Identification of misdiagnosed HIV clients in an Early Access to ART for All implementation study in Eswatini

Shaukat Khan, Emma Mafara, Munyaradzi Pasipamire, Donna Spiegelman, Sikhathele Mazibuko, Nombuso Ntshalintshali, Anita Hettema, Charlotte Lejeune, Fiona Walsh, Velephi Okello

Rapid diagnostic testing has made HIV diagnosis and subsequent treatment more accessible. However, multiple factors, including improper implementation of testing strategies and clerical errors, have been reported to lead to HIV misdiagnosis. The World Health Organization has recommended HIV retesting prior to antiretroviral therapy (ART) initiation which has become pertinent with scaling up of Early Access to ART for All (EAAA). In this analysis, misdiagnosed clients are identified from a subgroup of clients enrolled in EAAA implementation study in Swaziland.

Overall, 0.6% of all enrolled EAAA clients were misdiagnosed, and 64% of misdiagnosed clients were initiated on ART. The study concludes that with adoption of EAAA guidelines by national governments, ART initiation regardless of immunological criteria, strengthening of proficiency testing and adoption of retesting prior to ART initiation would allow identification of misdiagnosed clients and further reduce potential of initiating misdiagnosed clients on ART.

August 31, 2017
Year of publication
2017
Resource types
Journal and research articles
Countries
Tags
Swaziland, rapid diagnostic testing, testing strategies, testing errors, misdiagnosis, HIV misdiagnosis, retesting, antiretroviral therapy (ART), ART initiation, treatment, treatment initiation, Early Access to ART for All (EAAA)

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