title: Evaluation of PIMATM CD4 System for Decentralization of Immunological Monitoring of HIV-Infected Patients in Senegal.
abstract: HIV infection is a concern in the army troupes because of the risk behaviour of the military population. In order to allow regular access to CD4+ T cell enumeration of military personnel as well as their dependents and civilians living with HIV, the Senegalese Army AIDS program is implementing PIMATM Alere technology in urban and semi-urban military medical centres. Validation such device is therefore required prior their wide implementation. The purpose of this study was to compare CD4+ T cell count measurements between the PIMATM Alere to the BD FACSCountTM.
  
  
  
  We selected a total of 200 subjects including 50 patients with CD4+ T-cells below 200/mm3, 50 between 200 and 350/mm3, 50 between 351 and 500/mm3, and 50 above 500/mm3. CD4+ T-cell count was performed on venous blood using the BD FASCountTM as reference method and the PIMATM Point of Care technology. The mean biases and limits of agreement between the PIMATM Alere and BD FACSCountTM were assessed with the Bland-Altman analysis, the linear regression performed using the Passing-Bablok regression analysis, and the percent similarity calculated using the Scott method.
  
  
  
  Our data have shown a mean difference of 22.3 cells/mm3 [95%CI:9.1-35.5] between the BD FACSCountTM and PIMATM Alere CD4 measurements. However, the mean differences of the two methods was not significantly different to zero when CD4+ T-cell count was below 350/mm3 (P = 0.76). The Passing-Bablok regression in categorized CD4 counts has also showed concordance correlation coefficient of 0.89 for CD4+ T cell counts below 350/mm3 whilst it was 0.5 when CD4 was above 350/mm3.
  
  
  
  Overall, our data have shown that for low CD4 counts, the results from the PIMATM Alere provided accurate CD4+ T cell counts with a good agreement compared to the FACSCountTM.
authors.affiliation: Military Hospital of Ouakam, Dakar, Senegal.|Immunology Department, Faculty of Medicine, Pharmacy and Odontology of the Cheikh Anta Diop University of Dakar, Senegal.|Senegalese AIDS Army Program, Dakar, Senegal.
authors.forename: Babacar
authors.initials: B
authors.lastname: Faye
authors.affiliation: Military Hospital of Ouakam, Dakar, Senegal.|Immunology Department, Faculty of Medicine, Pharmacy and Odontology of the Cheikh Anta Diop University of Dakar, Senegal.|Immunology Department of the Laboratory of Bacteriology and Virology of Aristide le Dantec University Hospital of Dakar, Senegal.
authors.forename: Moustapha
authors.initials: M
authors.lastname: Mbow
authors.affiliation: Military Hospital of Ouakam, Dakar, Senegal.|Parasitology Department, Faculty of Medicine, Pharmacy and Odontology of the Cheikh Anta Diop University of Dakar, Senegal.
authors.forename: Mame
authors.initials: M
authors.lastname: Cheikh Seck
authors.affiliation: Immunology Department, Faculty of Medicine, Pharmacy and Odontology of the Cheikh Anta Diop University of Dakar, Senegal.
authors.forename: Babacar
authors.initials: B
authors.lastname: Mbengue
authors.affiliation: Immunology Department of the Laboratory of Bacteriology and Virology of Aristide le Dantec University Hospital of Dakar, Senegal.
authors.forename: Djiril
authors.initials: D
authors.lastname: Wade
authors.affiliation: Immunology Department of the Laboratory of Bacteriology and Virology of Aristide le Dantec University Hospital of Dakar, Senegal.
authors.forename: Makhtar
authors.initials: M
authors.lastname: Camara
authors.affiliation: Military Hospital of Ouakam, Dakar, Senegal.
authors.forename: Cathy
authors.initials: C
authors.lastname: Cissé
authors.affiliation: Military Hospital of Ouakam, Dakar, Senegal.
authors.forename: Salimata Guèye
authors.initials: SG
authors.lastname: Diouf
authors.affiliation: Senegalese AIDS Army Program, Dakar, Senegal.|South Garrison Medical Centre, Dakar, Senegal.
authors.forename: Babacar
authors.initials: B
authors.lastname: Ndao
authors.affiliation: Department of Defense HIV/AIDS Prevention Program, Naval Health Research Center, San Diego, CA, United States of America.
authors.forename: Audrey
authors.initials: A
authors.lastname: Djibo
authors.affiliation: Immunology Department, Faculty of Medicine, Pharmacy and Odontology of the Cheikh Anta Diop University of Dakar, Senegal.
authors.forename: Maguette Dème
authors.initials: MD
authors.lastname: Sylla Niang
authors.affiliation: Immunology Department, Faculty of Medicine, Pharmacy and Odontology of the Cheikh Anta Diop University of Dakar, Senegal.|Immunology Department of the Laboratory of Bacteriology and Virology of Aristide le Dantec University Hospital of Dakar, Senegal.
authors.forename: Tandakha
authors.initials: T
authors.lastname: Ndiaye
authors.affiliation: Department of Defense HIV/AIDS Prevention Program, Naval Health Research Center, San Diego, CA, United States of America.
authors.forename: Michael P
authors.initials: MP
authors.lastname: Grillo
authors.affiliation: Immunology Department, Faculty of Medicine, Pharmacy and Odontology of the Cheikh Anta Diop University of Dakar, Senegal.
authors.forename: Alioune
authors.initials: A
authors.lastname: Dièye
mesh_terms: D000328:Adult; D000368:Aged; D018791:CD4 Lymphocyte Count / Q000295:instrumentation* / Q000379:methods; D015496:CD4-Positive T-Lymphocytes / Q000276:immunology / Q000821:virology; D005260:Female; D005434:Flow Cytometry; D015658:HIV Infections / Q000175:diagnosis* / Q000276:immunology* / Q000517:prevention & control / Q000821:virology; D006772:Hospitals, Military / Q000458:organization & administration; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D008889:Military Personnel; D015166:Monitoring, Immunologic / Q000295:instrumentation* / Q000379:methods; D019095:Point-of-Care Systems / Q000458:organization & administration / Q000592:standards*; D012309:Risk-Taking; D012725:Sexual Behavior / Q000523:psychology