A Novel Community Health Worker Tool Outperforms WHO Clinical Staging for Assessment of Antiretroviral Therapy Eligibility in a Resource-Limited Setting

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MacPherson, Peter ORCID: 0000-0002-0329-9613, Lalloo, David G ORCID: 0000-0001-7680-2200, Thindwa, Deus, Webb, Emily L, Squire, S Bertel, Chipungu, Geoffrey A, Desmond, Nicola ORCID: 0000-0002-2874-8569, Makombe, Simon D, Taegtmeyer, Miriam, Choko, Augustine T et al (show 1 more authors) and 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. JAIDS-JOURNAL OF ACQUIRED IMMUNE DEFICIENCY SYNDROMES, 65 (2). E74-E78.

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Official URL: http://dx.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.

Item Type:	Article
Additional Information:	## TULIP Type: Articles/Papers (Journal) ##
Uncontrolled Keywords:	antiretroviral therapy, Africa, HIV, CD4 lymphocyte count, ART eligibility, WHO clinical staging system
Depositing User:	Symplectic Admin
Date Deposited:	08 Jun 2016 14:56
Last Modified:	15 Mar 2024 00:28
DOI:	10.1097/QAI.0b013e3182a20e74
Related URLs:	Author Publisher
URI:	https://livrepository.liverpool.ac.uk/id/eprint/3001606