Frequency of Specimen Rejection and Associated Factors at St., Addis Ababa, Ethiopia
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Date
2014-07
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Addis Ababa University
Abstract
Background: In resource limited settings CD4+ T cell count (CD4 testing) facility is not
available in peripheral areas and often either patients need to travel long distances or the samples
need to be transported to the centers where the facility for CD4 testing is available. These results
category completed CD4 testing within 12 weeks of HIV testing. Among those not immediately
eligible for ART (CD4 cells > 200/μl), only 31.5% completed CD4 testing within 12 weeks.
Overall, of HIV+ patients who initiated CD4 testing, 61.65% did not complete it within 12
weeks of diagnosis. Among the predicting factors, the higher the baseline CD4 cell count, the
lower the odds of completing CD4 testing within 12 weeks (P<0.05).
Conclusion: Majority of patients were already eligible for ART at the time of HIV diagnosis
even under the restrictive threshold of 200 CD4 cells/μl that prevailed at the time of the study.
But most did not complete CD4 testing within 12 weeks of diagnosis. Proper linkage of patient
tested positive at any testing center and provision of immediate baseline CD4 cell count has
indispensible role in reducing delayed treatment of patient with low CD4 cell count and
maintaining patient enrolled at ART clinic
in delays in the completion of CD4 testing, and hence further delays occur in obtaining
appropriate care and treatment.
Objective: To estimate rates of completion of CD4+ T cell count within 12 weeks of testing
positive for human immunodeficiency virus (HIV) as well as predictors for completion at ART
clinics in Afar region of Northeast Ethiopia.
Methods: The study was conducted in three most accessible selected Health centers with CD4
sample referring and ART services found in Afar Region of Northeast Ethiopia. Monthly report
of HIV Positive patients was used to identify individuals with HIV positive results. Routine data
was used separately to calculate the number and proportion of patients passing through PICHT,
VCT, PMTCT, TB clinic. Of the total 1299 positive individuals at each entry point, 931 were
linked to clinic patient card and ART data base. CD4 testing was considered complete once a
patient had retrieved the test results. To determine the rate of CD4 testing completion, records of
patient were reviewed. Predictors for completion were identified through multivariate logistic
regression. SPSS version 16 was used for data cleaning and analysis. P values less than 0.05
were taken as statistically significant.
Result: Between September 1, 2007 and June, 2013, a total of 1299 patients consisted of
492(37.88%), 387(29.79%), and 420(32.33%) at Gewane, Werer and Semera health centers,
respectively were tested positive for HIV. Patients who initiated CD4 testing after they tested
positive for HIV and enrolled to ART clinic had a median CD4 cell count of 172/μl (interquartile
range, IQR: 88–261). Majority 326 (59.8% of 545) had a CD4 cell count ≤ 200/μl and were
already eligible for ART. The other 219 (40.2% of 545) had a CD4 cell count > 200/μl and were
thus eligible for pre-ART medical care.
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Keywords
Specimen Rejection