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Clinical and Diagnostic Laboratory Immunology, January 2005, p. 86-92, Vol. 12, No. 1
1071-412X/05/$08.00+0     doi:10.1128/CDLI.12.1.86-92.2005
Copyright © 2005, American Society for Microbiology. All Rights Reserved.

Pediatric Human Immunodeficiency Virus Screening in an African District Hospital

A. J. De Baets,^1* B. S. Edidi,² M. J. Kasali,³ G. Beelaert,⁴ W. Schrooten,⁵ A. Litzroth,⁴ P. Kolsteren,¹ D. Denolf,⁶ and K. Fransen⁴

Nutrition and Child Health Unit,¹ Department of Microbiology,⁴ Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium,⁵ Laboratoire National de Référence Sida et IST,² Deutsche Gesellschaft für Zusammenarbeit, Kinshasa,⁶ Laboratoire Provincial de Référence Sida et IST de la Province Katanga, Lubumbashi, Democratic Republic of the Congo³

Received 8 July 2004/ Returned for modification 20 September 2004/ Accepted 24 September 2004

In order to evaluate alternative tests and strategies to simplify pediatric human immunodeficiency virus (HIV) screening at the district hospital level, a cross-sectional exploratory study was organized in the Democratic Republic of the Congo. Venous and capillary phlebotomies were performed on 941 Congolese children, aged 1 month to 12 years (153 children under 18 months and 788 children more than 18 months old). The HIV prevalence rate was 4.7%. An algorithm for children more than 18 months old, using serial rapid tests (Determine, InstantScreen, and Uni-Gold) performed on capillary blood stored in EDTA tubes, had a sensitivity of 100.0% (95% confidence interval [CI], 88.9 to 100.0%) and a specificity of 100.0% (95% CI, 99.5 to 100.0%). The results of this study suggest that the ultrasensitive p24 antigen assay may be performed on capillary plasma stored on filter paper (sensitivity and specificity, 100.0%; n = 87) instead of venous plasma (sensitivity, 92.3%; specificity, 100.0%; n = 150). The use of glucolets (instruments used to perform capillary phlebotomies), instead of syringes and needles, may reduce procedural pain and the risk of needle stick injuries at a comparable cost. Compared to the reference, HIV could have been correctly excluded based on one rapid test for at least 90% of these children. The results of this study point towards underutilized opportunities to simplify phlebotomy and pediatric HIV screening.

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* Corresponding author. Mailing address: Institute of Tropical Medicine, Nationalestraat 155, B-2000 Antwerp, Belgium. Phone: 32 3 247 62 03. Fax: 32 3 247 65 43. E-mail: anisah2{at}attglobal.net.

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Clinical and Diagnostic Laboratory Immunology, January 2005, p. 86-92, Vol. 12, No. 1
1071-412X/05/$08.00+0     doi:10.1128/CDLI.12.1.86-92.2005
Copyright © 2005, American Society for Microbiology. All Rights Reserved.

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