Table 2.
Results from the quantitative healthcare worker survey on Determine LAM feasibility and ease of use, overall and stratified by hospital, n = 81.
| Workload and location for Determine LAM testing | Overall population (n = 81) | LH (n = 25) | KBTH (n = 44) | TGH (n = 12) | |
|---|---|---|---|---|---|
| Do you perform the Determine LAM yourself? n = 77 | Yes or Sometimes | 40 (51.9) | 15 (60.0) | 15 (37.5) | 10 (83.3) |
| No | 37 (48.1) | 10 (40.0) | 25 (62.5) | 2 (16.7) | |
| How long time do you spend on average to inform the patients about Determine LAM testing? n = 69 | 0–5 min | 34 (49.3) | 9 (40.9) | 19 (54.3) | 6 (50.0) |
| 5–10 min | 26 (37.7) | 10 (45.5) | 11 (31.4) | 5 (41.7) | |
| > 10 min | 9 (13.0) | 3 (13.6) | 5 (14.3) | 1 (8.33) | |
| How long time is required on average before urine is obtained from the patient, counting from the time you requested it? n = 69 | 0–10 min | 18 (26.1) | 6 (27.3) | 9 (25.7) | 3 (25.0) |
| 10–30 min | 22 (31.9) | 7 (31.8) | 10 (28.6) | 5 (41.7) | |
| 30–60 min | 16 (23.2) | 8 (36.4) | 6 (17.1) | 2 (16.7) | |
| >60 min | 11 (15.9) | 1 (4.6) | 8 (22.9) | 2 (16.7) | |
| Often not possible within the same day | 2 (2.9) | 0 (0) | 2 (5.7) | 0 (0.0) | |
| How long do you spend on average for the total Determine LAM activity per patient? n = 61, median minutes (IQR) | 30 (25–40) | 30 (25–40) | 30 (20–35) | 32.5 (28.8–52.5) | |
| Where do you, in general, perform the Determine LAM test? n = 69 (more than one alternative allowed per respondent) | Bedside | 60 (87.0) | 23 (92.0) | 27 (84.4) | 10 (83.3) |
| Consultation room | 1 (1.4) | 0 (0.0) | 1 (3.1) | 0 (0.0) | |
| Designated room at the ward | 3 (4.3) | 1 (4.0) | 3 (9.4) | 0 (0.0) | |
| Designated room outside the ward | 1 (1.4) | 0 (0.0) | 1 (3.1) | 0 (0.0) | |
| Laboratory | 5 (7.2) | 1 (4.0) | 2 (6.3) | 2 (16.7) | |
| Other, describe | 3 (4.3) | 0 (0.0) | 3 (9.4) | 0 (0.0) | |
| If otherwise, provide a description of where the Determine LAM test was performed. | Designated room at consulting area; In the washroom; At the out-patient clinic when necessary | ||||
| What would to you be the optimal location to perform the Determine LAM test? n = 75 (more than one alternative allowed per respondent) | Bedside | 35 (46.7) | 16 (64.0) | 14 (36.8) | 5 (41.7) |
| Consultation room | 8 (10.7) | 1 (4.0) | 6 (15.8) | 1 (8.3) | |
| Designated room at the ward | 21 (28.0) | 5 (20.0) | 15 (39.5) | 1 (8.3) | |
| Laboratory | 20 (26.7) | 11 (44.0) | 4 (10.5) | 5 (41.7) | |
| Other, describe | 1 (1.3) | 0 (0.0) | 1 (2.6) | 0 (0.0) | |
| If otherwise, provide a description of the optimal place for the Determine LAM test to be performed. | At the OPD, when the patient is clinically suspected of TB. | ||||
| Determine LAM use and interpretation | Overall population (n = 81) | LH (n = 25) | KBTH (n = 44) | TGH (n = 12) | |
|---|---|---|---|---|---|
| How do you experience the Determine LAM info leaflet? n = 70 | Very easy | 28 (40) | 16 (66.7) | 9 (25.7) | 3 (27.3) |
| Easy | 40 (57.1) | 8 (33.3) | 24 (68.6) | 8 (72.7) | |
| Difficult | 2 (2.9) | 0 (0.0) | 2 (5.7) | 0 (0.0) | |
| Very difficult | 0 (0.0) | 0 (0.0) | 0 (0.0) | 0 (0.0) | |
| How do you experience the Determine LAM procedure overall? n = 69 | Very easy | 27 (39.1) | 16 (66.7) | 9 (27.3) | 2 (16.7) |
| Easy | 41 (59.4) | 8 (33.3) | 23 (69.7) | 10 (83.3) | |
| Difficult | 1 (1.5) | 0 (0.0) | 1 (3.0) | 0 (0.0) | |
| Very difficult | 0 (0.0) | 0 (0.0) | 0 (0.0) | 0 (0.0) | |
| Did you use the reference scale card to judge if Determine LAM test was positive or negative? n = 65 | Yes | 58 (89.2) | 19 (82.6) | 27 (90.0) | 12 (100.0) |
| No | 7 (10.8) | 4 (17.4) | 3 (10.0) | 0 (0.0) | |
| Did you use the reference scale card to grade the Determine LAM band intensity? n = 66 | Yes | 57 (86.4) | 19 (82.6) | 26 (83.9) | 12 (100.0) |
| No | 9 (13.6) | 4 (17.4) | 5 (16.1) | 0 (0.0) | |
| How did you experience interpretation of the Determine LAM test results with discrimination between the 4 intensity bands? n = 62 | Very easy | 19 (30.6) | 11 (52.4) | 3 (10.3) | 5 (41.7) |
| Easy | 36 (58.1) | 9 (42.9) | 20 (69.0) | 7 (58.3) | |
| Difficult | 5 (8.1) | 1 (4.8) | 4 (13.8) | 0 (0.0) | |
| Very difficult, describe | 2 (3.2) | 0 (0.0) | 2 (3.2) | 0 (0.0) | |
| If very difficult to discriminate between the 4 intensity bands, describe: | At the first encounter but upon subsequently explaining the procedure was ok; Sometimes it is difficult to see the trace line. | ||||
| Urine sample | Overall population (n = 81) | LH (n = 25) | KBTH (n = 44) | TGH (n = 12) | |
|---|---|---|---|---|---|
| How do you experience obtaining urine samples from patient? n = 67 | Very easy | 17 (25.4) | 9 (39.1) | 4 (11.8) | 4 (40.0) |
| Easy | 39 (58.2) | 10 (43.5) | 26 (76.5) | 3 (30.0) | |
| Difficult | 10 (14.9) | 4 (17.4) | 3 (8.8) | 3 (30.0) | |
| Very difficult | 1 (1.5) | 0 (0.0) | 1 (2.9) | 0 (0.0) | |
| How do you experience handling the urine sample? n = 68 | Very easy | 21 (30.9) | 13 (54.2) | 7 (20.6) | 1 (10.0) |
| Easy | 47 (69.1) | 11 (45.8) | 27 (79.4) | 9 (90.0) | |
| Difficult | 0 (0.0) | 0 (0.0) | 0 (0.0) | 0 (0.0) | |
| Very difficult | 0 (0.0) | 0 (0.0) | 0 (0.0) | 0 (0.0) | |
| How do you experience disposal of the urine sample? n = 67 | Very easy | 24 (35.8) | 13 (54.2) | 9 (27.3) | 2 (20.0) |
| Easy | 41 (61.2) | 10 (41.7) | 23 (69.7) | 8 (80.0) | |
| Difficult | 1 (1.5) | 0 (0.0) | 1 (3.0) | 0 (0.0) | |
| Very difficult | 1 (1.5) | 1 (4.2) | 0 (0.0) | 0 (0.0) | |
LH, Lekma Hospital; KBTH, Korle Bu Teaching Hospital; TGH, Tema General Hospital; TB, Tuberculosis; Determine LAM, lateral flow urine lipoarabinomannan assay, Determine™ TB LAM Ag test (Abbott Laboratories, Chicago, IL, USA); NA, Not applicable. Data are n (%) unless stated otherwise.