Malawi 农村地区基于家庭的社区快速 HIV 检测具有很高的准确性。
High accuracy of home-based community rapid HIV testing in rural Malawi.
机构信息
Karonga Prevention Study, Karonga District, Malawi.
出版信息
J Acquir Immune Defic Syndr. 2010 Dec 15;55(5):625-30. doi: 10.1097/QAI.0b013e3181f98628.
OBJECTIVE
To assess the performance of rapid HIV antibody tests when used as part of a home-based community wide counseling and testing strategy in northern Malawi.
DESIGN
A cross-sectional population survey of HIV infection, 2007 to 2008.
METHODS
Adults aged 15 years or older in a demographic surveillance area were counseled and then offered an HIV test at their home by government-certified counselors. Two initial rapid tests (Determine and Uni-Gold) were performed on all samples and a third, tie-breaker test (SD Bioline) used to resolve discordant results. All people who wanted to know were posttest-counseled and informed of their results with referral to local clinical services if found to be HIV-positive. Laboratory quality control comprised retesting all positive and every tenth negative venous blood sample collected.
RESULTS
A total of 10,819 adults provided venous blood samples for HIV testing, of whom 7.5% (813) were HIV-positive. The accuracy of the parallel testing strategy used was high with 99.6% sensitivity, 100.0% specificity, 99.9% positive predictive value, and 99.9% negative predictive value.
CONCLUSION
Face-to-face rapid testing by health personnel with minimum training at the client's home performs well when used on a wide scale in the community setting.
目的
评估快速 HIV 抗体检测在马拉维北部基于社区的家庭广泛咨询和检测策略中的应用效果。
设计
2007 年至 2008 年的 HIV 感染横断面人群调查。
方法
在一个人口监测区，年龄在 15 岁及以上的成年人接受咨询，然后由政府认证的咨询师在其家中进行 HIV 检测。所有样本均进行两次初始快速检测（Determine 和 Uni-Gold），然后使用第三种、决胜检测（SD Bioline）来解决不一致的结果。所有想知道检测结果的人都接受了检测后咨询，并告知其结果，如果发现 HIV 阳性，则转介到当地临床服务机构。实验室质量控制包括对所有阳性和每 10 个阴性静脉血样进行重检。
结果
共有 10819 名成年人提供了静脉血样进行 HIV 检测，其中 7.5%（813 人）为 HIV 阳性。所使用的平行检测策略准确性较高，灵敏度为 99.6%，特异性为 100.0%，阳性预测值为 99.9%，阴性预测值为 99.9%。
结论
经过最低限度培训的卫生人员在社区环境中对客户进行面对面的快速检测，在大规模应用时效果良好。
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