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International Lab Branch

Healthcare workers' acceptance and performance of point-of-care CD4 testing in Dar es Salaam. Nichole Arnett, Karen Chang, Mary Schmitz, Ruth Lemwayi, Patrich Rwehumbiza, Michael Mwasekaga, Luciana Kohatsu, Omotayo Bolu, Fasta Mosha, Sehin Birhanu, Lydia Lu, John Nkengasong

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International Lab Branch

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  1. Healthcare workers' acceptance and performance of point-of-care CD4 testing in Dar es Salaam Nichole Arnett, Karen Chang, Mary Schmitz, Ruth Lemwayi, Patrich Rwehumbiza, Michael Mwasekaga, Luciana Kohatsu, Omotayo Bolu, Fasta Mosha, Sehin Birhanu, Lydia Lu, John Nkengasong Larry Westerman, PhD MMSc Clinical and OI Monitoring Team International Laboratory Branch Division of Global HIV/AIDS CDC , Atlanta, Georgia International Lab Branch Center for Global Health / Division of Global HIV/AIDS

  2. Fingerstick- Direct Fingerstick- Microtube Pima- Venous Specimen Collection For Pima CD4 Testing

  3. Fingerstick- Direct R2= 0.82 Bias -20 2nd 1.8 9.9% 10.1% Fingerstick- Microtube R2= 0.88 Bias 0 3rd 3.0 4.9% 8.6% Pima- Venous R2= 0.89 Bias -10 1st 1.7 0.9% 7.7% Accuracy Invalid Test Failed CD4 Result Ease Of Use Preference 1=very easy 5=very difficult

  4. Collect supplies: - Lancet/alcohol/gauze Identify patient Clean finger with alcohol and dry Select target site- - 3rd or 4th Finger, preferred - Off center from finger pad - lancet blade should cut vertical to fingerprint ridges Hold finger firmly Place a new sterile lancet on the target site Activate lancet while applying firm downward pressure With your finger, apply pressure on opposite side of lanced finger Wipe away the first drop of blood with a sterile gauze • Fingerstick Technique is important for CD4 testing • Slighthly more variation and errors with fingerstick compared to venous • Collection of fingerstick specimen in an EDTA microtube more like venous blood

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