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Validation of a screening tool to identify older children living with HIV in primary care facilities in high HIV prevalence settings

OBJECTIVE: We previously proposed a simple tool consisting of five items to screen for risk of HIV infection in adolescents (10–19 years) in Zimbabwe. The objective of this study is to validate the performance of this screening tool in children aged 6–15 years attending primary healthcare facilities...

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Autores principales: Bandason, Tsitsi, McHugh, Grace, Dauya, Ethel, Mungofa, Stanley, Munyati, Shungu M., Weiss, Helen A., Mujuru, Hilda, Kranzer, Katharina, Ferrand, Rashida A.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Lippincott Williams & Wilkins 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4937807/
https://www.ncbi.nlm.nih.gov/pubmed/26588175
http://dx.doi.org/10.1097/QAD.0000000000000959
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author Bandason, Tsitsi
McHugh, Grace
Dauya, Ethel
Mungofa, Stanley
Munyati, Shungu M.
Weiss, Helen A.
Mujuru, Hilda
Kranzer, Katharina
Ferrand, Rashida A.
author_facet Bandason, Tsitsi
McHugh, Grace
Dauya, Ethel
Mungofa, Stanley
Munyati, Shungu M.
Weiss, Helen A.
Mujuru, Hilda
Kranzer, Katharina
Ferrand, Rashida A.
author_sort Bandason, Tsitsi
collection PubMed
description OBJECTIVE: We previously proposed a simple tool consisting of five items to screen for risk of HIV infection in adolescents (10–19 years) in Zimbabwe. The objective of this study is to validate the performance of this screening tool in children aged 6–15 years attending primary healthcare facilities in Zimbabwe. METHODS: Children who had not been previously tested for HIV underwent testing with caregiver consent. The screening tool was modified to include four of the original five items to be appropriate for the younger age range, and was administered. A receiver operator characteristic analysis was conducted to determine a suitable cut-off score. The sensitivity, specificity and predictive value of the modified tool were assessed against the HIV test result. RESULTS: A total of 9568 children, median age 9 (interquartile, IQR: 7–11) years and 4971 (52%) men, underwent HIV testing. HIV prevalence was 4.7% (95% confidence interval, CI:4.2–5.1%) and increased from 1.4% among those scoring zero on the tool to 63.6% among those scoring four (P < 0.001). Using a score of not less than one as the cut-off for HIV testing, the tool had a sensitivity of 80.4% (95% CI:76.5–84.0%), specificity of 66.3% (95% CI:65.3–67.2%), positive predictive value of 10.4% and a negative predictive value of 98.6%. The number needed to screen to identify one child living with HIV would drop from 22 to 10 if this screening tool was used. CONCLUSION: The screening tool is a simple and sensitive method to identify children living with HIV in this setting. It can be used by lay healthcare workers and help prioritize limited resources.
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spelling pubmed-49378072016-07-26 Validation of a screening tool to identify older children living with HIV in primary care facilities in high HIV prevalence settings Bandason, Tsitsi McHugh, Grace Dauya, Ethel Mungofa, Stanley Munyati, Shungu M. Weiss, Helen A. Mujuru, Hilda Kranzer, Katharina Ferrand, Rashida A. AIDS Epidemiology and Social OBJECTIVE: We previously proposed a simple tool consisting of five items to screen for risk of HIV infection in adolescents (10–19 years) in Zimbabwe. The objective of this study is to validate the performance of this screening tool in children aged 6–15 years attending primary healthcare facilities in Zimbabwe. METHODS: Children who had not been previously tested for HIV underwent testing with caregiver consent. The screening tool was modified to include four of the original five items to be appropriate for the younger age range, and was administered. A receiver operator characteristic analysis was conducted to determine a suitable cut-off score. The sensitivity, specificity and predictive value of the modified tool were assessed against the HIV test result. RESULTS: A total of 9568 children, median age 9 (interquartile, IQR: 7–11) years and 4971 (52%) men, underwent HIV testing. HIV prevalence was 4.7% (95% confidence interval, CI:4.2–5.1%) and increased from 1.4% among those scoring zero on the tool to 63.6% among those scoring four (P < 0.001). Using a score of not less than one as the cut-off for HIV testing, the tool had a sensitivity of 80.4% (95% CI:76.5–84.0%), specificity of 66.3% (95% CI:65.3–67.2%), positive predictive value of 10.4% and a negative predictive value of 98.6%. The number needed to screen to identify one child living with HIV would drop from 22 to 10 if this screening tool was used. CONCLUSION: The screening tool is a simple and sensitive method to identify children living with HIV in this setting. It can be used by lay healthcare workers and help prioritize limited resources. Lippincott Williams & Wilkins 2016-03-13 2016-02-28 /pmc/articles/PMC4937807/ /pubmed/26588175 http://dx.doi.org/10.1097/QAD.0000000000000959 Text en Copyright © 2016 Wolters Kluwer Health, Inc. All rights reserved. http://creativecommons.org/licenses/by-nc-nd/4.0 This is an open access article distributed under the Creative Commons Attribution License 4.0, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. http://creativecommons.org/licenses/by-nc-nd/4.0
spellingShingle Epidemiology and Social
Bandason, Tsitsi
McHugh, Grace
Dauya, Ethel
Mungofa, Stanley
Munyati, Shungu M.
Weiss, Helen A.
Mujuru, Hilda
Kranzer, Katharina
Ferrand, Rashida A.
Validation of a screening tool to identify older children living with HIV in primary care facilities in high HIV prevalence settings
title Validation of a screening tool to identify older children living with HIV in primary care facilities in high HIV prevalence settings
title_full Validation of a screening tool to identify older children living with HIV in primary care facilities in high HIV prevalence settings
title_fullStr Validation of a screening tool to identify older children living with HIV in primary care facilities in high HIV prevalence settings
title_full_unstemmed Validation of a screening tool to identify older children living with HIV in primary care facilities in high HIV prevalence settings
title_short Validation of a screening tool to identify older children living with HIV in primary care facilities in high HIV prevalence settings
title_sort validation of a screening tool to identify older children living with hiv in primary care facilities in high hiv prevalence settings
topic Epidemiology and Social
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4937807/
https://www.ncbi.nlm.nih.gov/pubmed/26588175
http://dx.doi.org/10.1097/QAD.0000000000000959
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