Quality assurance for point-of-care testing: Ethiopia’s experience

Kebede, Adisu; Kebede, Yenew; Desale, Adino; Mulugeta, Achamyeleh; Yaregal, Zelalem; Gebreegziabxier, Atsbeha; Tedla, Yared; Zeh, Clement; Ayana, Gonfa

doi:10.4102/ajlm.v5i2.452

Cited by 4 publications

(7 citation statements)

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“…This study was comparable with the study conducted in Nigeria between 2009 and 2011 [7]. Four rounds of pre-characterized plasma panels for HIV, sputum films for tuberculosis and blood films for malaria were distributed quarterly scores increased from 74% to 95% from the first round to the third round, but decreased in the fourth round for HIV PT and average scores increased from 42% in the first round to 78% in the second round; but a decrease to 34% was observed in the fourth round for Tuberculosis PT while Malaria PT performance was 2% at first, but average scores increased between the second and fourth rounds, culminating in a fourth-round score of 39% which showed low performance compared to the study conducted on quality assurance for point of care testing among different heath facilities [11]. Many participants requested training and mentoring.…”

Section: Performance Ratementioning

confidence: 55%

Performance of International External Quality Assessment Scheme Participant Laboratories in Ethiopia (2016-2018)

Mekonnen¹,

Gurmessa²,

Kebede³

et al. 2020

AJLM

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Section: Performance Ratementioning

confidence: 55%

Performance of International External Quality Assessment Scheme Participant Laboratories in Ethiopia (2016-2018)

Mekonnen¹,

Gurmessa²,

Kebede³

et al. 2020

AJLM

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“…The WHO reported the underutilization of conventional VL platforms, with only a 36.5% capacity of the existing platforms being used in the reported countries (224). Similarly, other studies have reported underutilization of POC or near-POC instruments (222,225). Decentralized VL testing, if properly planned, offers several advantages, including (i) cost-efficient, flexible, and close monitoring of patients; (ii) faster turnaround times for patient results; and (iii) early detection of treatment failures for better patient management.…”

Section: Decentralization Of Vl Testingmentioning

confidence: 96%

“…Decentralized laboratories for VL testing would need to be supported by strong systems, including a sample referral network, an EQA program, human resources, a quality management system, a laboratory information system (LIS), and a supply chain. For example, Ethiopia has a decentralized laboratory network for VL determination and EID together with an effective specimen referral network to ensure that patient specimens are efficiently transported to viral testing laboratories (220)(221)(222).…”

Section: Decentralization Of Vl Testingmentioning

confidence: 99%

Diagnosis of Human Immunodeficiency Virus Infection

Parekh

Fonjungo

et al. 2018

Clin Microbiol Rev

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SUMMARY HIV diagnostics have played a central role in the remarkable progress in identifying, staging, initiating, and monitoring infected individuals on life-saving antiretroviral therapy. They are also useful in surveillance and outbreak responses, allowing for assessment of disease burden and identification of vulnerable populations and transmission “hot spots,” thus enabling planning, appropriate interventions, and allocation of appropriate funding. HIV diagnostics are critical in achieving epidemic control and require a hybrid of conventional laboratory-based diagnostic tests and new technologies, including point-of-care (POC) testing, to expand coverage, increase access, and positively impact patient management. In this review, we provide (i) a historical perspective on the evolution of HIV diagnostics (serologic and molecular) and their interplay with WHO normative guidelines, (ii) a description of the role of conventional and POC testing within the tiered laboratory diagnostic network, (iii) information on the evaluations and selection of appropriate diagnostics, (iv) a description of the quality management systems needed to ensure reliability of testing, and (v) strategies to increase access while reducing the time to return results to patients. Maintaining the central role of HIV diagnostics in programs requires periodic monitoring and optimization with quality assurance in order to inform adjustments or alignment to achieve epidemic control.

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“…Coupled with the rapid scale-up of ART services in sub-Saharan Africa, the need for appropriate treatment response monitoring approaches had become indispensable [ 13 – 15 ]. However, it becomes evident that monitoring of treatment response remains the key challenge for program managers and policymakers in Ethiopia due to sub-optimal access to HIV VL testing for routine follow-up of treatment [ 16 – 18 ].…”

Section: Introductionmentioning

confidence: 99%

Immunological status and virological suppression among HIV-infected adults on highly active antiretroviral therapy

Melku

Abebe

Teketel

et al. 2020

Environ Health Prev Med

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Background: World Health Organization (WHO) recommends that viral load ([VL) is a primary tool that clinicians and researchers have used to monitor patients on antiretroviral therapy (ART), an antiviral drug against retroviruses. Whereas, CD4 cell counts can only be used to monitor clinical response to ART in the absence of VL testing service. Therefore, this study is aimed to assess the level of immunological status and virological suppression, and identify associated factors among human immunodeficiency virus ([HIV)-infected adults who were taking antiretroviral drugs of combination regimen know as highly active antiretroviral therapy (HAART). Methods: A hospital-based cross-sectional study was conducted at the University of Gondar comprehensive specialized referral hospital from February to April 2018. A total of 323 adult participants on HAART were selected using a systematic random sampling technique and enrolled into the study. Blood samples for viral load determination and CD4 cell count were collected. Binary logistic regression analysis was used to determine factors associated with immunologic status and virological suppression in HIV patients on HAART. Odds ratio with 95% CI was used to measure the strength of association. Results: Virological suppression (VL level < 1000 copies/ml) was found in 82% (95% CI 77.7, 86.1) of study participants, and it has been associated with CD4 cell count between 350 and 499 cells/mm 3 (adjusted odds ratio (AOR) = 2.56; 95% CI 1.14, 5.75) and > 499 cells/mm 3 (AOR = 7.71; 95% CI 3.48, 17.09) at VL testing and current age > 45 years old (AOR = 5.99; 95% CI 2.12, 16.91). Similarly, favorable immunological status (≥ 400 cells/mm 3 for male and ≥ 466 cells/mm 3 for female) was observed in 52.9% (95% CI 47.4, 58.8) of the study participants. Baseline CD4 cell count of > 200 cells/mm 3 , age at enrollment of 26 through 40 years old, and urban residence were significantly associated with favorable immunological status. Conclusion: Though the majority of HIV-infected adults who were on HAART had shown viral suppression, the rate of suppression was sub-optimal according to the UNAIDS 90-90-90 target to help end the AIDS pandemic by 2020. Nonetheless, the rate of immunological recovery in the study cohort was low. Hence, early initiation of HAART should be strengthened to achieve good virological suppression and immunological recovery.

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Quality assurance for point-of-care testing: Ethiopia’s experience

Abstract: No abstract available.

Cited by 4 publications

References 0 publications

Performance of International External Quality Assessment Scheme Participant Laboratories in Ethiopia (2016-2018)

Performance of International External Quality Assessment Scheme Participant Laboratories in Ethiopia (2016-2018)

Diagnosis of Human Immunodeficiency Virus Infection

Immunological status and virological suppression among HIV-infected adults on highly active antiretroviral therapy

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