Browsing by Author "Wamalwa DC"

Filter results by typing the first few letters
Now showing 1 - 1 of 1
  • Thumbnail Image
    Item
    Brief Report: Diagnostic Accuracy of Oral Mucosal Transudate Tests Compared with Blood-Based Rapid Tests for HIV Among Children Aged 18 Months to 18 Years in Kenya and Zimbabwe.
    (2019-Dec-01) Dziva Chikwari C; Njuguna IN; Neary J; Rainer C; Chihota B; Slyker JA; Katz DA; Wamalwa DC; Oyiengo L; Bandason T; McHugh G; Dauya E; Mujuru H; Stewart KA; John-Stewart GC; Ferrand RA; Wagner AD; Biomedical Research and Training Institute, Harare, Zimbabwe.; Clinical Research Department, London School of Hygiene and Tropical Medicine, London, United Kingdom.; University of Zimbabwe College of Health Sciences, Harare, Zimbabwe.; Research and Programs, Kenyatta National Hospital, Nairobi, Kenya.; Department of Paediatric and Child Health, University of Nairobi, Nairobi, Kenya.; Department of Medicine, Division of Allergy and Infectious diseases, School of Medicine, University of Washington, Seattle, WA.; National AIDS & STI Control Programme, Ministry of Health, Nairobi, Kenya.; Duke Global Health Institute, Duke University, Durham, NC.; Department of Global Health, University of Washington, Seattle, WA.; Department of Epidemiology, University of Washington, Seattle, WA.; Centre for Infectious Disease Research in Zambia, Lusaka, Zambia.; Departments of Medicine and Pediatrics, University of Washington, Nairobi, Kenya.; CIDRZ; Centre for Infectious Disease Research in Zambia (CIDRZ)
    BACKGROUND: Gaps persist in HIV testing for children who were not tested in prevention of mother-to-child HIV transmission programs. Oral mucosal transudate (OMT) rapid HIV tests have been shown to be highly sensitive in adults, but their performance has not been established in children. METHODS: Antiretroviral therapy-naive children aged 18 months to 18 years in Kenya and Zimbabwe were tested for HIV using rapid OraQuick ADVANCE Rapid HIV-1/2 Antibody test on oral fluids (OMT) and blood-based rapid diagnostic testing (BBT). BBT followed Kenyan and Zimbabwean national algorithms. Sensitivity and specificity were calculated using the national algorithms as the reference standard. RESULTS: A total of 1776 children were enrolled; median age was 7.3 years (interquartile range: 4.7-11.6). Among 71 children positive by BBT, all 71 were positive by OMT (sensitivity: 100% [97.5% confidence interval (CI): 94.9% to 100%]). Among the 1705 children negative by BBT, 1703 were negative by OMT (specificity: 99.9% [95% CI: 99.6% to 100.0%]). Due to discrepant BBT and OMT results, 2 children who initially tested BBT-negative and OMT-positive were subsequently confirmed positive within 1 week by further tests. Excluding these 2 children, the sensitivity and specificity of OMT compared with those of BBT were each 100% (97.5% CI: 94.9% to 100% and 99.8% to 100%, respectively). CONCLUSIONS: Compared to national algorithms, OMT did not miss any HIV-positive children. These data suggest that OMTs are valid in this age range. Future research should explore the acceptability and uptake of OMT by caregivers and health workers to increase pediatric HIV testing coverage.