Point-of-care CD4 technology invalid result rates in public health care settings across five countries

• DOI: 10.1371/journal.pone.0219021
• Publication Date: 2019-07-05T17:33:29Z
• Authors: Katherine Lamp; Seth McGovern; Youyi Fong; Biruhtesfa Abere; Adisu Kebede; Gonfa Ayana; Achamyeleh Mulugeta; Chares Diko Atem; Jean Bosco Elat N...; Divine Nzuobontane; Timothy Bollinger; Ilesh Jani; Nadia Sitoe; Charles Kiyaga; George Senyama; Phibeon Munyaradz...; Sekesai Mtapuri-Z...; Jilian A. Sacks; Naoko Doi; Trevor F. Peter; Lara Vojnov
• Keywords: Point-of-Care Testing; Point of care

Since 2010, point-of-care (POC) CD4 testing platforms have been introduced in both urban and rural settings to expand access by bringing diagnostic services closer patients. We conducted an analysis of routinely collected data determine the invalid result rates associated with POC testing.We analyzed 981,152 records from Alere Pima Analyzers between January 2011 December 2016 across five countries sub-Saharan Africa. Routinely programmatic were used rate test results per month, facility type, operator based on cumulative usage during study period. In addition, frequency types utilization control beads assessed.Across countries, 75,530 messages returned, resulting overall 7.7%. The country ranged 6.6% 11.2%. Invalid consistent types. inversely correlated usage: low volume operators (<50 tests over period) experienced 10.2%, while high (>500 5.5%. Two (exposure position reagent control) accounted for nearly 50% results. Routine showed that run 88.3% days device was used.Our found all health facilities, indicating decentralization lower level facilities did not exhibit or increase cartridge wastage. Additionally, usage, high-volume experiencing than low-volume operators. can, therefore, be performed decentralized national programs; however, adequate training, quality assurance, routine monitoring, ongoing mentorship should also implemented success.