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Improving the quality of HIV rapid testing in Ghana using the dried tube specimen-based proficiency testing program
BACKGROUND: The introduction of human immunodeficiency virus (HIV) antibody rapid testing (RT) in resource-limited settings has proven to be a successful intervention to increase access to prevention measures and improve timely linkage to care. However, the quality of testing has not always kept pac...
Autores principales: | , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9565402/ https://www.ncbi.nlm.nih.gov/pubmed/36240208 http://dx.doi.org/10.1371/journal.pone.0264105 |
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author | Nkrumah, Bernard Iriemenam, Nnaemeka C. Frimpong, Francis Kalou, Mireille B. Botchway, Berenice Adukpo, Rowland Jackson, Keisha G. Angra, Pawan Whistler, Toni Adhikari, Amitabh P. Ayisi-Addo, Stephen Melchior, Michael A. |
author_facet | Nkrumah, Bernard Iriemenam, Nnaemeka C. Frimpong, Francis Kalou, Mireille B. Botchway, Berenice Adukpo, Rowland Jackson, Keisha G. Angra, Pawan Whistler, Toni Adhikari, Amitabh P. Ayisi-Addo, Stephen Melchior, Michael A. |
author_sort | Nkrumah, Bernard |
collection | PubMed |
description | BACKGROUND: The introduction of human immunodeficiency virus (HIV) antibody rapid testing (RT) in resource-limited settings has proven to be a successful intervention to increase access to prevention measures and improve timely linkage to care. However, the quality of testing has not always kept pace with the scale-up of this testing strategy. To monitor the accuracy of HIV RT test results, a national proficiency testing (PT) program was rolled out at selected testing sites in Ghana using the dried tube specimen (DTS) approach. METHODS: Between 2015 and 2018, 635 HIV testing sites, located in five regions and supported by the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR), were enrolled in the HIV PT program of the Ghana Health Service National AIDS/STI Control Programme. These sites offered various services: HIV Testing and Counselling (HTC), prevention of mother-to-child transmission (PMTCT) and Antiretroviral Treatment (ART). The PT panels, composed of six DTS, were prepared by two regional laboratories, using fully characterized plasma obtained from the regional blood banks and distributed to the testing sites. The results were scored by the PT providers according to the predefined acceptable performance criteria which was set at ≥ 95%. RESULTS: Seven rounds of PT panels were completed successfully over three years. The number of sites enrolled increased from 205 in round 1 (June 2015) to 635 in round 7 (December 2018), with a noticeable increase in Greater Accra and Eastern regions. The average participation rates of enrolled sites ranged from 88.0% to 98.0% across the PT rounds. By round 7, HTC (257/635 (40.5%)) and PMTCT (237/635 (37.3%)) had a larger number of sites that participated in the PT program than laboratory (106/635 (16.7%)) and ART (12/635 (1.9%)) sites. The average testing performance rate improved significantly from 27% in round 1 to 80% in round 7 (p < 0.001). The highest performance rate was observed for ART (100%), HTC (92%), ANC/PMTCT (90%) and Laboratory (89%) in round 5. CONCLUSION: The DTS PT program showed a significant increase in the participation and performance rates during this period. Sub-optimal performances observed was attributed to non-compliance to the national testing algorithm and testing technique. However, the implementation of review meetings, peer-initiated corrective action, supportive supervisory training, and mentorship proved impactful. The decentralized approach to preparing the PT panels ensured ownership by the region and districts. |
format | Online Article Text |
id | pubmed-9565402 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-95654022022-10-15 Improving the quality of HIV rapid testing in Ghana using the dried tube specimen-based proficiency testing program Nkrumah, Bernard Iriemenam, Nnaemeka C. Frimpong, Francis Kalou, Mireille B. Botchway, Berenice Adukpo, Rowland Jackson, Keisha G. Angra, Pawan Whistler, Toni Adhikari, Amitabh P. Ayisi-Addo, Stephen Melchior, Michael A. PLoS One Research Article BACKGROUND: The introduction of human immunodeficiency virus (HIV) antibody rapid testing (RT) in resource-limited settings has proven to be a successful intervention to increase access to prevention measures and improve timely linkage to care. However, the quality of testing has not always kept pace with the scale-up of this testing strategy. To monitor the accuracy of HIV RT test results, a national proficiency testing (PT) program was rolled out at selected testing sites in Ghana using the dried tube specimen (DTS) approach. METHODS: Between 2015 and 2018, 635 HIV testing sites, located in five regions and supported by the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR), were enrolled in the HIV PT program of the Ghana Health Service National AIDS/STI Control Programme. These sites offered various services: HIV Testing and Counselling (HTC), prevention of mother-to-child transmission (PMTCT) and Antiretroviral Treatment (ART). The PT panels, composed of six DTS, were prepared by two regional laboratories, using fully characterized plasma obtained from the regional blood banks and distributed to the testing sites. The results were scored by the PT providers according to the predefined acceptable performance criteria which was set at ≥ 95%. RESULTS: Seven rounds of PT panels were completed successfully over three years. The number of sites enrolled increased from 205 in round 1 (June 2015) to 635 in round 7 (December 2018), with a noticeable increase in Greater Accra and Eastern regions. The average participation rates of enrolled sites ranged from 88.0% to 98.0% across the PT rounds. By round 7, HTC (257/635 (40.5%)) and PMTCT (237/635 (37.3%)) had a larger number of sites that participated in the PT program than laboratory (106/635 (16.7%)) and ART (12/635 (1.9%)) sites. The average testing performance rate improved significantly from 27% in round 1 to 80% in round 7 (p < 0.001). The highest performance rate was observed for ART (100%), HTC (92%), ANC/PMTCT (90%) and Laboratory (89%) in round 5. CONCLUSION: The DTS PT program showed a significant increase in the participation and performance rates during this period. Sub-optimal performances observed was attributed to non-compliance to the national testing algorithm and testing technique. However, the implementation of review meetings, peer-initiated corrective action, supportive supervisory training, and mentorship proved impactful. The decentralized approach to preparing the PT panels ensured ownership by the region and districts. Public Library of Science 2022-10-14 /pmc/articles/PMC9565402/ /pubmed/36240208 http://dx.doi.org/10.1371/journal.pone.0264105 Text en https://creativecommons.org/publicdomain/zero/1.0/This is an open access article, free of all copyright, and may be freely reproduced, distributed, transmitted, modified, built upon, or otherwise used by anyone for any lawful purpose. The work is made available under the Creative Commons CC0 (https://creativecommons.org/publicdomain/zero/1.0/) public domain dedication. |
spellingShingle | Research Article Nkrumah, Bernard Iriemenam, Nnaemeka C. Frimpong, Francis Kalou, Mireille B. Botchway, Berenice Adukpo, Rowland Jackson, Keisha G. Angra, Pawan Whistler, Toni Adhikari, Amitabh P. Ayisi-Addo, Stephen Melchior, Michael A. Improving the quality of HIV rapid testing in Ghana using the dried tube specimen-based proficiency testing program |
title | Improving the quality of HIV rapid testing in Ghana using the dried tube specimen-based proficiency testing program |
title_full | Improving the quality of HIV rapid testing in Ghana using the dried tube specimen-based proficiency testing program |
title_fullStr | Improving the quality of HIV rapid testing in Ghana using the dried tube specimen-based proficiency testing program |
title_full_unstemmed | Improving the quality of HIV rapid testing in Ghana using the dried tube specimen-based proficiency testing program |
title_short | Improving the quality of HIV rapid testing in Ghana using the dried tube specimen-based proficiency testing program |
title_sort | improving the quality of hiv rapid testing in ghana using the dried tube specimen-based proficiency testing program |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9565402/ https://www.ncbi.nlm.nih.gov/pubmed/36240208 http://dx.doi.org/10.1371/journal.pone.0264105 |
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