Quality Audit Of Rapid Hiv Diagnostic Processes And Outcomes In Selected Health Facilities In The Central Region Of Ghana

ABSTRACT Introduction Human immunodeficiency virus (HIV) is one of the leading infectious killers worldwide. An estimated 34.2 million people worldwide were living with HIV in 2011 with about 60% of the HIV infections occur in sub-Saharan Africa. Testing to know an individual‟s HIV status is a key intervention to the prevention and early management of cases. These notwithstanding, an estimated 50% of persons living with the virus have not tested for HIV. The introduction of rapid HIV test kits has increased access to HIV testing. The decentralised testing approach to tackling the HIV epidemic also comes with a need of an increased number of personnel to perform the task. The rapid HIV test although easy to do after proper training, by both laboratory and nonlaboratory persons, requires a quality assurance system in place to prevent errors and ensure the accuracy and reliability of rapid test results. This study set out to compare HIV test results from both laboratory and non-laboratory staff, to assess the knowledge of the testing staff on the dry tube specimen proficiency testing (DTSPT) scheme and to assess the competency of the testing staff. Method A convenience selection of 240 pregnant women who had already been tested for HIV in four antenatal clinics in the Central Region of Ghana and who consented to take part in this study were enrolled. Venous blood sample (3ml) was taken from these women and retested in the laboratory. A questionnaire on the dry tube specimen proficiency testing scheme was administered to all testing staff available during the time of the study. A site audit checklist was also used to assess staff competency. vii Results There was a 99.6% concordance between the laboratory and non-laboratory HIV test results. There was one (0.4%) discordant test result between the two testing groups. The non-laboratory group reported an HIV negative result which was HIV positive when it was re-tested in the laboratory. Majority (80%) of both group of testing staff did not know of DTSPT. Those who knew (20%) of the DTSPT had actually participated in the DTSPT training workshop. All the staff were competent to perform and interpret test results. Three (75%) of the health facilities did not have rapid test kits to provide voluntary counselling and testing services to PMTCT clients. Conclusion There was no significant difference between rapid HIV test done by laboratory and nonlaboratory persons. Staff knowledge of the dried tube specimen proficiency testing scheme was poor. Staff were competent to use the rapid HIV test kits correctly and test outcome was accurate and reliable. However, periodic staff training and quality control testing, and on-sites visits should be maintained.