In a presentation to staffers from the U.S. Agency on International Development (USAID) and the World Health Organization last week, Dr. Liz Corbett presented on early diagnosis and prevention of tuberculosis and HIV in the community.
A clinical researcher specializing in infectious diseases who has been based in Africa for more than a decade, Dr. Corbett is now based in Malawi and her main research interest is improving TB control in populations with high HIV prevalence. Her special focus is exploring novel public health strategies with potential to increase access to TB diagnosis and treatment.
Dr. Corbett’s presentation touched on HIV self-testing in the community and the great successes with oral saliva testing in Malawi. In a feasibility study conducted in urban Blantyre – the first self-testing study in Africa – an accurate result after the first self-test using the OraQuick Advance was achieved more than 99 percent of the time. Testers used an oral swab to gather cells from the outer gums above their teeth, and then inserted the swab into a “developer solution” for 20 minutes, but no more than 40 minutes, after which they could interpret the results. Trial participants could take the test in private, even in their own homes.
The percentage of testers who achieved a definitely correct result from their own test was above 96 percent, and only ten percent needed help or made an error. Perhaps even more interesting, people preferred this method of self testing at home over going to a hospital or clinic, door-to-door administered testing, a voluntary counseling and testing center or a testing campaign. Sixty four percent of men and 58 percent of women preferred the home self-test, with the hospital /clinic testing site identified as the next preference among 23 percent of women and 12 percent of men in the study. All participants said they would recommend the self-test to friends or family.
In another section of her presentation, and one of the most compelling slides, Dr. Corbett reported on a generation of adolescent, long-term survivors of maternal transmission of HIV. About one third of HIV-infected infants survive to adolescence even without treatment, which Dr. Corbett said was much higher than anticipated. In this video clip, Dr. Corbett discusses this group of peri-natally infected adolescents, and one of the severe consequences of growing up HIV positive – delayed puberty and stunting.
During her visit, Dr. Corbett also met with congressional staffers on the Hill from key global health and appropriations offices, as well as doctors and advocates at the TB Roundtable.