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.authorDavids, Malikaen_ZA
dc.contributor.authorDheda, Keertanen_ZA
dc.contributor.authorPai, Nitika Panten_ZA
dc.contributor.authorCogill, Dolphinaen_ZA
dc.contributor.authorPai, Madhukaren_ZA
dc.contributor.authorEngel, Noraen_ZA
dc.date.accessioned2016-01-02T05:04:41Z
dc.date.available2016-01-02T05:04:41Z
dc.date.issued2015en_ZA
dc.description.abstractBACKGROUND: 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.identifier.apacitationDavids, 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. <i>PLoS One</i>, http://hdl.handle.net/11427/16146en_ZA
dc.identifier.chicagocitationDavids, Malika, Keertan Dheda, Nitika Pant Pai, Dolphina Cogill, Madhukar Pai, and Nora Engel "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." <i>PLoS One</i> (2015) http://hdl.handle.net/11427/16146en_ZA
dc.identifier.citationDavids, 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.0141453en_ZA
dc.identifier.ris TY - Journal Article AU - Davids, Malika AU - Dheda, Keertan AU - Pai, Nitika Pant AU - Cogill, Dolphina AU - Pai, Madhukar AU - Engel, Nora AB - 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. DA - 2015 DB - OpenUCT DO - 10.1371/journal.pone.0141453 DP - University of Cape Town J1 - PLoS One LK - https://open.uct.ac.za PB - University of Cape Town PY - 2015 T1 - 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 TI - 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 UR - http://hdl.handle.net/11427/16146 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/16146
dc.identifier.urihttp://dx.doi.org/10.1371/journal.pone.0141453
dc.identifier.vancouvercitationDavids M, Dheda K, Pai NP, Cogill D, Pai M, Engel N. 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. 2015; http://hdl.handle.net/11427/16146.en_ZA
dc.language.isoengen_ZA
dc.publisherPublic Library of Scienceen_ZA
dc.publisher.departmentDivision of Pulmonologyen_ZA
dc.publisher.facultyFaculty of Health Sciencesen_ZA
dc.publisher.institutionUniversity of Cape Town
dc.rightsThis 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.holder© 2015 Davids et alen_ZA
dc.rights.urihttp://creativecommons.org/licenses/by/4.0en_ZA
dc.sourcePLoS Oneen_ZA
dc.source.urihttp://journals.plos.org/plosoneen_ZA
dc.subject.otherTuberculosis diagnosis and managementen_ZA
dc.subject.otherAllied health care professionalsen_ZA
dc.subject.otherHealth care providersen_ZA
dc.subject.otherNursesen_ZA
dc.subject.otherSouth Africaen_ZA
dc.subject.otherMycobacterium tuberculosisen_ZA
dc.subject.otherMedical doctorsen_ZA
dc.subject.otherTuberculosisen_ZA
dc.titleA 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 testsen_ZA
dc.typeJournal Articleen_ZA
uct.type.filetypeText
uct.type.filetypeImage
uct.type.publicationResearchen_ZA
uct.type.resourceArticleen_ZA
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