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A novel community health worker tool outperforms WHO clinical staging for assessment of antiretroviral therapy eligibility in a resource-limited setting

MacPherson, Peter ORCID: https://orcid.org/0000-0002-0329-9613, Lalloo, David ORCID: https://orcid.org/0000-0001-7680-2200, Thindwa, D, Webb, EL, Squire, Bertie ORCID: https://orcid.org/0000-0001-7173-9038, Chipungu, GA, Desmond, Nicola ORCID: https://orcid.org/0000-0002-2874-8569, Makombe, SD, Taegtmeyer, Miriam ORCID: https://orcid.org/0000-0002-5377-2536, Choko, AT and Corbett, EL (2014) 'A novel community health worker tool outperforms WHO clinical staging for assessment of antiretroviral therapy eligibility in a resource-limited setting'. JAIDS: Journal of Acquired Immune Deficiency Syndromes, Vol 65, Issue 2, e74-e78.

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Abstract

The accuracy of a novel community health worker (CHW) ART eligibility assessment tool was examined in community members in Blantyre, Malawi. Nurses independently performed WHO staging and CD4 counts. 110 (55.6%) of 198 HIV-positive participants had a CD4 count of <350 cells/mm. The CHW tool significantly outperformed WHO clinical staging in identifying CD4<350 cells/mm in terms of sensitivity (41% vs. 19%), positive predictive value (75% vs. 68%), negative predictive values (53% vs. 47%) and area under the receiver-operator curve (0.62 vs. 0.54, p=0.017). Reliance on WHO staging is likely to result in missed and delayed ART initiation.

Item Type: Article
Subjects: QY Clinical Pathology > Blood. Blood Chemistry > QY 402 Cellular elements
WA Public Health > WA 30 Socioeconomic factors in public health (General)
WA Public Health > Health Problems of Special Population Groups > WA 395 Health in developing countries
WC Communicable Diseases > Virus Diseases > Acquired Immunodeficiency Syndrome. HIV Infections > WC 503 Acquired immunodeficiency syndrome. HIV infections
WC Communicable Diseases > Virus Diseases > Acquired Immunodeficiency Syndrome. HIV Infections > WC 503.1 Diagnosis
WC Communicable Diseases > Virus Diseases > Acquired Immunodeficiency Syndrome. HIV Infections > WC 503.2 Therapy
Faculty: Department: Clinical Sciences & International Health > Clinical Sciences Department
Clinical Sciences & International Health > International Public Health Department
Digital Object Identifer (DOI): https://doi.org/10.1097/QAI.0b013e3182a20e74
Depositing User: q Moody
Date Deposited: 29 Jan 2014 09:51
Last Modified: 06 Feb 2018 13:06
URI: https://archive.lstmed.ac.uk/id/eprint/3525

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