Qualitative assessment of South African healthcare worker perspectives on an instrument-free rapid CD4 test
Authors & affiliation
Fiona Scorgie, Yasmin Mohamed, David Anderson, Suzanne M. Crowe, Stanley Lüchters, Matthew Chersich
Abstract
Background:Accurate measurement of CD4 cell counts remains an important tenet of clinical care for people livingwith HIV. We assessed an instrument-free point-of-care CD4 test (VISITECT® CD4) based on a lateral flow principle,which gives visual results after 40 min. The test involves five steps and categorises CD4 counts as above or below 350cells/μL. As one component of a performance evaluation of the test, this qualitative study explored the views ofhealthcare workers in a large women and children’s hospital on the acceptability and feasibility of the test.Methods:Perspectives on the VISITECT® CD4 test were elicited through in-depth interviews with eight healthcareworkers involved in the performance evaluation at an antenatal care facility in Johannesburg, South Africa. Audiorecordings were transcribed in full and analysed thematically.Results:Healthcare providers recognised the on-going relevance of CD4 testing. All eight perceived the VISITECT® CD4test to be predominantly user-friendly, although some felt that the need for precision and optimal concentration inperforming test procedures made it more challenging to use. The greatest strength of the test was perceived to be itsquick turn-around of results. There were mixed views on the semi-quantitative nature of the test results and how bestto integrate this test into existing health services. Participants believed that patients in this setting would likely acceptthe test, given their general familiarity with other point-of-care tests.Conclusions:Overall, the VISITECT® CD4 test was acceptable to healthcare workers and those interviewed weresupportive of scale-up and implementation in other antenatal care settings. Both health workers and patients will needto be oriented to the semi-quantitative nature of the test and how to interpret the results of tests.
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