A novel community health worker tool outperforms WHO clinical staging for assessment of antiretroviral therapy eligibility in a resource-limited setting

MacPherson, P. et al. (2014) A novel community health worker tool outperforms WHO clinical staging for assessment of antiretroviral therapy eligibility in a resource-limited setting. JAIDS Journal of Acquired Immune Deficiency Syndromes, 65(2), e74-e78. (doi: 10.1097/QAI.0b013e3182a20e74) (PMID:23846567) (PMCID:PMC3966510)

Abstract

The accuracy of a novel community health worker antiretroviral therapy eligibility assessment tool was examined in community members in Blantyre, Malawi. Nurses independently performed World Health Organization (WHO) staging and CD4 counts. One hundred ten (55.6%) of 198 HIV-positive participants had a CD4 count of <350 cells per cubic millimeter. The community health worker tool significantly outperformed WHO clinical staging in identifying CD4 count of <350 cells per cubic millimeter in terms of sensitivity (41% vs. 19%), positive predictive value (75% vs. 68%), negative predictive values (53% vs. 47%), and area under the receiver–operator curve (0.62 vs. 0.54; P = 0.017). Reliance on WHO staging is likely to result in missed and delayed antiretroviral therapy initiation.

• Item Type: Articles
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: MacPherson, Professor Peter
• Authors: MacPherson, P., Lalloo, D. G., Thindwa, D., Webb, E. L., Squire, S. B., Chipungu, G. A., Desmond, N., Makombe, S. D., Taegtmeyer, M., Choko, A. T., and Corbett, E. L.
• 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 and Wilkins
• ISSN: 1525-4135
• ISSN (Online): 1944-7884
• Published Online: 23 January 2014
• Copyright Holders: Copyright © 2013 by Lippincott Williams and Wilkins
• First Published: First published in Journal of Acquired Immune Deficiency Syndromes 65(2): e74–e78
• Publisher Policy: Reproduced under a Creative Commons licence