Evidence map›Paper›PMID 36240208›Full record

ArticlePloS one2022

Improving the quality of HIV rapid testing in Ghana using the dried tube specimen-based proficiency testing program.

Bernard Nkrumah, Nnaemeka C Iriemenam, Francis Frimpong, Mireille B Kalou, Berenice Botchway, Rowland Adukpo, Keisha G Jackson, Pawan Angra, Toni Whistler, Amitabh P Adhikari and 2 more

Open access · goldAbstract read
In one paragraph

Article in PloS one, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
0.7field-weighted citation impact, top 29% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 7 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors at 4 institutions in 4 countries.

Bernard NkrumahDivision of Global Health Protection, Center for Global Health, US Centers for Disease Control and Prevention, Accra, Ghana.ORCID 0000-0002-7613-5353
Nnaemeka C IriemenamDivision of Global HIV and TB, Center for Global Health, US Centers for Disease Control and Prevention, Abuja, Nigeria.ORCID 0000-0003-2187-8894
Francis FrimpongNational AIDS/STI Control Program, Ghana Health Service, Accra, Ghana.
Mireille B KalouDivision of Global HIV and TB, Center for Global Health, US Centers for Disease Control and Prevention, Port au Prince, Haiti.
Berenice BotchwayNational AIDS/STI Control Program, Ghana Health Service, Accra, Ghana.
Rowland AdukpoNational AIDS/STI Control Program, Ghana Health Service, Accra, Ghana.
Keisha G JacksonDivision of Global HIV and TB, Center for Global Health, US Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America.
Pawan AngraDivision of Global Health Protection, Center for Global Health, US Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America.
Toni WhistlerDivision of Global Health Protection, Center for Global Health, US Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America.ORCID 0000-0002-7250-908X
Amitabh P AdhikariDivision of Global HIV and TB, Center for Global Health, US Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America.
Stephen Ayisi-AddoNational AIDS/STI Control Program, Ghana Health Service, Accra, Ghana.
Michael A MelchiorDivision of Global HIV and TB, Center for Global Health, US Centers for Disease Control and Prevention, Harare, Zimbabwe.ORCID 0000-0001-9426-5437
Centers for Disease Control and Prevention · USGhana Health Service · GHGheskio Centers · HTNigeria Centre for Disease Control · NG

Funding

NCHHSTP CDC HHS U2G PS002987PEPFAR
6 · The paper itself

Abstract

backgroundThe introduction of human immunodeficiency virus (HIV) antibody rapid testing (RT) in resource-limited settings has proven to be a successful intervention to increase access to prevention measures and improve timely linkage to care. However, the quality of testing has not always kept pace with the scale-up of this testing strategy. To monitor the accuracy of HIV RT test results, a national proficiency testing (PT) program was rolled out at selected testing sites in Ghana using the dried tube specimen (DTS) approach.

methodsBetween 2015 and 2018, 635 HIV testing sites, located in five regions and supported by the U.S. President's Emergency Plan for AIDS Relief (PEPFAR), were enrolled in the HIV PT program of the Ghana Health Service National AIDS/STI Control Programme. These sites offered various services: HIV Testing and Counselling (HTC), prevention of mother-to-child transmission (PMTCT) and Antiretroviral Treatment (ART). The PT panels, composed of six DTS, were prepared by two regional laboratories, using fully characterized plasma obtained from the regional blood banks and distributed to the testing sites. The results were scored by the PT providers according to the predefined acceptable performance criteria which was set at ≥ 95%.

resultsSeven rounds of PT panels were completed successfully over three years. The number of sites enrolled increased from 205 in round 1 (June 2015) to 635 in round 7 (December 2018), with a noticeable increase in Greater Accra and Eastern regions. The average participation rates of enrolled sites ranged from 88.0% to 98.0% across the PT rounds. By round 7, HTC (257/635 (40.5%)) and PMTCT (237/635 (37.3%)) had a larger number of sites that participated in the PT program than laboratory (106/635 (16.7%)) and ART (12/635 (1.9%)) sites. The average testing performance rate improved significantly from 27% in round 1 to 80% in round 7 (p < 0.001). The highest performance rate was observed for ART (100%), HTC (92%), ANC/PMTCT (90%) and Laboratory (89%) in round 5.

conclusionThe DTS PT program showed a significant increase in the participation and performance rates during this period. Sub-optimal performances observed was attributed to non-compliance to the national testing algorithm and testing technique. However, the implementation of review meetings, peer-initiated corrective action, supportive supervisory training, and mentorship proved impactful. The decentralized approach to preparing the PT panels ensured ownership by the region and districts.

Indexed as

Acquired Immunodeficiency SyndromeHIV-1HIV InfectionsAnti-Retroviral AgentsFemaleGhanaHIV AntibodiesHumansInfectious Disease Transmission, VerticalAnti-Retroviral AgentsHIV Antibodies

Identifiers

PMID36240208
PMCPMC9565402
OpenAlexW4306194483

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.