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East Afr Med J. 2008 Oct;85(10):500-4.

Sensitivity and specificity of HIV rapid tests used for research and voluntary counselling and testing.

Author information

  • 1Department of Medical Microbiology, College of Health Sciences, University of Nairobi, P.O. Box 19676-00202, Nairobi, Kenya.

Abstract

BACKGROUND:

HIV rapid tests (RT) are a quick and non-technically demanding means to perform HIV voluntary counselling and testing (VCT) but understanding their limitations is vital to delivering quality VCT.

OBJECTIVE:

To determine the sensitivity and specificity of HIV rapid tests used for research and voluntary counselling and testing at four sites in East Africa.

DESIGN:

Cross-sectional study.

SETTING:

Masaka District, Uganda; a sugar plantation in Kakira, Uganda; Coastal Villages in the Kilifi District of Kenya; and the Urban slum of Kangemi located West of Nairobi, Kenya.

SUBJECTS:

Six thousands two hundred and fifty five consenting volunteers were enrolled into the study, and 675 prevalent HIV infections were identified.

RESULTS:

The RT sensitivity tended to be high for all assays at all sites (97.63-100%) with the exception of the Uni-Gold assay (90.24% in Kangemi, 96.58% in Kilifi). Twenty four RT results were recorded as 'weak positives', 22 (92%) of which were negative by ELISA. There was a high rate of RT false positives in Uganda (positive predictive values ranging from 45.70% to 86.62%).

CONCLUSIONS:

The sensitivity and specificity of the RT varied significantly across sites. The rate of RT misclassification in Uganda suggests that a multiple test algorithm may be preferable to a single test as screener for HIV VCT.

PMID:
19537426
[PubMed - indexed for MEDLINE]
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