The laboratory and quality response to HIV poct in rural Eastern Highlands, Goroka, Papua New Guinea

Abstract

The aim is to describe the development, delivery, and difficulties in monitoring quality human immunodeficiency virus (HIV) point of care testing (POCT) in rural health settings of Papua New Guinea. HIV antibody testing was performed at about 90% of all major laboratories in provincial hospitals throughout Papua New Guinea prior to 2006 using the Serodia Testing kit. Samples showing reactivity were then sent to the Capital, Port Moresby for confirmation, which often meant that the results took months to be sent back to the requesting laboratory, which eventually affected quality patient care. All major laboratories were finally given the approval to do confirmation in December 2006. Goroka was no exception, however with the expansion of and the increase in the number of VCT (voluntary counselling and testing) sites, this posed a challenge in terms of monitoring the quality of HIV POCT results. There are well over 35 rural sites in Goroka that are able to do HIV POCT either in antenatal clinics as part of the prevention of parent to child transmission (PPTCT), or routine VCT. The test is performed using the Determine Test strips by non-laboratory health staff, who often are not conscious of the paramount importance of giving a result that reflects the true status of the client. This means minimising all errors, be it technical or clerical, and that quality begins from the collection of sample right through to the reporting of the result, compounded with the fact the Goroka has some of the most rugged terrain, with lack of basic infrastructure such as roads making supervisory visits a nightmare.