The failure of routine rapid HIV testing: a case study of improving low sensitivity in the field |
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| Authors: | Benjamin J Wolpaw Catherine Mathews Mickey Chopra Diana Hardie Virginia de Azevedo Karen Jennings Mark N Lurie |
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| Institution: | (1) Health Systems Research Unit, South African Medical Research Council, Cape Town, South Africa;(2) School of Public Health and Family Medicine, University of Public Health, Cape Town, South Africa;(3) School of Public Health, University of the Western Cape, Bellville, South Africa;(4) National Health Laboratory Service and Division of Virology, University of Cape Town, Cape Town, South Africa;(5) Cape Town City Health Department, City of Cape Town, Cape Town, South Africa;(6) Department of Community Health, Brown University Medical School, Providence, USA |
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| Abstract: | Background The rapid HIV antibody test is the diagnostic tool of choice in low and middle-income countries. Previous evidence suggests
that rapid HIV diagnostic tests may underperform in the field, failing to detect a substantial number of infections. A research
study inadvertently discovered that a clinic rapid HIV testing process was failing to detect cases of established (high antibody
titer) infection, exhibiting an estimated 68.7% sensitivity (95% CI 41.3%-89.0%]) over the course of the first three weeks
of observation. The setting is a public service clinic that provides STI diagnosis and treatment in an impoverished, peri-urban
community outside of Cape Town, South Africa. |
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