Ikpe George, Ugwu Chukwuebuka, Amuta Chukwuemeka, Oparaocha Chibueze, Anyigor Chika J, Omoniyi Peter I, Chukwudinma Okwudili
Department of Public Health, Federal Ministry of Health, Abuja, Nigeria.
Department of Public Health, Faculty of Community Medicine, Abia State University, Aba, Nigeria.
J Public Health Afr. 2025 Aug 6;16(1):1265. doi: 10.4102/jphia.v16i1.1265. eCollection 2025.
Lateral flow lipoarabinomannan (LF-LAM) test used in the diagnosis of active tuberculosis (TB) among patients with advanced human immunodeficiency virus (HIV) disease remains a relatively new approach in the diagnosis of TB in Nigeria. This study focused on the use of LF-LAM assay Alere Determine™ in the diagnosis of active tuberculosis among patients with advanced HIV disease in Abia State.
This study was carried out to identify potential gaps that could be missed along the LF-LAM implementation cascade, which can be strengthened to improve quality of patients' care, while gaining insight into health workers' understanding of the test.
This study was carried out in Abia State, Nigeria.
Electronic data were extracted through a query run on health facility electronic databases, while manual chart abstraction was performed in facilities without and incomplete electronic medical records. In addition, qualitative interviews were conducted among health workers to gain insight.
Out of 1249 newly enrolled patients who were eligible for the test, only 605 (48.4%) were tested, and 644 (51.6%) were missed within the study period (October 2022 - September 2023). Out of this number, 159 (26.3%) were positive for the test, and only 68 (42%) were sent for further testing with GeneXpert, while 30 (18.9%) had no testing with GeneXpert and 61 (38.9%) had no documentation.
Low awareness and capacity among health workers including poor documentation practices contributed to missed opportunities for the patients who could have benefitted from this test.
The study recommends comprehensive training of healthcare workers on the utilisation of LF-LAM test and improvement of documentation practices in Abia State and Nigeria.
在晚期人类免疫缺陷病毒（HIV）疾病患者中用于诊断活动性结核病（TB）的侧向流动脂阿拉伯甘露聚糖（LF-LAM）检测在尼日利亚仍是结核病诊断中一种相对较新的方法。本研究聚焦于使用Alere Determine™ LF-LAM检测法在阿比亚州晚期HIV疾病患者中诊断活动性结核病。
本研究旨在识别LF-LAM实施流程中可能被遗漏的潜在差距，这些差距可得到强化以提高患者护理质量，同时深入了解卫生工作者对该检测的理解。
本研究在尼日利亚阿比亚州开展。
通过在医疗机构电子数据库上运行查询提取电子数据，而在没有电子病历或电子病历不完整的机构中进行手工病历摘要。此外，对卫生工作者进行定性访谈以深入了解情况。
在1249名符合检测条件的新登记患者中，在研究期间（2022年10月至2023年9月）仅有605名（48.4%）接受了检测，644名（51.6%）被遗漏。在这些被遗漏的患者中，159名（26.3%）检测呈阳性，仅有68名（42%）被送去用GeneXpert进行进一步检测，30名（18.9%）未用GeneXpert检测，61名（38.9%）没有记录。
卫生工作者的认识和能力较低，包括记录做法不佳，导致可能从该检测中受益的患者失去了机会。
该研究建议在阿比亚州和尼日利亚对医护人员进行关于LF-LAM检测使用的全面培训，并改善记录做法。
