{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,12]],"date-time":"2025-12-12T02:33:44Z","timestamp":1765506824525,"version":"3.37.3"},"reference-count":20,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2022,6,5]],"date-time":"2022-06-05T00:00:00Z","timestamp":1654387200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/100000030","name":"Centers for Disease Control and Prevention","doi-asserted-by":"publisher","award":["CDC-RFA-GH15-1575"],"award-info":[{"award-number":["CDC-RFA-GH15-1575"]}],"id":[{"id":"10.13039\/100000030","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["R01AI118511"],"award-info":[{"award-number":["R01AI118511"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,11,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>Reflex cryptococcal antigen (CrAg) screening of blood specimens with a CD4 count of &amp;lt;100 cells\/\u00b5L was performed at 45 South African CD4 laboratories using a lateral flow assay (LFA). Our objective was to evaluate the reliability of routine LFA results through comparative interlaboratory testing.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>All CrAg-positive and a selected number of CrAg-negative samples from the CD4 laboratories were retested at paired microbiology laboratories using the same LFA. Samples with discordant results were tested at a reference laboratory, using the LFA (with CrAg titers).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>During interlaboratory testing, 12,502 samples were retested, with 93 (0.7%) discordant results and a between-laboratory agreement of 99.3% (Cohen\u2019s kappa, 0.98). The proportion of retested samples with discordant results ranged from 0.17% to 5.31% per laboratory pair (median 0.28%), with 3 reporting &amp;gt;3% of results as discordant.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Routine CrAg screening results were reliable, with &amp;lt;1% of samples having discordant results, mainly due to interpretation and transcription errors.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/labmed\/lmac037","type":"journal-article","created":{"date-parts":[[2022,3,18]],"date-time":"2022-03-18T12:15:10Z","timestamp":1647605710000},"page":"614-618","source":"Crossref","is-referenced-by-count":3,"title":["Retrospective Assessment of a National Reflex Cryptococcal Antigen Screening Program in South Africa Through Interlaboratory Comparison of Lateral Flow Assay Results"],"prefix":"10.1093","volume":"53","author":[{"given":"Nozuko P","family":"Blasich","sequence":"first","affiliation":[{"name":"Centre for Healthcare-Associated Infections, Antimicrobial Resistance and Mycoses, National Institute for Communicable Diseases, a Division of the National Health Laboratory Service , Johannesburg , South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lindi M","family":"Coetzee","sequence":"additional","affiliation":[{"name":"School of Pathology, Faculty of Health Sciences, University of the Witwatersrand , Johannesburg , South Africa"},{"name":"National Priority Programmes CD4 Unit, National Health Laboratory Service , Johannesburg , South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Charlotte","family":"Sriruttan","sequence":"additional","affiliation":[{"name":"Centre for Healthcare-Associated Infections, Antimicrobial Resistance and Mycoses, National Institute for Communicable Diseases, a Division of the National Health Laboratory Service , Johannesburg , South Africa"},{"name":"School of Pathology, Faculty of Health Sciences, University of the Witwatersrand , Johannesburg , South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel","family":"DeSanto","sequence":"additional","affiliation":[{"name":"Centre for Healthcare-Associated Infections, Antimicrobial Resistance and Mycoses, National Institute for Communicable Diseases, a Division of the National Health Laboratory Service , Johannesburg , South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gregory S","family":"Greene","sequence":"additional","affiliation":[{"name":"Centre for Healthcare-Associated Infections, Antimicrobial Resistance and Mycoses, National Institute for Communicable Diseases, a Division of the National Health Laboratory Service , Johannesburg , South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Deborah K","family":"Glencross","sequence":"additional","affiliation":[{"name":"School of Pathology, Faculty of Health Sciences, University of the Witwatersrand , Johannesburg , South Africa"},{"name":"National Priority Programmes CD4 Unit, National Health Laboratory Service , Johannesburg , South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7869-9462","authenticated-orcid":false,"given":"Nelesh P","family":"Govender","sequence":"additional","affiliation":[{"name":"Centre for Healthcare-Associated Infections, Antimicrobial Resistance and Mycoses, National Institute for Communicable Diseases, a Division of the National Health Laboratory Service , Johannesburg , South Africa"},{"name":"School of Pathology, Faculty of Health Sciences, University of the Witwatersrand , Johannesburg , South Africa"},{"name":"Division of Medical Microbiology, Faculty of Health Sciences, University of Cape Town , Cape Town , South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2022,6,5]]},"reference":[{"issue":"1","key":"2022110311274686600_CIT0001","doi-asserted-by":"crossref","first-page":"1","DOI":"10.4102\/sajhivmed.v20i1.1030","article-title":"Southern African HIV Clinicians Society guideline for the prevention, diagnosis, and management of cryptococcal disease among HIV-infected persons: 2019 update","volume":"20","author":"Govender","year":"2019","journal-title":"South Afr J HIV Med"},{"year":"2018","key":"2022110311274686600_CIT0002"},{"author":"Coetzee","key":"2022110311274686600_CIT0003","article-title":"Roadmap for implementing a national early detection programme for reflexed CrAg screening in national health CD4 laboratories in South Africa"},{"author":"Coetzee","key":"2022110311274686600_CIT0004","article-title":"Rapid scale up of reflexed cryptococcal antigen screening across a CD4 laboratory network in South 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