High accuracy of home-based community rapid HIV testing in rural Malawi

Molesworth, A. M., Ndhlovu, R., Banda, E., Saul, J., Ngwira, B., Glynn, J. R., Crampin, A. C. and French, N. (2010) High accuracy of home-based community rapid HIV testing in rural Malawi. JAIDS: Journal of Acquired Immune Deficiency Syndromes, 55(5), pp. 625-630. (doi: 10.1097/qai.0b013e3181f98628) (PMID:21934554) (PMCID:PMC3248920)

Abstract

Objective: To assess the performance of rapid HIV antibody tests when used as part of a home-based community wide counseling and testing strategy in northern Malawi. Design: A cross-sectional population survey of HIV infection, 2007 to 2008. Methods: Adults aged 15 years or older in a demographic surveillance area were counseled and then offered an HIV test at their home by government-certified counselors. Two initial rapid tests (Determine and Uni-Gold) were performed on all samples and a third, tie-breaker test (SD Bioline) used to resolve discordant results. All people who wanted to know were posttest-counseled and informed of their results with referral to local clinical services if found to be HIV-positive. Laboratory quality control comprised retesting all positive and every tenth negative venous blood sample collected. Results: A total of 10,819 adults provided venous blood samples for HIV testing, of whom 7.5% (813) were HIV-positive. The accuracy of the parallel testing strategy used was high with 99.6% sensitivity, 100.0% specificity, 99.9% positive predictive value, and 99.9% negative predictive value. Conclusion: Face-to-face rapid testing by health personnel with minimum training at the client's home performs well when used on a wide scale in the community setting

• Item Type: Articles
• Additional Information: Funding for this study was provided by the Wellcome Trust, UK.
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Crampin, Professor Mia
• Authors: Molesworth, A. M., Ndhlovu, R., Banda, E., Saul, J., Ngwira, B., Glynn, J. R., Crampin, A. C., and French, N.
• College/School: College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Public Health
• Journal Name: JAIDS: Journal of Acquired Immune Deficiency Syndromes
• Publisher: Lippincott, Williams & Wilkins
• ISSN: 1525-4135
• ISSN (Online): 1944-7884