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EP349/#554 Logistics of time required to implement a screen-and-treat strategy using point-of-care HPV testing for the prevention of cervical cancer
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  1. Nomonde Mbatani1,
  2. Rakiya Saidu1,
  3. Delivette Castor2,
  4. Rosalind Boa1,
  5. Jennifer Moodley3,
  6. Louise Kuhn4 and
  7. Lynette Denny1
  1. 1University of Cape Town, Obstetrics and Gynaecology, Cape Town, South Africa
  2. 2Columbia University, Infectious Disease, New York, USA
  3. 3University of Cape Town, Public Health, Cape Town, South Africa
  4. 4Columbia University, Epidemiology, New York, USA

Abstract

Objectives We conducted a time-motion study to assess implementation feasibility of POC HPV testing within a SAT program.

Methods We recruited women from a primary health care facility in Khayelitsha, Cape Town between February 2015-May 2016. We identified the following critical steps necessary if POC HPV testing is to be integrated into a SAT protocol: consent, history and examination, and sample testing on-site. Since HPV Xpert was used, which requires 60 minute run time, we estimated that the total visit time until a treatment decision could be made, assuming no delays, would be 95 minutes. If treatment is indicated, an additional 30 minutes would be needed to complete the visit

Results We enrolled 715 women, 223 (31.2%) were HPV-positive. Women were aged 42.7 (SD 8.6) years on average. Median visit time until a treatment decision could be made was 2.93 hours (range: 0.58–6.73; IQR 1.38) overall, 3.13 hours (range: 1.71–6.73; IQR 1.23) for participants who stayed to receive their HPV results and 1.97 hours (range: 0.58–5.00; IQR 1.64) for those who did not (figure 1). The decision to stay for receipt of HPV results was associated with earlier arrival in the day (table 1).

Abstract EP349/#554 Table 1

Conclusions Staying to receive results adds almost an hour to the visit, but it enables treatment at the same visit as screening. Patients who arrived later in the day were less likely to stay for their results. The logistics of POC testing are complex and require careful consideration to ensure efficient visits with as little wait-times for patients as possible.

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