A Novel Community Health Worker Tool Outperforms WHO Clinical Staging for Assessment of Antiretroviral Therapy Eligibility in a Resource-Limited Setting

被引：1

作者：

MacPherson, Peter ^{[1
,2
]}

Lalloo, David G. ^{[1
]}

Thindwa, Deus ^{[2
]}

Webb, Emily L. ^{[3
]}

Squire, S. Bertel ^{[1
]}

Chipungu, Geoffrey A. ^{[4
]}

Desmond, Nicola ^{[2
,5
]}

Makombe, Simon D. ^{[6
]}

Taegtmeyer, Miriam ^{[5
]}

Choko, Augustine T. ^{[2
]}

Corbett, Elizabeth L. ^{[2
,3
]}

机构：

[1] Univ Liverpool, Liverpool Sch Trop Med, Dept Clin Sci, Liverpool L3 5QA, Merseyside, England

[2] Malawi Liverpool Wellcome Trust Clin Res Programm, TB & HIV Grp, Blantyre, Malawi

[3] London Sch Hyg & Trop Med, Dept Clin Res, London WC1, England

[4] Univ Malawi, Coll Med, Dept Pathol & Lab Med Sci, Blantyre, Malawi

[5] Univ Liverpool, Liverpool Sch Trop Med, Dept Int Publ Hlth, Liverpool L3 5QA, Merseyside, England

[6] Minist Hlth, HIV Dept, Lilongwe, Malawi

来源：

JAIDS-JOURNAL OF ACQUIRED IMMUNE DEFICIENCY SYNDROMES | 2014年 / 65卷 / 02期

基金：

英国惠康基金;

关键词：

antiretroviral therapy; Africa; HIV; CD4 lymphocyte count; ART eligibility; WHO clinical staging system; CASE-DEFINITION; HIV; INITIATION; AIDS; MORTALITY; BLANTYRE; DISEASE; CARE;

D O I：

10.1097/QAI.0b013e3182a20e74

中图分类号：

R392 [医学免疫学]; Q939.91 [免疫学];

学科分类号：

100102 ;

摘要：

The accuracy of a novel community health worker antiretroviral therapy eligibility assessment tool was examined in community members in Blantyre, Malawi. Nurses independently performed World Health Organization (WHO) staging and CD4 counts. One hundred ten (55.6%) of 198 HIV-positive participants had a CD4 count of <350 cells per cubic millimeter. The community health worker tool significantly outperformed WHO clinical staging in identifying CD4 count of <350 cells per cubic millimeter in terms of sensitivity (41% vs. 19%), positive predictive value (75% vs. 68%), negative predictive values (53% vs. 47%), and area under the receiver-operator curve (0.62 vs. 0.54; P = 0.017). Reliance on WHO staging is likely to result in missed and delayed antiretroviral therapy initiation.

引用

页码：E74 / E78

页数：5

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