Early Infant Diagnosis Sample Management in Mashonaland West Province, Zimbabwe, 2017

AIDS Research and Treatment
Hamufare MugauriMufuta Tshimanga

Abstract

In 2016, Mashonaland West Province had 7.4% (520) dried blood spot (DBS) samples for early infant diagnosis (EID) rejected by the Zimbabwe National Microbiology Reference Laboratory (NMRL). The samples were suboptimal, delaying treatment initiation for HIV-infected children. EID is the entry point to HIV treatment services in exposed infants. We determined reasons for DBS sample rejections and suggested solutions. A cause-effect analysis, modelled on Ishikawa, was used to identify factors impacting DBS sample quality. Interviewer-administered questionnaires and evaluation of sample collection process, using Standard Operating Procedure (SOP) was conducted. Rejected samples were reviewed. Epi Info™ was used to analyze findings. Eleven (73.3%) facilities did not adhere to SOP and (86.7%) did not evaluate DBS sample quality before sending for testing. Delayed feedback (up to 4 weeks) from NMRL extended EID delay for 14 (93.3%) of the facilities. Of the 53 participants, 62% knew valid sample identification. Insufficient samples resulted in most rejections (77.9%). Lack of training (94.3%) and ineffective supervision (69.8%) were also cited. Sample rejections could have been averted through SOP adherence. Ineffective supervision, ex...Continue Reading

References

Dec 7, 2007·Pediatrics·Jennifer S Read, UNKNOWN Committee on Pediatric AIDS, American Academy of Pediatrics
Nov 4, 2008·Pediatrics·UNKNOWN American Academy of Pediatrics Committee on Pediatric AIDS
Nov 14, 2008·Journal of Clinical Microbiology·Ryan J S KerrJulie A E Nelson
Jan 2, 2009·Pediatrics·Peter L HavensUNKNOWN American Academy of Pediatrics Committee on Pediatric AIDS
Feb 19, 2011·Journal of Clinical Virology : the Official Publication of the Pan American Society for Clinical Virology·M TamhaneD Persaud
Aug 27, 2011·The Journal of Pediatrics·Marianne BurgardUNKNOWN Agence Nationale de Recherche sur le SIDA et les Hepatites virales French Perinatal Cohort
Nov 30, 2012·The Pediatric Infectious Disease Journal·Kapila Bhowan, Gayle G Sherman
May 14, 2016·World Journal of Virology·Auchi InalegwuNicaise Ndembi

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Methods Mentioned

BETA
PCR

Software Mentioned

Epi Info

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