Background
Before the release of the current HIV testing recommendation on retesting for verification (RFV), the Cameroon Baptist Convention Health Services (CBCHS) established 0.5% (0.3% in ART and 1.8% in PMTCT sites) misdiagnosis and inappropriate ART treatment among ART clients in Northwest and Southwest regions. This study aimed at assessing adherence to HIV testing guideline and issues involved.
Methods
This cross-sectional study received administrative and ethical approval from the Northwest Public Health Regional Delegation and the ethics committee of CBCHS (IRB study number: IRB2021- 74). Participants from 27 purposefully selected sites consented and anonymously completed a questionnaire containing questions on their training, work experience, knowledge and practice on RFV, and challenges and facilitators. Records of all clients who tested HIV positive in 2021 were reviewed to confirm RFV. The data was analysed for frequencies and proportions.
Results
A total of 25 (93.6%) facilities had the minimum two laboratory staff required for RFV, most (93.8%) had a minimum training of diploma in laboratory sciences and had two or more years of work experience (91.7%). The staff knowledge was averagely 81% accurate on HIV testing algorithm, 79% on RFV and 63% on its practice. The main facilitators of RFV were availability of rapid test kits (46%) and trained staff (10%) while bottlenecks were limited test kits (34%) and refusals (28%). Second event testing was performed for 92.5% (1525) of cases, of whom 93.4% was by another tester. Most independent testers knew the results of the first event test before conducting the second event test. Cases of documentation of second event testing without conducted it were reported.
Conclusion
Facilities staff were adequately trained and knowledgeable staff on RFV but the practice was low. More training and supervision are required for improvement on adherence to protocols for HIV RFV, thus eliminating misdiagnosis and inappropriate ART treatment.