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

作者：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; Corbett Elizabeth L

来源：JAIDS: Journal of Acquired Immune Deficiency Syndromes , 2014, 65(2): E74-E78.

DOI：10.1097/QAI.0b013e3182a20e74

• antiretroviral therapy
• Africa
• HIV
• CD4 lymphocyte count
• ART eligibility
• WHO clinical staging system

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 %26lt;350 cells per cubic millimeter. The community health worker tool significantly outperformed WHO clinical staging in identifying CD4 count of %26lt;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.

• 出版日期2014-2-1