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Evaluation of current rapid HIV test algorithms in Rakai, Uganda
Ronald M Galiwango1, Richard Musoke, Lawrence Lubyayi
1Rakai Health Sciences Program, Kalisizo, Uganda. rmgaliwango@rhsp.org
Journal of Virological Methods
|April 16, 2013
Summary
Serial HIV testing using Stat-Pak as the initial screening test demonstrated comparable performance to parallel testing in Uganda. This approach could offer cost savings for rapid HIV diagnosis in resource-limited settings.
Area of Science:
- Public Health
- Infectious Diseases
- Diagnostic Accuracy
Background:
- Rapid HIV tests are vital for diagnosis in resource-limited settings.
- Uganda's Ministry of Health permits serial and parallel HIV rapid testing strategies.
- Determine, Stat-Pak, and Uni-Gold are approved rapid HIV test kits.
Purpose of the Study:
- To evaluate the performance of serial and parallel HIV testing algorithms.
- To compare the accuracy of Determine and Stat-Pak test kits in serial testing.
- To assess the diagnostic accuracy of rapid HIV testing in Uganda.
Main Methods:
- A cross-sectional diagnostic accuracy study was conducted.
- Performance was assessed using parallel and serial testing algorithms.
- Enzyme immunoassay-Western blot (EIA-WB) was used as the reference standard.
Main Results:
- Parallel testing achieved 99.7% sensitivity and 99.8% specificity.
- Serial testing with Stat-Pak first yielded 99.6% sensitivity and 99.7% specificity.
- Serial testing with Determine first showed 97.3% sensitivity and 99.9% specificity.
Conclusions:
- Serial testing with Stat-Pak as the initial screen is as effective as parallel testing.
- Determine demonstrated lower sensitivity as an initial screening test compared to Stat-Pak.
- Serial testing strategies may offer cost-saving benefits for HIV diagnosis.
