Performance Evaluation for the HIV And Syphilis Detection Protocols Used By The Medical Commission Diagnostic Laboratory In Qatar

Abstract

Background: The Medical Commission is responsible for screening all newcomers and expatriates in Doha, Qatar to ensure that infectious diseases do not enter the country. The infectious disease tests include; HIV, Hepatitis B, Hepatitis C, Syphilis, and Tuberculosis. Aim: In this study, we aim to evaluate the diagnostic efficiency of the protocols used in the Medical Commission for the diagnosis of HIV and Syphilis using specific statistical measures. Methodology: The replicates of ELISA reading was analyzed and used for repeatability and reproducibility purpose. For RPR testing, a total of 198 syphilis reactive samples during the period of January 2019 to December 2019 were included in this study. Results: HIV screening retrospective data has been collected from a total of 585,587 individuals who visited the Medical Commission, in which 595 were positive for HIV. The assays obtained from these individuals for HIV were analyzed and compared to each other to test the reproducibility and cost effectiveness of this diagnosis protocol. Two rounds of HIV diagnostic results showed a 99.83% agreement (overall and positive percent agreements; 95% CI, 99.05-99.97%). For syphilis analysis, data were obtained from the RPR test performed on 198 blood samples. In line with this, the overall percent agreement between the two RPR dilution2 and TPA Elisa was 36.55% (95% CI; 30.14%-43.47%), whereas the positive percent agreement was 100% (94.93%-100%). In order to ensure true positives, PPV results were obtained and were found similar to the overall percent agreement of the RPR dilution 2 and TBA ELISA i.e. 36.55% (30.14%-43.47%). Conclusion: The medical commission used highly performance techniques that are reliable and efficient for screening of STDs. Nevertheless, further studies are needed to test the agreement of these tests with other confirmatory tests done at Hamad Medical Corporation.