Accuracy and Feasibility of Point of Care (POC) Early Infant Diagnosis (EID) in Nigeria: A Field Evaluation
The timely commencement of treatment within the first
12 weeks of life in children reduces the HIV disease progression by 75% and mortality
by 76%. For all children infected with HIV to receive essential treatment and care,
few things are more important than early and accurate HIV diagnosis. Traditional
methods of providing Early Infant Diagnosis (EID) have been bedeviled with several
challenges. Point of Care (POC) testing for EID has been recommended as a game-changer.
A field evaluation was conducted across 6 healthcare facilities between February
2017 and August 2018 to determine the accuracy and operational feasibility of POC
testing for EID in Nigeria. The conceptual framework rides on the WHO SDI ASSURED
criteria. Participants were infants aged between 4 weeks and 18 months born to HIV-positive
mothers and visiting the clinic for the first time for EID. Results obtained from
the POC was compared with the Standard of Care (SOC) to determine accuracy and feasibility.
A total of 245 participants took part in the study, with 76% visiting the clinic
for EID within 2 months of life. The average turnaround time for EID test using
the SOC was 67 days. Analysis of the 10.4% error rate indicate significant correlation
by personnel (r= 0.01122, P=0.841706). An average concordance percentage of 99.6%,
sensitivity of 91.7% and specificity of 100.0% was observed. Operator’s assessment
indicates that the equipment is very good and acceptable. The POC testing for EID
is acceptable, rapid, and robust; hence, viable for use in Nigeria.
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