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BMC Health Serv Res. 2019 Feb 14;19(1):123. doi: 10.1186/s12913-019-3948-x.

Qualitative assessment of South African healthcare worker perspectives on an instrument-free rapid CD4 test.

Author information

1
Wits Reproductive Health and HIV Institute (Wits RHI), Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa. fscorgie@wrhi.ac.za.
2
Burnet Institute, Melbourne, Australia.
3
School of Public Health and Preventive Medicine, Monash University, Clayton, Victoria, Australia.
4
Department of Population Health, Aga Khan University, Nairobi, Kenya.
5
International Centre for Reproductive Health, Department of Public Health and Primary Care, Ghent University, Gent, Belgium.
6
Wits Reproductive Health and HIV Institute (Wits RHI), Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.

Abstract

BACKGROUND:

Accurate measurement of CD4 cell counts remains an important tenet of clinical care for people living with HIV. We assessed an instrument-free point-of-care CD4 test (VISITECT® CD4) based on a lateral flow principle, which gives visual results after 40 min. The test involves five steps and categorises CD4 counts as above or below 350 cells/μL. As one component of a performance evaluation of the test, this qualitative study explored the views of healthcare workers in a large women and children's hospital on the acceptability and feasibility of the test.

METHODS:

Perspectives on the VISITECT® CD4 test were elicited through in-depth interviews with eight healthcare workers involved in the performance evaluation at an antenatal care facility in Johannesburg, South Africa. Audio recordings were transcribed in full and analysed thematically.

RESULTS:

Healthcare providers recognised the on-going relevance of CD4 testing. All eight perceived the VISITECT® CD4 test to be predominantly user-friendly, although some felt that the need for precision and optimal concentration in performing test procedures made it more challenging to use. The greatest strength of the test was perceived to be its quick turn-around of results. There were mixed views on the semi-quantitative nature of the test results and how best to integrate this test into existing health services. Participants believed that patients in this setting would likely accept the test, given their general familiarity with other point-of-care tests.

CONCLUSIONS:

Overall, the VISITECT® CD4 test was acceptable to healthcare workers and those interviewed were supportive of scale-up and implementation in other antenatal care settings. Both health workers and patients will need to be oriented to the semi-quantitative nature of the test and how to interpret the results of tests.

KEYWORDS:

Acceptability; CD4; HIV; Point of care; Qualitative research; South Africa

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