*Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, United Kingdom; †TB and HIV Group, Malawi-Liverpool-Wellcome Trust Clinical Research Programme, Blantyre, Malawi; ‡Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, United Kingdom; §Department of Pathology and Laboratory Medical Sciences, College of Medicine, University of Malawi, Blantyre, Malawi; ‖Department of International Public Health, Liverpool School of Tropical Medicine, Liverpool, United Kingdom; and ¶HIV Department, Ministry of Health, Lilongwe, Malawi.
J Acquir Immune Defic Syndr. 2014 Feb 1;65(2):e74-8. doi: 10.1097/QAI.0b013e3182a20e74.
The accuracy of a novel community health worker antiretroviral therapy eligibility assessment tool was examined in community members in Blantyre, Malawi. Nurses independently performed World Health Organization (WHO) staging and CD4 counts. One hundred ten (55.6%) of 198 HIV-positive participants had a CD4 count of <350 cells per cubic millimeter. The community health worker tool significantly outperformed WHO clinical staging in identifying CD4 count of <350 cells per cubic millimeter in terms of sensitivity (41% vs. 19%), positive predictive value (75% vs. 68%), negative predictive values (53% vs. 47%), and area under the receiver-operator curve (0.62 vs. 0.54; P = 0.017). Reliance on WHO staging is likely to result in missed and delayed antiretroviral therapy initiation.
研究人员在马拉维布兰太尔的社区成员中检验了一种新型社区卫生工作者抗逆转录病毒治疗资格评估工具的准确性。护士独立进行世界卫生组织（WHO）分期和 CD4 计数。在 198 名 HIV 阳性参与者中，有 110 名（55.6%）的 CD4 计数<350 个细胞/立方毫米。就敏感性（41%对 19%）、阳性预测值（75%对 68%）、阴性预测值（53%对 47%）和接收者操作特征曲线下面积（0.62 对 0.54；P=0.017）而言，社区卫生工作者工具在识别 CD4 计数<350 个细胞/立方毫米方面显著优于 WHO 临床分期。依赖 WHO 分期可能导致抗逆转录病毒治疗的机会错失和延迟。
