Diagnostic technique

Efficacy in Rural/Urban

Advantage

Limitation

Reference

WHO/CDC recommendation

Immunological test-Antibody test

Rural and urban

Cost effective.

Less sensitivity. False negative if ab concentration is low. Time taking.

[48] .

Combination ag/ab assay recommended by WHO/CDC instead of ab alone assay (WHO 2012; CDC 2014)

Immunological test-antigen/antibody (Ag/Ab) combination assay

Rural and urban

More sensitive than antibody test alone. Faster detection window.

False positive. Specific for HIV-1/2 antigen/antibody used

[49] [50] [51] [54] .

Combination ag/ab assay recommended by FDA/CDC/WHO [60] as first step in HIV detection.

NAAT

Urban

Most sensitive. Can detect and quantitate virus to stage the disease condition for therapy consideration.

High technology lab settings required. Skilled personnel need for the test. Not cost effective. Should be use to confirm and assist in therapy planning after ag/ab test.

[52] [53] .

Combination ag/ab assay recommended by FDA/CDC (CDC 2014) as first step followed by further confirmation by NAAT [81] .