Xpert HIV-1 qual point-of-care testing for HIV early infant diagnosis in Tanzania: experiences and perceptions of health care workers in a 2016 study.

IF 2.1 4区 医学 Q3 INFECTIOUS DISEASES
Siriel Boniface, Anange Lwilla, Hellen Mahiga, Doreen Pamba, Otto Geisenberger, John France, Rebecca Mokeha, Lilian Njovu, Abisai Kisinda, Nyanda Elias Ntinginya, Michael Hoelscher, Arne Kroidl, Issa Sabi
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Abstract

Background: HIV early infant diagnosis (HEID) at the centralized laboratory faces many challenges that impact the cascade of timely HEID. Point of Care (PoC) HEID has shown to reduce test turnaround times, allow for task shifting and has the potential to reduce infant mortality. We aimed at assessing the feasibility of nurse based PoC-HEID in five facilities of Mbeya region.

Methods: We analysed data from healthcare workers at five obstetric health facilities that participated in the BABY study which enrolled mothers living with HIV and their HIV exposed infants who were followed up until 6 weeks post-delivery. Nurses and laboratory personnel were trained and performed HEID procedures using the Xpert HIV-1 Qual PoC systems. Involved personnel were interviewed on feasibility, knowledge and competency of procedures and overall impression of the use of HIV-1 Qual PoC system in clinical settings.

Results: A total of 28 health care workers (HCWs) who participated in the study between 2014 and 2016 were interviewed, 23 being nurses, 1 clinical officer, 1 lab scientist and 3 lab technicians The median age was 39.5 years. Majority of the nurses (22/24) and all lab staff were confident using Gene Xpert PoC test after being trained. None of them rated Gene Xpert handling as too complicated despite minor challenges. Five HCWs (5/24) reported power cut as the most often occurring problem. As an overall impression, all interviewees agreed on PoC HEID to be used in clinical settings however, about half of them (11/24) indicated that the PoC-HEID procedures add a burden onto their routine workload.

Conclusion: Overall, health care workers in our study demonstrated very good perceptions and experiences of using PoC HEID. Efforts should be invested on quality training, targeted task distribution at the clinics, continual supportive supervision and power back up mechanisms to make the wide-scale adoption of nurse based PoC HEID testing a possibility.

坦桑尼亚用于婴儿艾滋病早期诊断的 Xpert HIV-1 质量护理点检测:2016 年一项研究中医护人员的经验和看法。
背景:集中实验室的婴儿艾滋病早期诊断(HEID)工作面临着许多挑战,这些挑战影响了婴儿艾滋病早期诊断的及时性。实践证明,护理点(PoC)婴儿艾滋病早期诊断(HEID)可缩短检测周转时间,实现任务转移,并有可能降低婴儿死亡率。我们的目的是评估在姆贝亚地区的五家医疗机构开展以护士为基础的 PoC-HEID 的可行性:我们分析了参与 BABY 研究的五家产科医疗机构的医护人员提供的数据,该研究招募了感染 HIV 的母亲及其感染 HIV 的婴儿,并对其进行随访至分娩后 6 周。护士和实验室人员接受了培训,并使用 Xpert HIV-1 Qual PoC 系统执行了 HEID 程序。对相关人员进行了访谈,内容涉及程序的可行性、知识和能力,以及在临床环境中使用 HIV-1 Qual PoC 系统的总体印象:共有 28 名医护人员(HCWs)在 2014 年至 2016 年间参与了该研究,其中 23 人为护士,1 人为临床官员,1 人为实验室科学家,3 人为实验室技术人员。大多数护士(22/24)和所有实验室工作人员在接受培训后都有信心使用基因 Xpert PoC 检测。尽管存在一些小问题,但没有人认为基因 Xpert 的操作过于复杂。五名医护人员(5/24)报告说,断电是最经常出现的问题。总体印象是,所有受访者都同意在临床环境中使用PoC-HEID,但约有一半受访者(11/24)表示,PoC-HEID程序给他们的日常工作量增加了负担:总体而言,在我们的研究中,医护人员对使用 PoC HEID 有非常好的认识和经验。应努力开展高质量的培训、在诊所进行有针对性的任务分配、持续的支持性监督和后备电源机制,以便能够广泛采用基于护士的 PoC HEID 检测。
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来源期刊
AIDS Research and Therapy
AIDS Research and Therapy INFECTIOUS DISEASES-
CiteScore
3.80
自引率
4.50%
发文量
51
审稿时长
16 weeks
期刊介绍: AIDS Research and Therapy publishes articles on basic science, translational, clinical, social, epidemiological, behavioral and educational sciences articles focused on the treatment and prevention of HIV/AIDS, and the search for the cure. The Journal publishes articles on novel and developing treatment strategies for AIDS as well as on the outcomes of established treatment strategies. Original research articles on animal models that form an essential part of the AIDS treatment research are also considered
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