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

See all articles by Sarang Deo

Sarang Deo

Indian School of Business (ISB), Hyderabad - Operations Management

Lindy Crea

Clinton Foundation Health Access Initiative (CHAI), Mozambique

Jorge Quevedo

Clinton Foundation Health Access Initiative (CHAI), Mozambique

Jonathan Lehe

Clinton Foundation Health Access Initiative (CHAI), Mozambique

Lara Vojnov

Clinton Foundation Health Access Initiative (CHAI), Mozambique

Trevor Peter

Clinton Foundation Health Access Initiative (CHAI), Mozambique

Ilesh Jani

Instituto Nacional de Saude

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

Suggested Citation

Deo, Sarang and Crea, Lindy and Quevedo, Jorge and Lehe, Jonathan and Vojnov, Lara and Peter, Trevor and Jani, Ilesh, Expedited Results Delivery Systems Using GPRS Technology Significantly Reduce Early Infant Diagnosis Test Turnaround Times (September 1, 2015). JAIDS, 70, e1-e4, Available at SSRN: https://ssrn.com/abstract=2510213 or http://dx.doi.org/10.2139/ssrn.2510213

Sarang Deo (Contact Author)

Indian School of Business (ISB), Hyderabad - Operations Management ( email )

India

HOME PAGE: http://www.isb.edu/faculty-research/faculty/directory/deo-sarang

Lindy Crea

Clinton Foundation Health Access Initiative (CHAI), Mozambique ( email )

Maputo
Mozambique

Jorge Quevedo

Clinton Foundation Health Access Initiative (CHAI), Mozambique ( email )

Maputo
Mozambique

Jonathan Lehe

Clinton Foundation Health Access Initiative (CHAI), Mozambique ( email )

Maputo
Mozambique

Lara Vojnov

Clinton Foundation Health Access Initiative (CHAI), Mozambique ( email )

Maputo
Mozambique

Trevor Peter

Clinton Foundation Health Access Initiative (CHAI), Mozambique ( email )

Maputo
Mozambique

Ilesh Jani

Instituto Nacional de Saude ( email )

Avenida Eduardo Mondlane, No. 1008
Maputo
Mozambique

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