ABSTRACT
OBJECTIVES: HIV rapid antibody tests are widely used in Africa, but dual testing sometimes produces discordant results. It is not clear if discordant rapid HIV tests should always heighten suspicion by frontline health workers that early HIV infection is present. Some studies have reported that discordant rapid tests have value for identifying early HIV infection in high HIV prevalence populations. It is not known if rapid test performance influenced this conclusion, or if this observation will hold true for low HIV prevalence populations. We therefore explored the occurrence of discordant rapid HIV tests in a low-resource community. METHODS: A cross-sectional sample of HIV status-unaware adults with recent exposure to unsafe sex was assessed using a validated risk-based tool (University of North Carolina (UNC)-Malawi Risk Screening Score) for acute HIV infection. Participants received rapid testing with Determine™ HIV 1/2 and Uni-Gold™ HIV assays, plus plasma HIV-1 antigen testing with the COBAS® Ampliprep/COBAS® Taqman® HIV-1 assay, followed by western blot in those with detected HIV-1 antigen. RESULTS: Of 408 participants, 1.0% were confirmed to have established HIV infection. The discordance between rapid tests at initial screening was 2.45 and 2.94% when the two assays were used sequentially and simultaneously, respectively. Discordant rapid tests were strongly associated with risk scores > 2 [odds ratio (OR) 10.88; 95% confidence interval (CI) 2.35-50.43], and with detected HIV-1 RNA (OR 26.06; 95% CI 3.91-173.60). CONCLUSIONS: When the sample occurrence of discordance between the first and second tests is below 5%, discordant rapid tests in an adult with sexual risk behaviour should trigger strong suspicion of early HIV infection in low HIV prevalence populations.
Subject(s)
Diagnostic Tests, Routine/methods , HIV Antibodies/blood , HIV Antigens/blood , HIV Infections/diagnosis , Immunoassay/methods , Adolescent , Adult , Aged , Aged, 80 and over , Cross-Sectional Studies , Female , HIV-1/isolation & purification , Humans , Malawi , Male , Middle Aged , Reproducibility of Results , Young AdultABSTRACT
This study aimed to find out if levels of family support are correlated with blood glucose control among Nigerians with type 2 diabetes. One hundred and fifty (150) patients attending the diabetes clinic of the University College Hospital, Ibadan, were assessed for their perception of family support using a validated family support measure. Fasting plasma glucose was used as the index of glycaemic control, and 39% of subjects were rated as having 'strong' perceived family support, while 31% and 11% were rated wth 'weak' and 'no' perceived family support, respectively. Mean fasting plasma glucose was 7.0±2.5 mmol/L, with lower levels of blood glucose in those who perceived their family as supportive, compared with those who perceived their family as unsupportive. Positive family support was found to correlate positively with blood glucose control
