title: Evaluation of current rapid HIV test algorithms in Rakai, Uganda.
abstract: Rapid HIV tests are a crucial component of HIV diagnosis in resource limited settings. In Uganda, the Ministry of Health allows both serial and parallel HIV rapid testing using Determine, Stat-Pak and Uni-Gold. In serial testing, a non-reactive result on Determine ends testing. The performance of serial and parallel algorithms with Determine and Stat-Pak test kits was assessed. A cross-sectional diagnostic test accuracy evaluation using three rapid HIV test kits as per the recommended parallel test algorithm was followed by EIA-WB testing with estimates of the performance of serial testing algorithm. In 2520 participants tested by parallel rapid algorithms, 0.6% had weakly reactive result. Parallel testing had 99.7% sensitivity and 99.8% specificity. If Stat-Pak was used as the first screening test for a serial algorithm, the sensitivity was 99.6% and specificity was 99.7%. However, if Determine was used as the screening test, sensitivity was 97.3% and specificity was 99.9%. Serial testing with Stat-Pak as the initial screening test performed as well as parallel testing, but Determine was a less sensitive screen. Serial testing could be cost saving.
authors.affiliation: Rakai Health Sciences Program, Kalisizo, Uganda. rmgaliwango@rhsp.org
authors.forename: Ronald M
authors.initials: RM
authors.lastname: Galiwango
authors.forename: Richard
authors.initials: R
authors.lastname: Musoke
authors.forename: Lawrence
authors.initials: L
authors.lastname: Lubyayi
authors.forename: Robert
authors.initials: R
authors.lastname: Ssekubugu
authors.forename: Sarah
authors.initials: S
authors.lastname: Kalibbala
authors.forename: Viola
authors.initials: V
authors.lastname: Ssekweyama
authors.forename: Viola
authors.initials: V
authors.lastname: Mirembe
authors.forename: Gertrude
authors.initials: G
authors.lastname: Nakigozi
authors.forename: Steven J
authors.initials: SJ
authors.lastname: Reynolds
authors.forename: David
authors.initials: D
authors.lastname: Serwadda
authors.forename: Ronald H
authors.initials: RH
authors.lastname: Gray
authors.forename: Godfrey
authors.initials: G
authors.lastname: Kigozi
mesh_terms: D000293:Adolescent; D000328:Adult; D000465:Algorithms; D003955:Diagnostic Tests, Routine / Q000379:methods*; D005260:Female; D015658:HIV Infections / Q000175:diagnosis*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012680:Sensitivity and Specificity; D014454:Uganda; D055815:Young Adult