External quality assurance with dried tube specimens (DTS) for point-of-care syphilis and HIV tests: experience in an indigenous populations screening programme in the Brazilian Amazon
| Autor: | Ione Conceição Pereira Pinto, Nina Schwartz Benzaken, Adele Schwartz Benzaken, Rosanna W. Peeling, Christiane Lourenço Nogueira, Lisléia Golfetto, Kimberly A. Sollis, David Mabey, Enrique Galban, Maria Luiza Bazzo |
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| Rok vydání: | 2013 |
| Předmět: |
Point-of-Care Systems
Concordance Human immunodeficiency virus (HIV) HIV Infections Dermatology Reference laboratory medicine.disease_cause Screening programme Acquired immunodeficiency syndrome (AIDS) Environmental health medicine Health Services Indigenous Humans Mass Screening Syphilis Point of care business.industry Indians South American Reproducibility of Results medicine.disease Infectious Diseases Immunology Feasibility Studies Dried Blood Spot Testing business Quality assurance Brazil Program Evaluation |
| Zdroj: | Sexually Transmitted Infections. 90:14-18 |
| ISSN: | 1472-3263 1368-4973 |
| Popis: | Objectives The availability of point-of-care (POC) tests for infectious diseases has revolutionised the provision of healthcare for remote rural populations without access to laboratories. However, quality assurance for POC tests has been largely overlooked. We have evaluated the use and stability of dry tube specimens (DTS) for External Quality Assurance (EQA) for HIV and syphilis screening in remote indigenous populations in the Amazon region of Brazil. Methods All healthcare workers (HCWs) participating in the community-screening were trained. We used HIV and syphilis DTS panels developed by the reference laboratory, containing samples with negative and positive results at different antibody concentrations, for both infections. DTS panels were distributed to HCWs in the communities for reconstitution and testing using POC HIV and syphilis tests. The results of testing were sent to the reference laboratory for marking and remedial action taken where necessary. Results In total 268 HCWs tested 1607 samples for syphilis and 1608 samples for HIV. Results from HCWs showed a concordance rate of 90% for syphilis and 93% for HIV (κ coefficients of 0.74 and 0.78, respectively) with reference laboratories. Most false negatives were in samples of very low antibody concentration. DTS syphilis specimens produced the expected results after storage at 2–8°C or at 18–24°C for up to 3 weeks. Conclusions The results show that POC tests for syphilis and HIV give valid results in environments where traditional tests do not work, but errors in the interpretation of POC test results were identified by the EQA programme using DTS. EQA using DTS can help to improve the quality of screening programmes using POC tests in remote regions. |
| Databáze: | OpenAIRE |
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