An overview of the quality assurance programme for HIV rapid testing in South Africa: Outcome of a 2-year phased implementation of quality assurance program

This is the first large-scale assessment of the implementation of HIV Rapid Test Quality Improvement Initiative in South Africa. We used a quasi-experimental one group post-test only design. The intervention implemented starting April 2014 comprised health-care worker training on quality assurance (...

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Bibliographic Details
Published in:PloS one 2019-09, Vol.14 (9), p.e0221906-e0221906
Main Authors: Woldesenbet, Selamawit Alemu, Kalou, Mireille, Mhlongo, Dumisani, Kufa, Tendesayi, Makhanya, Makhosazana, Adelekan, Adeboye, Diallo, Karidia, Maleka, Mahlatse, Singh, Beverley, Parekh, Bharat, Mohlala, Amanda, Manyike, Peter T, Tucker, Tim J, Puren, Adrian J
Format: Article
Language:English
Subjects:
Acquired immune deficiency syndrome
AIDS
AIDS Serodiagnosis - standards
Biology and Life Sciences
Certification
Clinics
Disease control
Disease prevention
Domains
Ecology and Environmental Sciences
Engineering and Technology
Health care facilities
Health surveillance
HIV
HIV Infections - diagnosis
Human immunodeficiency virus
Humans
Intervention
Laboratory Proficiency Testing
Medical diagnosis
Medical laboratories
Medical tests
Medicine and Health Sciences
People and places
Physical training
Public health
Quality assessment
Quality assurance
Quality Assurance, Health Care
Quality Control
Quality Improvement
South Africa
Training
Tuberculosis
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Summary:This is the first large-scale assessment of the implementation of HIV Rapid Test Quality Improvement Initiative in South Africa. We used a quasi-experimental one group post-test only design. The intervention implemented starting April 2014 comprised health-care worker training on quality assurance (QA) of HIV rapid testing and enrolment of the facilities in proficiency testing (PT), targeting 2,077 healthcare facilities in 32 high HIV burden districts. Following the intervention, two consecutive rounds of site assessments were undertaken. The first, conducted after a median of 7.5 months following the training, included 1,915 facilities that participated in the QA training, while the second, conducted after a median of one-year following the first-round assessment included 517 (27.0%) of the 1,915 facilities. In both assessments, the Stepwise-Process-for-Improving-the-quality-of-HIV-Rapid-Testing (SPI-RT) checklist was used to score facilities' performance in 7 domains: training, physical facility, safety, pre-testing, testing, post-testing and external quality assessment. Facilities' level of readiness for national certification was assessed. Between 2016 and 2017, there were four PT cycles. PT participation increased from 32.4% (620/1,915) in 2016 to 91.5% (1,753/1,915) in 2017. In each PT cycle, PT results were returned by 76%-87% of facilities and a satisfactory result (>80%) was achieved by ≥95% of facilities. In the SPI-RT assessment, in round-one, 22.3% of facilities were close to or eligible for national certification-this significantly increased to 38.8% in round-two (P-value
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0221906