Expedited Results Delivery Systems Using GPRS Technology Significantly Reduce Early Infant Diagnosis Test Turnaround Times
JAIDS, 70, e1-e4
Posted: 16 Oct 2014 Last revised: 27 Mar 2019
Date Written: September 1, 2015
Abstract
Background: Late delivery of test results is likely to be associated with patient loss to follow-up in HIV early infant diagnosis (EID) programs in resource-limited settings.
Methods: We used EID program data collected during a pilot implementation of an expedited results delivery system(ERDS) using GPRS printers in Mozambique from 2009 through 2010. Our dataset comprised 1,757 patient records, of which 767 were from before and 990 from after implementation of ERDS. We used multivariate logistic regression model to determine the association between late result delivery (more than 30 days between sample collection and result delivery to the health facility) and the probability of result collection by the infant's caregiver. We used a sample selection model to determine the association between late result delivery to the facility and further delay in collection of results by the caregiver.
Results: The mean test turnaround time reduced from 68.13 to 41.05 days post-ERDS. Of the 1,757 results, only 665 (37.8%) were collected by caregivers. After controlling for confounders, the late delivery of results was associated with a reduction of approximately 18% (0.44 vs. 0.36; p-value<0.01) in the probability of results collected by the caregivers (OR=0.67, p-value<0.05). Late delivery of results was also associated with a further average increase in 20.91 days of delay in collection of results (p-value<0.01).
Conclusions: Late delivery of results is associated with lower probability of them being collected and a further increase in communication delay. EID programs should further evaluate the cost-effectiveness of operational interventions (e.g. GPRS printers) that reduce delays.
Keywords: Early infant diagnosis, diagnosis delay, loss to follow-up, GPRS technology
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