title: Validity of oral mucosal transudate specimens for HIV testing using enzyme-linked immunosorbent assay in children in Chimanimani district, Zimbabwe.
abstract: OBJECTIVE
  To assess the validity of oral mucosal transudate (OMT) specimens for HIV testing in children using enzyme-linked immunosorbent assay (ELISA).
  
  
  METHODS
  A cross-sectional descriptive study was conducted as part of a community-based behavioural and HIV sero-status survey of adults and children in the Chimanimani district of Zimbabwe. Dried blood spot (DBS) and OMT samples were collected from children aged between 2 and 14 years, inclusive. Both samples were tested for HIV using the Vironostika Uniform II plus O kits. The main study outcomes were the sensitivity and specificity of OMT samples, with DBS as the gold-standard specimen.
  
  
  RESULTS
  Paired DBS and OMT specimens were available from 1 274 (94.4%) of the 1 350 children enrolled. Using the DBS, HIV prevalence was 3.2%. Overall sensitivity of OMT was 48.8% (95% confidence interval (CI) 33.3 - 64.5), and specificity was 98.5% (95% CI 97.7 - 99.1).
  
  
  CONCLUSIONS
  The overall sensitivity of OMT specimens for HIV testing in children using ELISA was low. Stratifying the analysis by sector showed that OMT samples are good specimens for HIV testing. It is important to note that factors such as the low HIV prevalence in our study population, quality of the OMT, diet and oral hygiene could have influenced the results.
authors.affiliation: Biomedical Research and Training Institute, Zimbabwe. wmashange@yahoo.co.uk
authors.forename: Wilson
authors.initials: W
authors.lastname: Mashange
authors.forename: Stella May
authors.initials: SM
authors.lastname: Gwini
authors.forename: Stanford T
authors.initials: ST
authors.lastname: Mahati
authors.forename: Stephen S
authors.initials: SS
authors.lastname: Buzuzi
authors.forename: Chenjerai K
authors.initials: CK
authors.lastname: Mutambanengwe
authors.forename: Shungu
authors.initials: S
authors.lastname: Munyati
authors.forename: Brian
authors.initials: B
authors.lastname: Chandiwana
authors.forename: Simbarashe
authors.initials: S
authors.lastname: Rusakaniko
authors.forename: Exnevia
authors.initials: E
authors.lastname: Gomo
mesh_terms: D000293:Adolescent; D000914:Antibodies, Viral / Q000032:analysis*; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D004797:Enzyme-Linked Immunosorbent Assay / Q000379:methods*; D005122:Exudates and Transudates / Q000821:virology; D005260:Female; D015658:HIV Infections / Q000175:diagnosis* / Q000453:epidemiology; D006801:Humans; D008297:Male; D009061:Mouth Mucosa / Q000276:immunology / Q000821:virology*; D015995:Prevalence; D011933:Reagent Kits, Diagnostic; D012680:Sensitivity and Specificity; D015030:Zimbabwe / Q000453:epidemiology
chemical_list: D000914:Antibodies, Viral; D011933:Reagent Kits, Diagnostic