Feasibility, Preference, and Impact of a Rapid Multiplexed Point-of-Care Digital Innovation (AideSmart!) to Expedite Screening of Sexually Transmitted Blood-Borne Infections in At-Risk Populations in Canada: Cross-Sectional Study.

Autor:	Karellis A; Research Institute of the McGill University Health Centre, Montreal, QC, Canada., Webster D; Centre for Research, Education & Clinical Care of At-Risk Populations, Saint John, NB, Canada., Boulanger J; REZO, Montreal, QC, Canada., Harland K; Centre for Research, Education & Clinical Care of At-Risk Populations, Saint John, NB, Canada., Feltmate P; Centre for Research, Education & Clinical Care of At-Risk Populations, Saint John, NB, Canada., Materniak S; Centre for Research, Education & Clinical Care of At-Risk Populations, Saint John, NB, Canada., Daunais-Laurin G; REZO, Montreal, QC, Canada., Mesa C; National Laboratory for HIV Reference Services, Winnipeg, MB, Canada., Vaikla O; Research Institute of the McGill University Health Centre, Montreal, QC, Canada., Kim J; National Laboratory for HIV Reference Services, Winnipeg, MB, Canada., Pant Pai N; Research Institute of the McGill University Health Centre, Montreal, QC, Canada.; Faculty of Medicine, McGill University, Montreal, QC, Canada.
Jazyk:	angličtina
Zdroj:	Journal of medical Internet research [J Med Internet Res] 2024 Oct 18; Vol. 26, pp. e55075. Date of Electronic Publication: 2024 Oct 18.
DOI:	10.2196/55075
Abstrakt:	Background: With the need to expedite the detection of multiple sexually transmitted blood-borne infections (STBBIs), there is an increased demand for digital innovations and tests that improve the efficiency of point-of-care testing in outreach community settings. Multiplexed testing is being offered to at-risk populations by frontline health care professionals. Objective: With this in mind, we evaluated AideSmart! (for health aides or health care workers), an integrated app and platform solution that enables multiplexed STBBI screening at the point of care, for feasibility, preference, accuracy, and impact. With AideSmart!, we provided trained health care workers with the ability to perform rapid multiplexed tests; offer STBBI pre- or posttest counseling; maintain quality assurance of testing; facilitate linkages to care; and enhance health care provider-patient communication, data documentation, and patient engagement through the multiplexed STBBI screening and linkage process. We evaluated the performance of multiplexed tests. Methods: In a cross-sectional study conducted during the COVID-19 pandemic, we recruited at-risk populations in Canada from community-based organizations in Montreal, Quebec, and Saint John, New Brunswick, with unknown serostatus for HIV, hepatitis C virus (HCV), and syphilis. Following orientation and pretest counseling with AideSmart!, we performed multiplexed tests, simultaneously screening for HIV, HCV, and syphilis, using 2 rapid investigational multiplexed tests (Chembio for HIV and syphilis and MedMira for HIV, HCV, and syphilis) followed by confirmatory testing from local and national laboratories. Results: Of the 401 participants, all (100%) accepted the AideSmart! multiplexed strategy: 59.4% (148/249) preferred multiplexed rapid tests over laboratory tests, and 56.6% (141/249) preferred receiving same-day test results. Rapid test results were obtained in 15 minutes (vs laboratory tests at 4-24 days). A total of 29 new infections (n=27, 93% HCV; n=1, 3% syphilis; and n=1, 3% HIV) were identified and treated within a week. Feasibility of the strategy (completion of testing and linkages to care) was at 76.1% (305/401). Health care professionals provided positive feedback and emphasized the importance of knowing one's negative or positive serostatus, especially during a pandemic. Multiplexed rapid tests' specificity (against laboratory reference standards) exceeded 98% (98.7%-100%) for all pathogens and devices. An electronic reader, used by the Chembio rapid test, enhanced sensitivity (HIV: 100%, 95% CI 79.4%-100%; syphilis: 86.8%, 95% CI 71.9%-95.6% [Chembio] vs HIV: 100%, 95% CI 78.2%-100%; HCV: 90.3%, 95% CI 80.1%-96.4%; and syphilis: 57.9%, 95% CI 40.8%-73.7% [MedMira]). Conclusions: The AideSmart! digital multiplexed rapid screening strategy for health care workers facilitated STBBI testing for multiple STBBIs and arranged for pre- or posttest counseling and rapid linkages with high feasibility and acceptability. Electronic readers enhanced the diagnostic performance of multiplexed biomarker tests. This study generated data in support of digital multiplexed strategies in digitally enabled settings for at-risk populations nationally and worldwide. (©Angela Karellis, Duncan Webster, Jean Boulanger, Kate Harland, Paige Feltmate, Stefanie Materniak, Gabriel Daunais-Laurin, Christine Mesa, Olivia Vaikla, John Kim, Nitika Pant Pai. Originally published in the Journal of Medical Internet Research (https://www.jmir.org), 18.10.2024.)
Databáze:	MEDLINE
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