Rafferty H, Chirro O, Oduor C, Wahome E, Ngoi C, van der Elst E, Berger R, Rowland-Jones S, Graham SM, Sanders EJ. Pilot testing of an online training module about screening for acute HIV infection in adult patients seeking urgent healthcare.
Int Health 2019;
11:93-100. [PMID:
30388277 PMCID:
PMC6398591 DOI:
10.1093/inthealth/ihy077]
[Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2018] [Revised: 08/08/2018] [Accepted: 10/24/2018] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND
Acute HIV infection (AHI) is the phase of HIV infection immediately after acquisition, during which many patients develop symptoms and often seek healthcare. However, clinicians in sub-Saharan Africa are not currently taught about AHI.
METHODS
This study pilot-tested a self-directed AHI training module among clinical officers (COs) in coastal Kenya and assessed knowledge gained and challenges to instituting screening. The training module included four domains: AHI definition and importance of AHI recognition; symptoms and screening algorithms; diagnostic strategies; and management. AHI knowledge was assessed before and immediately after training. Participants' ability to utilize an AHI screening algorithm was evaluated with a case-based exercise.
RESULTS
Self-directed training was completed by 45 COs. Pre-test scores were low (median score 35% IQR 30-45%), but improved significantly after training (median post-test score 75%, IQR 70-85%, Wilcoxon signed-rank test p<0.0001). Participants had challenges in understanding the utility and application of a screening algorithm to identify patients for whom AHI testing would be indicated. Knowledge of AHI was poor at baseline, but improved with self-directed learning. Based on these findings, we revised and improved the AHI training module and pre- and post-assessments, which are now freely available online at www.marps-africa.org.
CONCLUSIONS
Guidelines on AHI screening and diagnosis are urgently needed in high HIV transmission areas.
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