Original Research

Onsite healthcare worker acceptability and performance of the point-of-care Pima CD4 assay in Dar es Salaam, Tanzania

Mary E. Schmitz, Karen Chang, Nichole Arnett, Luciana Kohatsu, Ruth Lemwayi, Michael Mwasekaga, John Nkengasong, Omotayo Bolu, Fausta Mosha, Larry Westerman
African Journal of Laboratory Medicine | Vol 8, No 1 | a740 | DOI: https://doi.org/10.4102/ajlm.v8i1.740 | © 2019 Mary E. Schmitz, Karen Chang, Nichole Arnett, Luciana Kohatsu, Ruth Lemwayi, Michael Mwasekaga, John Nkengasong, Omotayo Bolu, Fausta Mosha, Larry Westerman | This work is licensed under CC Attribution 4.0
Submitted: 21 December 2017 | Published: 21 November 2019

About the author(s)

Mary E. Schmitz, United States Centers for Disease Control and Prevention, Dar es Salaam, United Republic of Tanzania; and, ASPH/CDC Allan Rosenfield Global Health, Dar es Salaam, Tanzania, United Republic of
Karen Chang, United States Centers for Disease Control and Prevention, Dar es Salaam, United Republic of Tanzania; and, ASPH/CDC Allan Rosenfield Global Health, Dar es Salaam, Tanzania, United Republic of
Nichole Arnett, Division of Global HIV and TB, United States Centers for Disease Control and Prevention, Atlanta, Georgia, United States
Luciana Kohatsu, Division of Global HIV and TB, United States Centers for Disease Control and Prevention, Atlanta, Georgia, Tanzania, United Republic of
Ruth Lemwayi, African Field Epidemiology Network (AFENET), Dar es Salaam, Tanzania, United Republic of
Michael Mwasekaga, United States Centers for Disease Control and Prevention, Dar es Salaam, Tanzania, United Republic of
John Nkengasong, Division of Global HIV and TB, United States Centers for Disease Control and Prevention, Atlanta, Georgia, United States
Omotayo Bolu, Division of Global HIV and TB, United States Centers for Disease Control and Prevention, Atlanta, Georgia, United States
Fausta Mosha, African Field Epidemiology Network (AFENET), Dar es Salaam, United Republic of Tanzania; and, Tanzania Ministry of Health, Community Development, Gender, Elderly and Children, Dar es Salaam, Tanzania, United Republic of
Larry Westerman, Division of Global HIV and TB, United States Centers for Disease Control and Prevention, Atlanta, Georgia, United States

Abstract

Background: Healthcare workers’ acceptance of and ability to perform point-of-care testing is important for reliable and accurate results. The Alere Pima CD4 assay (Pima CD4) is the CD4 point-of-care test for HIV management in Tanzania.

Objectives: To evaluate healthcare workers’ acceptance and performance of Pima CD4 testing.

Methods: The study was implemented in five high volume sites in Dar es Salaam, Tanzania, in 2011. Trained healthcare workers performed Pima testing using three whole-blood specimens collected from each patient: venous blood, fingerstick blood directly applied to a Pima cartridge (capillary-direct), and fingerstick blood collected in a microtube (capillary-microtube). Using a semi-structured interview guide, we interviewed 11 healthcare workers about specimen collection methods and Pima CD4 acceptability. Quantitative responses were analysed using descriptive statistics. Open-ended responses were summarised by thematic areas. Pima CD4 results were analysed to determine variation between cadres.

Results: Healthcare workers found Pima CD4 user-friendly and recommended its use in low volume, peripheral facilities. Both venous and capillary-direct blood were considered easy to collect, with venous preferred. Advantages noted with venous and capillary-microtube methods were the ability to retest, perform multiple tests, or delay testing. Pima CD4 results were trusted by the healthcare workers and were in agreement with laboratory Pima testing.

Conclusion: In this point-of-care testing setting, the Pima CD4 assay was accepted by healthcare workers. Both venous and fingerstick capillary blood specimens can be used with Pima CD4, but fingerstick methods may require more intensive training on technique to minimise variation in results and increase acceptability.


Keywords

point-of-care; CD4; HIV; user acceptability; microtube

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