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

Macpherson, Peter; Lalloo, David G; Thindwa, Deus; Webb, Emily L; Squire, S Bertel; Chipungu, Geoffrey A; Desmond, Nicola; Makombe, Simon D; Taegtmeyer, Miriam; Choko, Augustine T; +1 more... Corbett, Elizabeth L; (2014) A novel community health worker tool outperforms WHO clinical staging for assessment of antiretroviral therapy eligibility in a resource-limited setting. Journal of acquired immune deficiency syndromes (1999), 65 (2). e74-e78. ISSN 1525-4135 DOI: https://doi.org/10.1097/QAI.0b013e3182a20e74

Abstract

The accuracy of a novel community health worker antiretroviral therapy eligibility assessment tool was examined in community members in Blantyre, Malawi. Nurses independently performed World Health Organization (WHO) staging and CD4 counts. One hundred ten (55.6%) of 198 HIV-positive participants had a CD4 count of <350 cells per cubic millimeter. The community health worker tool significantly outperformed WHO clinical staging in identifying CD4 count of <350 cells per cubic millimeter 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 antiretroviral therapy initiation.

Additional Information

Item Type	Article
Faculty and Department	Faculty of Epidemiology and Population Health > Dept of Infectious Disease Epidemiology Faculty of Infectious and Tropical Diseases > Dept of Clinical Research
Research Centre	Tropical Epidemiology Group
PubMed ID	23846567
ISI	335650300006
Related URLs	OA Location