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Diagnostics
Volume 10
Issue 2
10.3390/diagnostics10020081
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Article

Assessment of the Impact of Rapid Point-of-Care CD4 Testing in Primary Healthcare Clinic Settings: A Survey Study of Client and Provider Perspectives

by
Shabashini Reddy
1,2,
Andrew Gibbs
3,
Elizabeth Spooner
4,
Noluthando Ngomane
5,
Tarylee Reddy
6,
Nozipho |Luthuli
7,
Gita Ramjee
4,
Anna Coutsoudis
8 and
Photini Kiepiela
1,2,*
1
South African Medical Research Council, Durban 4000, South Africa
2
Wits Health Consortium, Parktown, Johannesburg 2091, South Africa
3
South African Medical Research Council, Gender and Health Research Unit, Durban Centre for Rural Health, University of KwaZulu Natal, Durban 4000, South Africa
4
South African Medical Research Council, HIV Prevention Research Unit, Durban 3600, South Africa
5
Occupational Health, Hillcrest, Durban 3610, South Africa
6
South African Medical Research Council, Biostatistics Unit, Durban 4000, South Africa
7
eThekwini Health Unit, Durban 4000, South Africa
8
School of Clinical Medicine, University of KwaZulu Natal, Durban 4000, South Africa
*
Author to whom correspondence should be addressed.
Diagnostics 2020, 10(2), 81; https://doi.org/10.3390/diagnostics10020081
Submission received: 5 November 2019 / Revised: 5 December 2019 / Accepted: 7 December 2019 / Published: 1 February 2020
(This article belongs to the Special Issue Implementation and Scale Up of Point of Care (POC) Diagnostics in Resource-Limited Settings)
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Abstract

Background: The high burden of disease in South Africa presents challenges to public health services. Point-of-care (POC) technologies have the potential to address these gaps and improve healthcare systems. This study ascertained the acceptability and impact of POC CD4 testing on patients’ health and clinical management. Methods: We conducted a qualitative survey study with patients (n = 642) and healthcare providers (n = 13) at the Lancers Road (experienced POC) and Chesterville (non-experienced POC) primary healthcare (PHC) clinics from September 2015 to June 2016. Results: Patients (99%) at Lancers and Chesterville PHCs were positive about POC CD4 testing, identifying benefits: No loss/delay of test results (6.4%), cost/time saving (19.5%), and no anxiety (5.1%), and 58.2% were ready to initiate treatment. Significantly more patients at Chesterville than Lancers Road PHC felt POC would provide rapid clinical decision making (64.7% vs. 48.1%; p < 0.0001) and better clinic accessibility (40.4% vs. 24.7%; p < 0.0001) respectively. Healthcare providers thought same-day CD4 results would impact: Clinical management (46.2%), patient readiness (46.2%), and adherence (23.0%), and would reduce follow-up visits (7.7%), while 38.5% were concerned that further tests and training (15.4%) were required before antiretroviral therapy (ART) initiation. Conclusion: The high acceptability of POC CD4 testing and the immediate health, structural, and clinical management benefits necessitates POC implementation studies.
Keywords: point-of-care CD4+ t testing; qualitative survey; acceptability; patients; healthcare providers; primary healthcare clinics point-of-care CD4+ t testing; qualitative survey; acceptability; patients; healthcare providers; primary healthcare clinics

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MDPI and ACS Style

Reddy, S.; Gibbs, A.; Spooner, E.; Ngomane, N.; Reddy, T.; |Luthuli, N.; Ramjee, G.; Coutsoudis, A.; Kiepiela, P. Assessment of the Impact of Rapid Point-of-Care CD4 Testing in Primary Healthcare Clinic Settings: A Survey Study of Client and Provider Perspectives. Diagnostics 2020, 10, 81. https://doi.org/10.3390/diagnostics10020081

AMA Style

Reddy S, Gibbs A, Spooner E, Ngomane N, Reddy T, |Luthuli N, Ramjee G, Coutsoudis A, Kiepiela P. Assessment of the Impact of Rapid Point-of-Care CD4 Testing in Primary Healthcare Clinic Settings: A Survey Study of Client and Provider Perspectives. Diagnostics. 2020; 10(2):81. https://doi.org/10.3390/diagnostics10020081

Chicago/Turabian Style

Reddy, Shabashini, Andrew Gibbs, Elizabeth Spooner, Noluthando Ngomane, Tarylee Reddy, Nozipho |Luthuli, Gita Ramjee, Anna Coutsoudis, and Photini Kiepiela. 2020. "Assessment of the Impact of Rapid Point-of-Care CD4 Testing in Primary Healthcare Clinic Settings: A Survey Study of Client and Provider Perspectives" Diagnostics 10, no. 2: 81. https://doi.org/10.3390/diagnostics10020081

APA Style

Reddy, S., Gibbs, A., Spooner, E., Ngomane, N., Reddy, T., |Luthuli, N., Ramjee, G., Coutsoudis, A., & Kiepiela, P. (2020). Assessment of the Impact of Rapid Point-of-Care CD4 Testing in Primary Healthcare Clinic Settings: A Survey Study of Client and Provider Perspectives. Diagnostics, 10(2), 81. https://doi.org/10.3390/diagnostics10020081

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