Abstract
HIV rapid diagnostic tests (RDTs) are now used widely in non-laboratory settings by non-laboratory-trained operators. Quality assurance programmes are essential in ensuring the quality of HIV RDT outcomes. However, there is no cost-effective means of supplying the many operators of RDTs with suitable quality assurance schemes. Therefore, it was examined whether photograph-based RDT results could be used and correctly interpreted in the non-laboratory setting. Further it was investigated if a single training session improved the interpretation skills of RDT operators. The photographs were interpreted, a 10-minute tutorial given and then a second interpretation session was held. It was established that the results could be read with accuracy. The participants (n = 75) with a range of skills interpreted results (>80% concordance with reference results) from a panel of 10 samples (three negative and seven positive) using four RDTs. Differences in accuracy of interpretation before and after the tutorial were marked in some cases. Training was more effective for improving the accurate interpretation of more complex results, e.g. results with faint test lines or for multiple test lines, and especially for improving interpretation skills of inexperienced participants. It was demonstrated that interpretation of RDTs was improved using photographed results allied to a 10-minute training session. It is anticipated that this method could be used for training but also for quality assessment of RDT operators without access to conventional quality assurance or training schemes requiring wet samples.
Highlights
Classic testing strategies for HIV diagnosis that yield close to 100% predictive values, involve testing a plasma or serum sample with an enzyme immunoassay followed by Western blot [1]
Computer monitor and printer were calibrated by ColorMunki Photo (X-Rite Inc, USA) to ensure printouts accurately reflected the rapid diagnostic tests (RDTs) results shown on the computer monitor
Training using photographed RDTs was effective in improving the interpretation accuracy of RDTs
Summary
Classic testing strategies for HIV diagnosis that yield close to 100% predictive values, involve testing a plasma or serum sample with an enzyme immunoassay followed by Western blot [1]. These strategies require dedicated laboratory equipment and experienced laboratory-trained operators. With the extensive roll-out of anti-HIV therapies in the last 5 years, faster and more accessible testing has become imperative It is preferred by public health groups in the US where the rate of individuals returning for their results has been low in some situations [3]. Testing in facilities such as voluntary HIV counseling and testing centers (VCT) and venues such as bathhouses has become the norm [4,5]
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