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. 2020 Feb 1;10(2):81.
doi: 10.3390/diagnostics10020081.

Assessment of the Impact of Rapid Point-of-Care CD4 Testing in Primary Healthcare Clinic Settings: A Survey Study of Client and Provider Perspectives

Shabashini Reddy  1   2 , Andrew Gibbs  3 , Elizabeth Spooner  4 , Noluthando Ngomane  5 , Tarylee Reddy  6 , Nozipho Luthuli  7 , Gita Ramjee  4 , Anna Coutsoudis  8 , Photini Kiepiela  1   2
Affiliations

Assessment of the Impact of Rapid Point-of-Care CD4 Testing in Primary Healthcare Clinic Settings: A Survey Study of Client and Provider Perspectives

Shabashini Reddy et al. Diagnostics (Basel). .

Abstract

Background: The high burden of disease in South Africa presents challenges to public health services. Point-of-care (POC) technologies have the potential to address these gaps and improve healthcare systems. This study ascertained the acceptability and impact of POC CD4 testing on patients' health and clinical management.

Methods: We conducted a qualitative survey study with patients (n = 642) and healthcare providers (n = 13) at the Lancers Road (experienced POC) and Chesterville (non-experienced POC) primary healthcare (PHC) clinics from September 2015 to June 2016.

Results: Patients (99%) at Lancers and Chesterville PHCs were positive about POC CD4 testing, identifying benefits: No loss/delay of test results (6.4%), cost/time saving (19.5%), and no anxiety (5.1%), and 58.2% were ready to initiate treatment. Significantly more patients at Chesterville than Lancers Road PHC felt POC would provide rapid clinical decision making (64.7% vs. 48.1%; p < 0.0001) and better clinic accessibility (40.4% vs. 24.7%; p < 0.0001) respectively. Healthcare providers thought same-day CD4 results would impact: Clinical management (46.2%), patient readiness (46.2%), and adherence (23.0%), and would reduce follow-up visits (7.7%), while 38.5% were concerned that further tests and training (15.4%) were required before antiretroviral therapy (ART) initiation.

Conclusion: The high acceptability of POC CD4 testing and the immediate health, structural, and clinical management benefits necessitates POC implementation studies.

Keywords: acceptability; healthcare providers; patients; point-of-care CD4+ t testing; primary healthcare clinics; qualitative survey.

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Conflict of interest statement

The authors declare that they have no financial or personal relationship(s) that may have inappropriately influenced them in writing this article.

Figures

Figure 1
Figure 1
Schematic flow of the PHC clinic procedures with respect to HIV Counselling and Testing (HCT) [29].
See this image and copyright information in PMC

References

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