Acceptability and feasibility of point-of-care CD4 testing on HIV continuum of care in low and middle income countries: a systematic review.

Background: CD4 testing is, and will remain an important part of HIV treatment and care in low and middle income countries (LMICs). We report the findings of a systematic review assessing acceptability and feasibility of POC CD4 testing in field settings.Methods: Electronic databases were searched f...

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Published in:BMC Health Services Research Vol. 16; pp. 1 - 13
Main Authors: Pham, Minh D., Agius, Paul A., Romero, Lorena, McGlynn, Peter, Anderson, David, Crowe, Suzanne M., Luchters, Stanley
Format: research systematic review tables/charts Journal Article
Published: BioMed Central 8/2/2016
Online Access:View this record in EBSCOhost
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      dt: 8/2/2016
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      pub: BioMed Central
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        atl: Acceptability and feasibility of point-of-care CD4 testing on HIV continuum of care in low and middle income countries: a systematic review.
      aug:
        au:
          Pham, Minh D.
          Agius, Paul A.
          Romero, Lorena
          McGlynn, Peter
          Anderson, David
          Crowe, Suzanne M.
          Luchters, Stanley
        affil: Burnet Institute, Melbourne, VIC, Australia
      sug:
        subj:
          Anti-HIV Agents
          Continuity of Patient Care
          CD4 Lymphocyte Count
          Personal Satisfaction
          Primary Health Care
          Adult
          Male
          Equipment Failure
          Female
          Blood Specimen Collection
          Developing Countries
          Middle Age
          Systematic Review
          Human
          Adult: 19-44 years
          Middle Aged: 45-64 years
          Male
          Female
      ab: Background: CD4 testing is, and will remain an important part of HIV treatment and care in low and middle income countries (LMICs). We report the findings of a systematic review assessing acceptability and feasibility of POC CD4 testing in field settings.Methods: Electronic databases were searched for studies published in English between 2005 and 2015 that describe POC CD4 platforms. Studies conducted in LMICs and under field conditions outside a laboratory environment were eligible. Qualitative and descriptive data analysis was used to present the findings.Results: Twelve studies were included, 11 of which were conducted in sub-Saharan countries and used one POC CD4 test (The Alere Pima CD4). Patients reported positively regarding the implementation of POC CD4 testing at primary health care and community level with ≥90 % of patients accepting the test across various study settings. Health service providers expressed preference toward POC CD4 testing as it is easy-to-use, efficient and satisfied patients' needs to a greater extent as compared to conventional methods. However, operational challenges including preference toward venous blood rather than finger-prick sampling, frequent device failures and operator errors, quality of training for test operators and supervisors, and increased staff workload were also identified.Conclusions: POC CD4 testing seems acceptable and feasible in LIMCs under field conditions. Further studies using different POC CD4 tests available on the market are required to provide critical data to support countries in selection and implementation of appropriate POC CD4 technologies.
      pubtype: Academic Journal
      doctype:
        research
        systematic review
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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