Scorgie Fiona, Mohamed Yasmin, Anderson David, Crowe Suzanne M, Luchters Stanley, Chersich Matthew F
Wits Reproductive Health and HIV Institute (Wits RHI), Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
Burnet Institute, Melbourne, Australia.
BMC Health Serv Res. 2019 Feb 14;19(1):123. doi: 10.1186/s12913-019-3948-x.
Accurate measurement of CD4 cell counts remains an important tenet of clinical care for people living with HIV. We assessed an instrument-free point-of-care CD4 test (VISITECT® CD4) based on a lateral flow principle, which gives visual results after 40 min. The test involves five steps and categorises CD4 counts as above or below 350 cells/μL. As one component of a performance evaluation of the test, this qualitative study explored the views of healthcare workers in a large women and children's hospital on the acceptability and feasibility of the test.
Perspectives on the VISITECT® CD4 test were elicited through in-depth interviews with eight healthcare workers involved in the performance evaluation at an antenatal care facility in Johannesburg, South Africa. Audio recordings were transcribed in full and analysed thematically.
Healthcare providers recognised the on-going relevance of CD4 testing. All eight perceived the VISITECT® CD4 test to be predominantly user-friendly, although some felt that the need for precision and optimal concentration in performing test procedures made it more challenging to use. The greatest strength of the test was perceived to be its quick turn-around of results. There were mixed views on the semi-quantitative nature of the test results and how best to integrate this test into existing health services. Participants believed that patients in this setting would likely accept the test, given their general familiarity with other point-of-care tests.
Overall, the VISITECT® CD4 test was acceptable to healthcare workers and those interviewed were supportive of scale-up and implementation in other antenatal care settings. Both health workers and patients will need to be oriented to the semi-quantitative nature of the test and how to interpret the results of tests.
准确测量CD4细胞计数仍然是HIV感染者临床护理的一项重要原则。我们评估了一种基于侧向流动原理的无需仪器的即时检测CD4测试（VISITECT® CD4），该测试在40分钟后给出可视化结果。该测试包括五个步骤，并将CD4计数分为高于或低于350个细胞/μL。作为该测试性能评估的一个组成部分，这项定性研究探讨了一家大型妇幼医院的医护人员对该测试的可接受性和可行性的看法。
通过对南非约翰内斯堡一家产前护理机构参与性能评估的八名医护人员进行深入访谈，了解他们对VISITECT® CD4测试的看法。对音频记录进行了全文转录，并进行了主题分析。
医疗服务提供者认识到CD4检测的持续相关性。所有八人都认为VISITECT® CD4测试主要对用户友好，尽管有些人认为在执行测试程序时需要精度和最佳浓度使其使用起来更具挑战性。该测试最大的优势被认为是其快速得出结果。对于测试结果的半定量性质以及如何最好地将该测试整合到现有医疗服务中，存在不同看法。参与者认为，鉴于患者对其他即时检测测试普遍熟悉，该环境中的患者可能会接受该测试。
总体而言，医护人员可以接受VISITECT® CD4测试，接受采访的人员支持在其他产前护理环境中扩大规模并实施该测试。医护人员和患者都需要了解该测试的半定量性质以及如何解释测试结果。
