Research

An investigation of fingerstick blood collection for point-of-care HIV-1 viral load monitoring in South Africa

Tyler Joseph Maiers, Natasha Gous, Matilda Nduna, Sally M McFall, David M Kelso, Mark J Fisher, Kara M Palamountain, Lesley E Scott, Wendy S Stevens

Abstract


Background. Viral load (VL) quantification is an important tool in determining newly developed drug resistance or problems with adherence to antiretroviral therapy (ART) in HIV-positive patients. VL monitoring is becoming the standard of care in many resource-limited settings. Testing in resource-limited settings may require sampling by fingerstick because of general shortages of skilled phlebotomists and the expense of venepuncture supplies and problems with their distribution.

Objective. To assess the feasibility and ease of collecting 150 µL capillary blood needed for the use of a novel collection device following a classic fingerstick puncture.

Methods. Patients were recruited by the study nurse upon arrival for routine ART monitoring at the Themba Lethu Clinic in Johannesburg, South Africa. Each step of the fingerstick and blood collection protocol was observed, and their completion or omission was recorded.

Results. One hundred and three patients consented to the study, of whom three were excluded owing to the presence of callouses. From a total of 100 patients who consented and were enrolled, 98% of collection attempts were successful and 86% of participants required only one fingerstick to successfully collect 150 µL capillary blood. Study nurse adherence to the fingerstick protocol revealed omissions in several steps that may lower the success rate of capillary blood collection and reduce the performance of a subsequent VL assay.

Conclusion. The findings of this study support the feasibility of collecting 150 µL of capillary blood via fingerstick for point-of-care HIV-1 VL testing in a resource-limited setting.

Authors' affiliations

Tyler Joseph Maiers, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA

Natasha Gous, Department of Molecular Medicine and Haematology, School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa

Matilda Nduna, National Health Laboratory Service, Johannesburg, South Africa

Sally M McFall, Center for Innovation in Global Health Technologies, Northwestern University, Evanston, IL, USA

David M Kelso, Center for Innovation in Global Health Technologies, Northwestern University, Evanston, IL, USA

Mark J Fisher, Center for Innovation in Global Health Technologies, Northwestern University, Evanston, IL, USA

Kara M Palamountain, Center for Innovation in Global Health Technologies, Northwestern University, Evanston, IL, USA; Kellogg School of Management, Northwestern University, Evanston, IL, USA

Lesley E Scott, Department of Molecular Medicine and Haematology, School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa

Wendy S Stevens, Department of Molecular Medicine and Haematology, School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; National Health Laboratory Service, Johannesburg, South Africa

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Keywords

HIV; Fingerstick; Diagnostics; Blood collection

Cite this article

South African Medical Journal 2015;105(3):228-231. DOI:10.7196/SAMJ.7799

Article History

Date submitted: 2014-09-09
Date published: 2015-02-03

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