A survey on use of rapid tests and tuberculosis diagnostic practices by primary health care providers in South Africa: implications for the development of new point-of-care tests

 

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dc.contributor.author Davids, Malika en_ZA
dc.contributor.author Dheda, Keertan en_ZA
dc.contributor.author Pai, Nitika Pant en_ZA
dc.contributor.author Cogill, Dolphina en_ZA
dc.contributor.author Pai, Madhukar en_ZA
dc.contributor.author Engel, Nora en_ZA
dc.date.accessioned 2016-01-02T05:04:41Z
dc.date.available 2016-01-02T05:04:41Z
dc.date.issued 2015 en_ZA
dc.identifier.citation Davids, M., Dheda, K., Pai, N. P., Cogill, D., Pai, M., & Engel, N. (2015). A survey on use of rapid tests and tuberculosis diagnostic practices by primary health care providers in South Africa: implications for the development of new point-of-care tests. PloS one, 10(10), e0141453. doi:10.1371/journal.pone.0141453 en_ZA
dc.identifier.uri http://hdl.handle.net/11427/16146
dc.identifier.uri http://dx.doi.org/10.1371/journal.pone.0141453
dc.description.abstract BACKGROUND: Effective infectious disease control requires early diagnosis and treatment initiation. Point-of-care testing offers rapid turn-around-times, facilitating same day clinical management decisions. To maximize the benefits of such POC testing programs, we need to understand how rapid tests are used in everyday clinical practice. METHODS: In this cross-sectional survey study, 400 primary healthcare providers in two cities in South Africa were interviewed on their use of rapid tests in general, and tuberculosis diagnostic practices, between September 2012 and June 2013. Public healthcare facilities were selected using probability-sampling techniques and private healthcare providers were randomly selected from the Health Professional Council of South Africa list. To ascertain differences between the two healthcare sectors 2-sample z-tests were used to compare sample proportions. RESULTS: The numbers of providers interviewed were equally distributed between the public (n = 200) and private sector (n = 200). The most frequently reported tests in the private sector include blood pressure (99.5%), glucose finger prick (89.5%) and urine dipstick (38.5%); and in the public sector were pregnancy (100%), urine dipstick (100%), blood pressure (100%), glucose finger prick (99%) and HIV rapid test (98%). The majority of TB testing occurs in the public sector, where significantly more providers prefer Xpert MTB/RIF assay, the designated clinical TB diagnostic tool by the national TB program, as compared to the private sector (87% versus 71%, p-value >0.0001). Challenges with regard to TB diagnosis included the long laboratory turn-around-time, difficulty in obtaining sputum samples and lost results. All providers indicated that a new POC test for TB should be rapid and cheap, have good sensitivity and specificity, ease of sample acquisition, detect drug-resistance and work in HIV-infected persons. Conclusion/significance The existing centralized laboratory services, poor quality assurance, and lack of staff capacity deter the use of more rapid tests at POC. Further research into the practices and choices of these providers is necessary to aid the development of new POC tests. en_ZA
dc.language.iso eng en_ZA
dc.publisher Public Library of Science en_ZA
dc.rights This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. en_ZA
dc.rights.uri http://creativecommons.org/licenses/by/4.0 en_ZA
dc.source PLoS One en_ZA
dc.source.uri http://journals.plos.org/plosone en_ZA
dc.subject.other Tuberculosis diagnosis and management en_ZA
dc.subject.other Allied health care professionals en_ZA
dc.subject.other Health care providers en_ZA
dc.subject.other Nurses en_ZA
dc.subject.other South Africa en_ZA
dc.subject.other Mycobacterium tuberculosis en_ZA
dc.subject.other Medical doctors en_ZA
dc.subject.other Tuberculosis en_ZA
dc.title A survey on use of rapid tests and tuberculosis diagnostic practices by primary health care providers in South Africa: implications for the development of new point-of-care tests en_ZA
dc.type Journal Article en_ZA
dc.rights.holder © 2015 Davids et al en_ZA
uct.type.publication Research en_ZA
uct.type.resource Article en_ZA
dc.publisher.institution University of Cape Town
dc.publisher.faculty Faculty of Health Sciences en_ZA
dc.publisher.department Division of Pulmonology en_ZA
uct.type.filetype Text
uct.type.filetype Image


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This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Except where otherwise noted, this item's license is described as This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.