Proficiency Testing and Onsite Assessment of HIV Rapid Testing sites at Health Facilities enrolled in HIV Rapid Test Quality Improvement Initiative (RTQII) in Ethiopia
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Date
2020-06
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Addis Abeba University
Abstract
Background: HIV rapid testing services must ensure that appropriate quality assurance programs and well
understood testing algorithms are implemeted to obtain accurate and reliable test results. Proficiency testing
programs are important for improving HIV rapid testing quality while conducting an onsite evaluation
provides a chance to observe the overall testing situation and support on identified gaps.
Objective:To assess the performance of HIV Rapid testing sites in Rapid Test Quality Improvement
Initiative(RTQII) enrolled health facilities through proficiency testing and onsite evaluation.
Method:Health facility based cross sectional study was conducted from August to December 2019on 159
HIV testing sites (HTS) in 41 Health facilities (HFs) in five administrative regions and two city
administrations in Ethiopia. Characterized HIV dried tube specimen (DTS) PT panels were prepared and
verified at the Ethiopian Public Health Institute (EPHI) and distributed to the sites. Also onsite evaluation,
accompanied by checklists with structured interviews, was conducted. The collected data was analyzed by
SPSS version 23 and chi square test was applied to identify the association between acceptable performance
and different factors.Testing sites whose PT scores matched 100% with the expected result together with
adherence to the National HIV Testing Algorithm(NHTA) were considered acceptable.
Results: The overall acceptable performance (100% PT score with the correct algorithm followed) was
found to be 62% while 12% scored 80% and 11% scored between 20 to 60%. The rest 15 % were not
considered as acceptable due to failure to adhere to the NHTA.Testing sites that participated in External
Quality Assessment/Proficiency Testing(EQA/PT) schemes has shown better performance than those that
did not participate in PT schemes with 70% and 56% performance, respectively (p=0.057). Though
adherence to the NHTA, Training on HIV rapid testing, following SOP, were all positively associated with
HIV rapid testing performances, all of them were not statistically significant.
Conclusion:Expansion of HIV diagnostic services at different points of care must ensure that appropriate
quality assurance programs has been put in place. The lower level of PT performance together with problems
observed during onsite evaluations calls for regular supervision, strong EQA programmes, adequate hands
on training, and proper assignment of testing personnel.
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Keywords
Acceptable Performance, dry tube sample, HIV testing sites, national HIV testing algorithm, proficiency testing