International Lab BranchCenter for Global Health / Division of Global HIV/AIDS

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 MMScClinical and OI Monitoring Team International Laboratory Branch

Division of Global HIV/AIDSCDC , Atlanta, Georgia

Healthcare workers' acceptance and performance of point-of-care CD4

testing in Dar es Salaam 

Specimen Collection For Pima CD4 Testing

Fingerstick-Direct

Fingerstick-Microtube

Pima-Venous

Preference

Fingerstick-Direct

Fingerstick-Microtube

Pima-Venous

EaseOf

Use

Failed CD4

Result

Invalid

TestAccuracy

2nd

3rd

1st

1.8

3.0

1.7

1=very easy5=very difficult

9.9%

4.9%

0.9%

10.1%

8.6%

7.7%

R2= 0.82Bias -20

R2= 0.88Bias 0

R2= 0.89Bias -10

1. Collect supplies: - Lancet/alcohol/gauze2. Identify patient 3. Clean finger with

alcohol and dry

4. Select target site- - 3rd or 4th Finger, preferred - Off center from finger pad - lancet blade should cut vertical to fingerprint ridges

5. Hold finger firmly6. Place a new sterile lancet on

the target site7. Activate lancet while applying

firm downward pressure

7. With your finger, apply pressure on opposite side of lanced finger

8. 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