Assessment of Quality Assurance practice and proficiency of HIV rapid testing providers at point of care sites in selected public health facility of Addis Ababa, Ethiopia

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Addis Ababa Universty


Background: The implementation of HIV point-of-care testing technologies reduced turn-around-time (TAT), pre-analytical errors and sample transporting errors. But, it increased the complexity of QA implementation because it involves non laboratorians and outspread the testing sites to be covered by Proficiency testing. Objectives: To assess quality assurance practice for HIV rapid testing services at point of care sites in public health facilities in Addis Ababa, Ethiopia Methods: A cross-sectional prospective study was conducted based on random sampling technique in 3 hospitals and 41 health centers which included 265 point of care HIV rapid testing sites. Conveniently 310 HIV Rapid Test providers were also included. Standardized Checklists were used for the assessment. Data were captured, cleaned and analyzed using SPSS version 20. Results: HIV rapid testing sites had 65.59% performance score. Of the 265 point of care HIV rapid testing sites that were evaluated On-site, 0.4% of them have Zero level performance which Needs improvement in all areas and immediate remediation. One level performance was noted in 27.2% of testing points which needs improvement in specific areas; and 64.2% of testing points have level two performance which means partly eligible for HIV rapid testing. Three level performances that is close to national site certification is seen in 7.9% of testing points. Among 310 HIV rapid testing providers, 302 (97.4%) could correctly detect negative and positive panel samples. Eight (2.6%) had discordant result during screening test (test one) among these 3(37.5%) had false positive reports that corrected through the algorithm on the final result; 4 (50%) had false negative reports and 1(10%) was report as invalid. In the onsite checklist, lack of SOP for safety, use of expired Kits, lack of clean water for hand washing at testing sites, data management of quality elements of Registrations book contents and lack of personnel training on internal quality control and External quality assurance, lack of timer, were mentioned as a major bottle neck for quality performance. Conclusion: HIV rapid testing sites had 65.59% performance score which is below 80 %. HIV rapid testing providers scored 99.40% for proficiency panel testing which is below acceptable score of 100%. False negative results need attention since positives are released to the community due to misdiagnosis. Immediate intervention is needed on the identified findings.



External Quality Assurance, proficiency testing, onsite evaluation, HIV Point of care testing