Evaluation of the Performance of OraQuick® Rapid HIV-1/2 Test among decedents in Kisumu, Kenya

Details

• Alternative Title:
  J Acquir Immune Defic Syndr
• Personal Author:
  Opollo, Valarie ; Nyakeriga, Emmanuel ; Kingwara, Leonard ; Sila, Alex ; Oguta, Macxine ; Oyaro, Boaz ; Onyango, Dickens ; Mboya, Frankline O. ; Waruru, Anthony ; Musingila, Paul ; Mwangome, Mary ; Nyagah, Lilly M. ; Ngugi, Catherine ; Sava, Solomon ; Waruiru, Wanjiru ; Young, Peter W. ; Junghae, Muthoni
• Description:
  Background:
  
  Estimating cause-related mortality among the dead is not common, yet for clinical and public health purposes, a lot can be learnt from the dead. HIV/AIDS accounted for the third most frequent cause of deaths in Kenya; 39.7 deaths per 100,000 population in 2019. OraQuick® has previously been validated on oral fluid and implemented as a screening assay for HIV self-testing in Kenya among living subjects. We assessed the feasibility and diagnostic accuracy of OraQuick® for HIV screening among decedents.
  
  Methods:
  
  Trained morticians collected oral fluid from 132 pre- and post-embalmed decedents aged >18 months at Jaramogi Oginga Odinga Teaching and Referral Hospital mortuary in western Kenya and tested for HIV using OraQuick®. Test results were compared with those obtained using the national HIV Testing Services algorithm on matched pre-embalming whole blood specimens as a gold standard (Determine® HIV and First Response® HIV 1–2-O). We calculated positive predictive values (PPV), negative predictive values (NPV), Area Under Curve (AUC), sensitivity and specificity of OraQuick® compared to the national HTS algorithm.
  
  Results:
  
  OraQuick® had similar sensitivity of 92.6%, (95.0% confidence interval (CI):75.7– 99.1) on pre- and post-embalmed samples compared to the gold standard. Specificity was 97.1% (95.0% CI:91.9–99.4) and 95.2%, (95.0% CI:89.2–98.4) pre and post embalming respectively. Pre and post embalming PPV was 89.3% (95.0% CI:71.8–97.7) and 83.3% (95.0% CI:65.3–94.4) respectively. The AUC pre-and post embalming was 94.9% (95% CI: 89.6 – 100) and 93.9% (95% CI, 88.5 – 99.4) respectively.
  
  Conclusions:
  
  The study showed a relatively high performance sensitivity and specificity of OraQuick® HIV-1/2 test among decedents, similar to those observed among living subjects. OraQuick® HIV-1/2 presents a convenient and less invasive screening test for surveillance of HIV among decedents within a mortuary setting.
  
  
• Subjects:
  HIV-1 HIV Antibodies HIV Infections Humans Infant Kenya Reagent Kits, Diagnostic Sensitivity And Specificity
• Keywords:
  HIV HIV Mortality Surveillance Minimally Invasive HIV Testing OraQuick® Rapid Testing
• Source:
  J Acquir Immune Defic Syndr. 89(3):282-287
• Pubmed ID:
  34732683
• Pubmed Central ID:
  PMC8826608
• Document Type:
  Journal Article
• Funding:
  U2G GH001520/GH/CGH CDC HHSUnited States/ ; PEPFAR/PEPFARUnited States/
• Volume:
  89
• Issue:
  3
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha-512:bb19a7a27aa3345f982cabc2ef4df9e620b2bc647bb893734f184586dc8155dfb07117371acef27583c4088b2ea95de77564f3dd0d886ee7d424ee7af00d2a22
• Download URL:
  https://stacks.cdc.gov/view/cdc/114455/cdc_114455_DS1.pdf
• File Type:
  [PDF - 274.27 KB ]