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

Authors

Minh D. Pham, Burnet Institute, Australia
Paul A. Agius, Burnet Institute, Australia
Lorena Romero, The Alfred Hospital, The Ian Potter Library, Australia
Peter McGlynn, Monash University, Australia
David Anderson, Burnet Institute, Australia
Suzanne M. Crowe, Burnet Institute, Australia
Stanley Luchters, Aga Khan UniversityFollow

Document Type

Article

Department

Population Health (East Africa)

Abstract

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.

Comments

This work was published before the author joined Aga Khan University.

Publication (Name of Journal)

BMC Health Services Research

Recommended Citation

Pham, M. D., Agius, P. A., Romero, L., McGlynn, P., Anderson, D., Crowe, S. M., Luchters, S. (2016). Acceptability and feasibility of point-of-care CD4 testing on HIV continuum of care in low and middle income countries: a systematic review. BMC Health Services Research, 16(343), 1-12.
Available at: https://ecommons.aku.edu/eastafrica_fhs_mc_popul_health/53

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.