Xpert HIV-1 qual point-of-care testing for HIV early infant diagnosis in Tanzania: experiences and perceptions of health care workers in a 2016 study

Siriel Boniface; Anange Lwilla; Hellen Mahiga; Doreen Pamba; Otto Geisenberger; John France; Rebecca Mokeha; Lilian Njovu; Abisai Kisinda; Nyanda Elias Ntinginya; Michael Hoelscher; Arne Kroidl; Issa Sabi

doi:10.1186/s12981-024-00619-2

Xpert HIV-1 qual point-of-care testing for HIV early infant diagnosis in Tanzania: experiences and perceptions of health care workers in a 2016 study

AIDS Res Ther. 2024 May 16;21(1):33. doi: 10.1186/s12981-024-00619-2.

Authors

Siriel Boniface^#¹, Anange Lwilla^#², Hellen Mahiga¹, Doreen Pamba^{1

3}, Otto Geisenberger^{4

5}, John France⁶, Rebecca Mokeha⁶, Lilian Njovu¹, Abisai Kisinda¹, Nyanda Elias Ntinginya¹, Michael Hoelscher⁵, Arne Kroidl^{4

5

3}, Issa Sabi¹

Affiliations

¹ National Institute for Medical Research, Mbeya Medical Research Center, P.O.Box 2410, Mbeya, Tanzania.
² National Institute for Medical Research, Mbeya Medical Research Center, P.O.Box 2410, Mbeya, Tanzania. alwilla@nimr-mmrc.org.
³ CIHLMU Center for International Health, University Hospital, LMU Munich, Munich, Germany.
⁴ Division of Infectious Diseases and Tropical Medicine, University Hospital, LMU Munich, Munich, Germany.
⁵ German Center for Infection Research (DZIF), Munich, Germany.
⁶ Department of Obstetrics and Gynaecology, Mbeya Zonal Referral Hospital, Mbeya, Tanzania.

^# Contributed equally.

Abstract

Background: HIV early infant diagnosis (HEID) at the centralized laboratory faces many challenges that impact the cascade of timely HEID. Point of Care (PoC) HEID has shown to reduce test turnaround times, allow for task shifting and has the potential to reduce infant mortality. We aimed at assessing the feasibility of nurse based PoC-HEID in five facilities of Mbeya region.

Methods: We analysed data from healthcare workers at five obstetric health facilities that participated in the BABY study which enrolled mothers living with HIV and their HIV exposed infants who were followed up until 6 weeks post-delivery. Nurses and laboratory personnel were trained and performed HEID procedures using the Xpert HIV-1 Qual PoC systems. Involved personnel were interviewed on feasibility, knowledge and competency of procedures and overall impression of the use of HIV-1 Qual PoC system in clinical settings.

Results: A total of 28 health care workers (HCWs) who participated in the study between 2014 and 2016 were interviewed, 23 being nurses, 1 clinical officer, 1 lab scientist and 3 lab technicians The median age was 39.5 years. Majority of the nurses (22/24) and all lab staff were confident using Gene Xpert PoC test after being trained. None of them rated Gene Xpert handling as too complicated despite minor challenges. Five HCWs (5/24) reported power cut as the most often occurring problem. As an overall impression, all interviewees agreed on PoC HEID to be used in clinical settings however, about half of them (11/24) indicated that the PoC-HEID procedures add a burden onto their routine workload.

Conclusion: Overall, health care workers in our study demonstrated very good perceptions and experiences of using PoC HEID. Efforts should be invested on quality training, targeted task distribution at the clinics, continual supportive supervision and power back up mechanisms to make the wide-scale adoption of nurse based PoC HEID testing a possibility.

Keywords: Early infant diagnosis; HIV; Point-of-care testing; Primary healthcare workers; Vertical HIV transmission.

MeSH terms

Adult
Attitude of Health Personnel
Early Diagnosis*
Female
HIV Infections* / diagnosis
HIV Testing / methods
HIV-1*
Health Personnel*
Humans
Infant
Infant, Newborn
Infectious Disease Transmission, Vertical / prevention & control
Male
Point-of-Care Testing*
Pregnancy
Tanzania

Abstract

MeSH terms

Grants and funding