Operational Assessment of Point-of-Care Diagnostics in Primary Healthcare Clinics

NCT ID: NCT02692274

Last Updated: 2016-02-26

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Total Enrollment

309 participants

Study Classification

OBSERVATIONAL

Study Start Date

2015-04-30

Study Completion Date

2016-02-29

Brief Summary

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Diagnostic point-of-care (POC) tests are being rapidly developed and implemented in resource-limited settings. There has been a rapid rise of HIV and TB POC tests in South Africa during the last 10-15 years. The investigators sought to determine the existing availability, current usage and future need of POC tests among rural primary healthcare (PHC) clinics in South Africa's KwaZulu-Natal Province.

Detailed Description

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Several new diagnostics generation devices are specifically designed to assist clinical staff replacing the equivalent laboratory tests and allowing a wide range of disease diagnoses to be performed immediately at the POC. The clinical impact of POC diagnostics has been shown in a variety of diseases conditions, particularly HIV/AIDS and TB. The World Health Organisation (WHO) called for new clinical diagnostics methods that are designed to function in setting with limited access to laboratory services. Thus, leading to an increase in marketing, manufacturing and development of POC diagnostics instruments and reagents for use in clinical POC. The advent of POC tests in South Africa has led to an improved control of infectious diseases such as HIV and mycobacterium tuberculosis (TB), in this era of drug-resistance. Increased availability of POC test in rural and resource-limited settings is encouraged.

To maximize the impact of novel diagnostics on patient outcomes in resource-limited settings, the implementation of new diagnostics must be performed within a given context and culture. However, the population-level of diagnostic utility in South Africa is not known. The investigators aim to estimate the level of POC diagnostic availability, usage and need in rural South Africa, using a cross sectional survey of rural primary healthcare (PHC) clinics in KwaZulu Natal (KZN). The survey focused on the conditions for which the respondent considered a POC test might help improve their clinical decision making during patient care. Determining the current accessibility, availability, usage and need for POC diagnostics in rural and resource limited settings can help inform developers and implementers of POC diagnostic services on context-specific deployment and implementation of POC diagnostics to address the unmet needs of patients in these settings.

Conditions

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HIV

Study Design

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Study Time Perspective

CROSS_SECTIONAL

Study Groups

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Primary Health care clinics

A survey of 100 primary Health care clinics was carried out

No interventions assigned to this group

Pregnant and breast feeding women

208 patients were recruited from nine clinics that participated in the survey for evaluation of the accuracy of results produced by the HIV rapid test.

No interventions assigned to this group

Eligibility Criteria

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Inclusion Criteria

* Primary Healthcare clinics located in rural and semi-rural settings

Exclusion Criteria

* Primary Healthcare clinics located in urban settings
Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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African Population and Health Research Center

OTHER

Sponsor Role collaborator

University of Washington

OTHER

Sponsor Role collaborator

University of KwaZulu

OTHER

Sponsor Role lead

Responsible Party

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Tivani Mashamba-Thompson

Mrs

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Tivani P Mashamba-Thompson, Masters

Role: PRINCIPAL_INVESTIGATOR

University of KwaZulu

Benn K Sartorius, PhD

Role: STUDY_DIRECTOR

University of KwaZulu

Paul K Drain, MD,MPH

Role: STUDY_DIRECTOR

University of Washington

Locations

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University of KwaZulu Natal

Durban, KwaZulu-Natal, South Africa

Site Status

Countries

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South Africa

References

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Drain PK, Garrett NJ. The arrival of a true point-of-care molecular assay-ready for global implementation? Lancet Glob Health. 2015 Nov;3(11):e663-4. doi: 10.1016/S2214-109X(15)00186-2. No abstract available.

Reference Type BACKGROUND
PMID: 26475005 (View on PubMed)

Drain PK, Hyle EP, Noubary F, Freedberg KA, Wilson D, Bishai WR, Rodriguez W, Bassett IV. Diagnostic point-of-care tests in resource-limited settings. Lancet Infect Dis. 2014 Mar;14(3):239-49. doi: 10.1016/S1473-3099(13)70250-0. Epub 2013 Dec 10.

Reference Type BACKGROUND
PMID: 24332389 (View on PubMed)

Nabyonga J, Orem J. From knowledge to policy: lessons from Africa. Sci Transl Med. 2014 Jun 11;6(240):240ed13. doi: 10.1126/scitranslmed.3008852. No abstract available.

Reference Type BACKGROUND
PMID: 24920657 (View on PubMed)

Thomas TL, DiClemente R, Snell S. Overcoming the triad of rural health disparities: How local culture, lack of economic opportunity, and geographic location instigate health disparities. Health Educ J. 2014 May;73(3):285-294. doi: 10.1177/0017896912471049.

Reference Type BACKGROUND
PMID: 25242822 (View on PubMed)

Mashamba-Thompson TP, Sartorius B, Drain PK. Operational assessment of point-of-care diagnostics in rural primary healthcare clinics of KwaZulu-Natal, South Africa: a cross-sectional survey. BMC Health Serv Res. 2018 May 29;18(1):380. doi: 10.1186/s12913-018-3207-6.

Reference Type DERIVED
PMID: 29843711 (View on PubMed)

Other Identifiers

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HRKM 40/15

Identifier Type: OTHER

Identifier Source: secondary_id

BE484/14

Identifier Type: -

Identifier Source: org_study_id

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