHC clinics that offer voluntary HIV testing and counselling in rural KZN, South Africa from August 2015 to October 2016. All the participating clinics were purposively selected from the province-wide survey of diagnostic services. We completed an on-site monitoring checklist, adopted from the WHO guidelines for assuring accuracy and reliability of HIV rapid tests, to assess the quality management system for HIV rapid testing at each clinic. To determine clinic's compliance to WHO quality standards for HIV rapid testing the following quality measure was used, a 3-point scale (high, moderate and poor). A high score was defined as a percentage rating of 90 to 100%, moderate was defined as a percentage rating of 70 to 90%, and poor was defined as a percentage rating of less than 70%. Clinic audit scores were summarized and compared. We employed Pearson pair wise correlation coefficient to determine correlations between clinics audit scores and clinic and clinics characteristics. Linear regression model was computed to estimate statistical significance of the correlates. Correlations were reported as significant at p ≤0.05. RESULTS: Nine out of 11 audited rural PHC clinics are located outside 20Km of the nearest town and hospital. Majority (18.2%) of the audited rural PHC clinics reported that HIV rapid test was performed by HIV lay counsellors. Overall, ten clinics were rated moderate, in terms of their compliance to the stipulated WHO guidelines. Audit results showed that rural PHC clinics' average rating score for compliance to the WHO guidelines ranged between 64.4% (CI: 44%- 84%) and 89.2% (CI: 74%- 100%).Ten out of eleven of the clinics were rated as moderate (70-89%). All clinic have scored highest for the following audit component: equipment; process control and specimen management; and facility ad safety, with 100%. Clinics obtained the lowest scores for the assessment audit component followed by process improvement and organisation, with 40.9% (CI: 15.7-66.1%), 45.5% (CI: 10.4-80.5%) and 56.8% (CI: 31.8 81.8%), respectively. A statistically significant correlation was observed between the following: category of staff performing the HIV rapid tests in the audited clinics and service and satisfactory audit component; weekly average number of patients using the audited PHC clinics and service and satisfactory audit component; number of HIV lay counsellors in the audited clinics and quality control audit component with p<0.05. DISCUSSION: In the small audit of primary healthcare clinics located within the rural part of KwaZulu-Natal, results revealed an overall moderate rating of the quality management system for rapid HIV testing. Improvements in the organisation, quality control, process improvement and assessment components could enable a higher quality assurance rating for rural HIV testing in KwaZulu-Natal.
[Mh] Termos MeSH primário: Sorodiagnóstico da AIDS
Garantia da Qualidade dos Cuidados de Saúde
Serviços de Saúde Rural/organização & administração
[Mh] Termos MeSH secundário: Estudos Transversais
Fidelidade a Diretrizes
Seres Humanos
Auditoria Administrativa
Serviços de Saúde Rural/normas
África do Sul
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171016
[Lr] Data última revisão:
171016
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170823
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0183044


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[PMID]:28759622
[Au] Autor:Hardie DR; Korsman SN; Hsiao NY; Morobadi MD; Vawda S; Goedhals D
[Ad] Endereço:Division of Virology, Department of Pathology, University of Cape Town, Cape Town, South Africa.
[Ti] Título:Contamination with HIV antibody may be responsible for false positive results in specimens tested on automated platforms running HIV 4th generation assays in a region of high HIV prevalence.
[So] Source:PLoS One;12(7):e0182167, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:INTRODUCTION: In South Africa where the prevalence of HIV infection is very high, 4th generation HIV antibody/p24 antigen combo immunoassays are the tests of choice for laboratory based screening. Testing is usually performed in clinical pathology laboratories on automated analysers. To investigate the cause of false positive results on 4th generation HIV testing platforms in public sector laboratories, the performance of two automated platforms was compared in a clinical pathology setting, firstly on routine diagnostic specimens and secondly on known sero-negative samples. METHODS: Firstly, 1181 routine diagnostic specimens were sequentially tested on Siemens and Roche automated 4th generation platforms. HIV viral load, western blot and follow up testing were used to determine the true status of inconclusive specimens. Subsequently, known HIV seronegative samples from a single donor were repeatedly tested on both platforms and an analyser was tested for surface contamination with HIV positive serum to identify how suspected specimen contamination could be occurring. RESULTS: Serial testing of diagnostic specimens yielded 163 weakly positive or discordant results. Only 3 of 163 were conclusively shown to indicate true HIV infection. Specimen contamination with HIV antibody was suspected, based on the following evidence: the proportion of positive specimens increased on repeated passage through the analysers; viral loads were low or undetectable and western blots negative or indeterminate on problem specimens; screen negative, 2nd test positive specimens tested positive when reanalysed on the screening assay; follow up specimens (where available) were negative. Similarly, an increasing number of known negative specimens became (repeatedly) sero-positive on serial passage through one of the analysers. Internal and external analyser surfaces were contaminated with HIV serum, evidence that sample splashes occur during testing. CONCLUSIONS: Due to the extreme sensitivity of these assays, contamination with minute amounts of HIV antibody can cause a negative sample to test positive. Better contamination control measures are needed on analysers used in clinical pathology environments, especially in regions where HIV sero-prevalence is high.
[Mh] Termos MeSH primário: Sorodiagnóstico da AIDS/normas
Automação Laboratorial/normas
Contaminação de Equipamentos
Infecções por HIV/sangue
[Mh] Termos MeSH secundário: Sorodiagnóstico da AIDS/instrumentação
Anticorpos Antivirais/sangue
Anticorpos Antivirais/imunologia
Automação Laboratorial/instrumentação
Reações Falso-Positivas
HIV/imunologia
Infecções por HIV/epidemiologia
Seres Humanos
Prevalência
África do Sul
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Antibodies, Viral)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170928
[Lr] Data última revisão:
170928
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170801
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0182167



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