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

Peter MacPherson; David Lalloo; Deus Thindwa; Emily L. Webb; Bertie Squire; Geoffrey A. Chipungu; Nicola Desmond; Simon D. Makombe; Miriam Taegtmeyer; Augustine Choko; Elizabeth L. Corbett

doi:10.1097/qai.0b013e3182a20e74

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

Peter MacPherson
, David Lalloo
, Deus Thindwa
, Emily L. Webb
, Bertie Squire
, Geoffrey A. Chipungu
, Nicola Desmond
, Simon D. Makombe
, Miriam Taegtmeyer
, Augustine Choko
, Elizabeth L. Corbett

University of Malawi
London School of Hygiene and Tropical Medicine
Ministry of Health, Malawi

Research output: Contribution to journal › Article › peer-review

3 Citations (Scopus)

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.

Original language	English
Pages (from-to)	e74-e78
Journal	Journal of Acquired Immune Deficiency Syndromes
Volume	65
Issue number	2
DOIs	https://doi.org/10.1097/qai.0b013e3182a20e74
Publication status	Published - 1 Feb 2014

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being

Keywords

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

Access to Document

10.1097/qai.0b013e3182a20e74

Cite this

MacPherson, P., Lalloo, D., Thindwa, D., Webb, E. L., Squire, B., Chipungu, G. A., Desmond, N., Makombe, S. D., Taegtmeyer, M., Choko, A., & Corbett, E. 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, 65(2), e74-e78. https://doi.org/10.1097/qai.0b013e3182a20e74

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

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.",

keywords = "Africa, Antiretroviral therapy, ART eligibility, CD4 lymphocyte count, HIV, WHO clinical staging system",

author = "Peter MacPherson and David Lalloo and Deus Thindwa and Webb, \{Emily L.\} and Bertie Squire and Chipungu, \{Geoffrey A.\} and Nicola Desmond and Makombe, \{Simon D.\} and Miriam Taegtmeyer and Augustine Choko and Corbett, \{Elizabeth L.\}",

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doi = "10.1097/qai.0b013e3182a20e74",

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MacPherson, P, Lalloo, D, Thindwa, D, Webb, EL, Squire, B, Chipungu, GA, Desmond, N, Makombe, SD, Taegtmeyer, M , Choko, A & Corbett, EL 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, vol. 65, no. 2, pp. e74-e78. https://doi.org/10.1097/qai.0b013e3182a20e74

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; Thindwa, Deus et al.
In: Journal of Acquired Immune Deficiency Syndromes, Vol. 65, No. 2, 01.02.2014, p. e74-e78.

Research output: Contribution to journal › Article › peer-review

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T1 - A novel community health worker tool outperforms WHO clinical staging for assessment of antiretroviral therapy eligibility in a resource-limited setting

AU - MacPherson, Peter

AU - Lalloo, David

AU - Thindwa, Deus

AU - Webb, Emily L.

AU - Squire, Bertie

AU - Chipungu, Geoffrey A.

AU - Desmond, Nicola

AU - Makombe, Simon D.

AU - Taegtmeyer, Miriam

AU - Choko, Augustine

AU - Corbett, Elizabeth L.

PY - 2014/2/1

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N2 - 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.

AB - 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.

KW - Africa

KW - Antiretroviral therapy

KW - ART eligibility

KW - CD4 lymphocyte count

KW - HIV

KW - WHO clinical staging system

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DO - 10.1097/qai.0b013e3182a20e74

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VL - 65

SP - e74-e78

JO - Journal of Acquired Immune Deficiency Syndromes

JF - Journal of Acquired Immune Deficiency Syndromes

IS - 2

ER -

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

Abstract

UN SDGs

Keywords

Access to Document

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Cite this