Pilot testing of an online training module about screening for acute HIV infection in adult patients seeking urgent healthcare
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-direc...
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| Veröffentlicht in: | International health 2019-03, Vol.11 (2), p.93-100 |
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| creator | Rafferty, Hannah Chirro, Oscar Oduor, Clifford Wahome, Elizabeth Ngoi, Caroline van der Elst, Elise Berger, René Rowland-Jones, Sarah Graham, Susan M Sanders, Eduard J |
| description | 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 |
| doi_str_mv | 10.1093/inthealth/ihy077 |
| format | Article |
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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.</description><identifier>ISSN: 1876-3413</identifier><identifier>EISSN: 1876-3405</identifier><identifier>DOI: 10.1093/inthealth/ihy077</identifier><identifier>PMID: 30388277</identifier><language>eng</language><publisher>England: Oxford University Press</publisher><subject>Acute Disease ; Adolescent ; Adult ; Algorithms ; Ambulatory Care - statistics & numerical data ; Clinical Competence - statistics & numerical data ; Education, Distance ; Female ; HIV Infections - diagnosis ; Humans ; Kenya ; Male ; Mass Screening ; Original ; Patient Acceptance of Health Care ; Physicians, Primary Care - education ; Physicians, Primary Care - statistics & numerical data ; Pilot Projects ; Young Adult</subject><ispartof>International health, 2019-03, Vol.11 (2), p.93-100</ispartof><rights>The Author(s) 2018. Published by Oxford University Press Royal Society of Tropical Medicine and Hygiene. 2018</rights><rights>The Author(s) 2018. Published by Oxford University Press Royal Society of Tropical Medicine and Hygiene.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c432t-b38df187aad42cf31f710eab7b17d66b4a9dc785b9c1e6585dfb1e2201891e2a3</citedby><cites>FETCH-LOGICAL-c432t-b38df187aad42cf31f710eab7b17d66b4a9dc785b9c1e6585dfb1e2201891e2a3</cites><orcidid>0000-0002-0398-1567</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,776,780,881,1598,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30388277$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Rafferty, Hannah</creatorcontrib><creatorcontrib>Chirro, Oscar</creatorcontrib><creatorcontrib>Oduor, Clifford</creatorcontrib><creatorcontrib>Wahome, Elizabeth</creatorcontrib><creatorcontrib>Ngoi, Caroline</creatorcontrib><creatorcontrib>van der Elst, Elise</creatorcontrib><creatorcontrib>Berger, René</creatorcontrib><creatorcontrib>Rowland-Jones, Sarah</creatorcontrib><creatorcontrib>Graham, Susan M</creatorcontrib><creatorcontrib>Sanders, Eduard J</creatorcontrib><title>Pilot testing of an online training module about screening for acute HIV infection in adult patients seeking urgent healthcare</title><title>International health</title><addtitle>Int Health</addtitle><description>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.</description><subject>Acute Disease</subject><subject>Adolescent</subject><subject>Adult</subject><subject>Algorithms</subject><subject>Ambulatory Care - statistics & numerical data</subject><subject>Clinical Competence - statistics & numerical data</subject><subject>Education, Distance</subject><subject>Female</subject><subject>HIV Infections - diagnosis</subject><subject>Humans</subject><subject>Kenya</subject><subject>Male</subject><subject>Mass Screening</subject><subject>Original</subject><subject>Patient Acceptance of Health Care</subject><subject>Physicians, Primary Care - education</subject><subject>Physicians, Primary Care - statistics & numerical data</subject><subject>Pilot Projects</subject><subject>Young Adult</subject><issn>1876-3413</issn><issn>1876-3405</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>TOX</sourceid><sourceid>EIF</sourceid><recordid>eNqFUUFvFCEUJsbG1urdk-FoYtbCsAPMxcQ01TZp0h5ar-QN89hFZ2EFpkkv_vaynbqxp57e4_F93_vgI-QDZ18468SJD2WNMJb1iV_fM6VekSOulVyIJWtf73suDsnbnH8xJrWQzRtyKJjQulHqiPy99mMstGAuPqxodBQCjWH0AWlJ4MNuuonDNCKFPk6FZpsQH8cuJgp2KkjPL35SHxza4mOoHYVKKHQLxWMomWbE3zvGlFb1TGfPFhK-IwcOxozvn-oxuf1-dnN6vri8-nFx-u1yYZeiKYte6MHV1wAMy8Y6wZ3iDKFXPVeDlP0SusEq3fad5Shb3Q6u59g0jOuuVhDH5Ousu536DQ62ukgwmm3yG0j3JoI3z2-CX5tVvDNSdLrteBX49CSQ4p-p_pbZ-GxxHCFgnLJpeNO1opNSViiboTbFnBO6_RrOzC42s4_NzLFVysf_7e0J_3KqgM8zIE7bl-UeAGJsqp4</recordid><startdate>20190301</startdate><enddate>20190301</enddate><creator>Rafferty, Hannah</creator><creator>Chirro, Oscar</creator><creator>Oduor, Clifford</creator><creator>Wahome, Elizabeth</creator><creator>Ngoi, Caroline</creator><creator>van der Elst, Elise</creator><creator>Berger, René</creator><creator>Rowland-Jones, Sarah</creator><creator>Graham, Susan M</creator><creator>Sanders, Eduard J</creator><general>Oxford University Press</general><scope>TOX</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-0398-1567</orcidid></search><sort><creationdate>20190301</creationdate><title>Pilot testing of an online training module about screening for acute HIV infection in adult patients seeking urgent healthcare</title><author>Rafferty, Hannah ; Chirro, Oscar ; Oduor, Clifford ; Wahome, Elizabeth ; Ngoi, Caroline ; van der Elst, Elise ; Berger, René ; Rowland-Jones, Sarah ; Graham, Susan M ; Sanders, Eduard J</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c432t-b38df187aad42cf31f710eab7b17d66b4a9dc785b9c1e6585dfb1e2201891e2a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Acute Disease</topic><topic>Adolescent</topic><topic>Adult</topic><topic>Algorithms</topic><topic>Ambulatory Care - statistics & numerical data</topic><topic>Clinical Competence - statistics & numerical data</topic><topic>Education, Distance</topic><topic>Female</topic><topic>HIV Infections - diagnosis</topic><topic>Humans</topic><topic>Kenya</topic><topic>Male</topic><topic>Mass Screening</topic><topic>Original</topic><topic>Patient Acceptance of Health Care</topic><topic>Physicians, Primary Care - education</topic><topic>Physicians, Primary Care - statistics & numerical data</topic><topic>Pilot Projects</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Rafferty, Hannah</creatorcontrib><creatorcontrib>Chirro, Oscar</creatorcontrib><creatorcontrib>Oduor, Clifford</creatorcontrib><creatorcontrib>Wahome, Elizabeth</creatorcontrib><creatorcontrib>Ngoi, Caroline</creatorcontrib><creatorcontrib>van der Elst, Elise</creatorcontrib><creatorcontrib>Berger, René</creatorcontrib><creatorcontrib>Rowland-Jones, Sarah</creatorcontrib><creatorcontrib>Graham, Susan M</creatorcontrib><creatorcontrib>Sanders, Eduard J</creatorcontrib><collection>Oxford Journals Open Access Collection</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>International health</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Rafferty, Hannah</au><au>Chirro, Oscar</au><au>Oduor, Clifford</au><au>Wahome, Elizabeth</au><au>Ngoi, Caroline</au><au>van der Elst, Elise</au><au>Berger, René</au><au>Rowland-Jones, Sarah</au><au>Graham, Susan M</au><au>Sanders, Eduard J</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Pilot testing of an online training module about screening for acute HIV infection in adult patients seeking urgent healthcare</atitle><jtitle>International health</jtitle><addtitle>Int Health</addtitle><date>2019-03-01</date><risdate>2019</risdate><volume>11</volume><issue>2</issue><spage>93</spage><epage>100</epage><pages>93-100</pages><issn>1876-3413</issn><eissn>1876-3405</eissn><abstract>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.</abstract><cop>England</cop><pub>Oxford University Press</pub><pmid>30388277</pmid><doi>10.1093/inthealth/ihy077</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0002-0398-1567</orcidid><oa>free_for_read</oa></addata></record> |
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| source | Oxford Journals Open Access Collection; MEDLINE; EZB-FREE-00999 freely available EZB journals; Alma/SFX Local Collection |
| subjects | Acute Disease Adolescent Adult Algorithms Ambulatory Care - statistics & numerical data Clinical Competence - statistics & numerical data Education, Distance Female HIV Infections - diagnosis Humans Kenya Male Mass Screening Original Patient Acceptance of Health Care Physicians, Primary Care - education Physicians, Primary Care - statistics & numerical data Pilot Projects Young Adult |
| title | Pilot testing of an online training module about screening for acute HIV infection in adult patients seeking urgent healthcare |
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