Ontology highlight
ABSTRACT: Objective
This is the first large-scale assessment of the implementation of HIV Rapid Test Quality Improvement Initiative in South Africa.Methods
We used a quasi-experimental one group post-test only design. The intervention implemented starting April 2014 comprised health-care worker training on quality assurance (QA) of HIV rapid testing and enrolment of the facilities in proficiency testing (PT), targeting 2,077 healthcare facilities in 32 high HIV burden districts. Following the intervention, two consecutive rounds of site assessments were undertaken. The first, conducted after a median of 7.5 months following the training, included 1,915 facilities that participated in the QA training, while the second, conducted after a median of one-year following the first-round assessment included 517 (27.0%) of the 1,915 facilities. In both assessments, the Stepwise-Process-for-Improving-the-quality-of-HIV-Rapid-Testing (SPI-RT) checklist was used to score facilities' performance in 7 domains: training, physical facility, safety, pre-testing, testing, post-testing and external quality assessment. Facilities' level of readiness for national certification was assessed.Result
Between 2016 and 2017, there were four PT cycles. PT participation increased from 32.4% (620/1,915) in 2016 to 91.5% (1,753/1,915) in 2017. In each PT cycle, PT results were returned by 76%-87% of facilities and a satisfactory result (>80%) was achieved by ?95% of facilities. In the SPI-RT assessment, in round-one, 22.3% of facilities were close to or eligible for national certification-this significantly increased to 38.8% in round-two (P-value<0.001). The median SPI-RT score for the domains HIV pre-testing (83.3%) and post-testing (72.2%) remained the same between the two rounds. The median score for the testing domain increased by 5.6% (to 77.8%).Conclusion
Facilities performance on the domains that are critical for accuracy of diagnosis (i.e. pre-testing, testing and post-testing) remained largely unchanged. This study provided several recommendations to improve QA implementation in South Africa, including the need to improve routine use of internal quality control for corrective actions.
SUBMITTER: Woldesenbet SA
PROVIDER: S-EPMC6762059 | biostudies-literature | 2019
REPOSITORIES: biostudies-literature
Woldesenbet Selamawit Alemu SA Kalou Mireille M Mhlongo Dumisani D Kufa Tendesayi T Makhanya Makhosazana M Adelekan Adeboye A Diallo Karidia K Maleka Mahlatse M Singh Beverley B Parekh Bharat B Mohlala Amanda A Manyike Peter T PT Tucker Tim J TJ Puren Adrian J AJ
PloS one 20190926 9
<h4>Objective</h4>This is the first large-scale assessment of the implementation of HIV Rapid Test Quality Improvement Initiative in South Africa.<h4>Methods</h4>We used a quasi-experimental one group post-test only design. The intervention implemented starting April 2014 comprised health-care worker training on quality assurance (QA) of HIV rapid testing and enrolment of the facilities in proficiency testing (PT), targeting 2,077 healthcare facilities in 32 high HIV burden districts. Following ...[more]