Wexler Catherine, Cheng An-Lin, Gautney Brad, Finocchario-Kessler Sarah, Goggin Kathy, Khamadi Samoel
University of Kansas Medical Center, Department of Family Medicine, Kansas City, Kansas, United States of America.
University of Missouri-Kansas City, School of Medicine, Kansas City, Missouri, United States of America.
PLoS One. 2017 Aug 10;12(8):e0181005. doi: 10.1371/journal.pone.0181005. eCollection 2017.
Long turnaround times (TAT) for the processing and posting of results of infant HIV DNA PCR samples can hinder the success of early infant diagnosis (EID) programs. The HITSystem is an eHealth intervention that alerts staff when services are overdue or results are delayed. We conducted a retrospective analysis of 3669 HIV-exposed infants enrolled in 15 Kenya hospital EID programs and three laboratories using the HITSystem from 2011-2014. We assessed mean and median TAT from when a sample was: 1) obtained to when it was shipped to the laboratory, 2) shipped to when it was received at the laboratory, 3) received to when a result was posted, and 4) the total time from obtaining the sample (step 1) to posting the result (step 3). TAT were compared by laboratory, clinic, year, and month of sample collection. 3625 infant samples had results posted by end of 2014. Mean TAT from sample collection to shipping was 5.2 days, from shipping to laboratory receipt was 2.0 days, and from laboratory receipt to result posting was 17.4 days. Altogether, it took an average of 24.7 days from sample collection until result posting. There was significant variation between laboratories, particularly in laboratory processing times (step 3). TAT showed a decreasing trend from 2011-2014, although TAT in December remained higher. Compared with other Kenyan studies, TAT in these HITSystem enrolled settings were shorter. Significant variation between laboratories, however, indicates the need to strengthen protocols and infrastructure to ensure that all laboratories can provide rapid, high-quality services.
婴儿HIV DNA PCR样本检测结果的处理和发布周转时间过长，可能会阻碍早期婴儿诊断（EID）项目的成功实施。HITSystem是一种电子健康干预措施，当服务逾期或结果延迟时会提醒工作人员。我们对2011年至2014年在肯尼亚15家医院的EID项目中登记并使用HITSystem的3669名暴露于HIV的婴儿以及三个实验室进行了回顾性分析。我们评估了从样本：1）采集到运送到实验室、2）运送到实验室收到、3）收到到结果发布以及4）从采集样本（步骤1）到发布结果（步骤3）的平均和中位数周转时间。周转时间按实验室、诊所、年份和样本采集月份进行比较。到2014年底，3625份婴儿样本发布了结果。从样本采集到运送的平均周转时间为5.2天，从运送至实验室收到为2.0天，从实验室收到到结果发布为17.4天。总体而言，从样本采集到结果发布平均需要24.7天。各实验室之间存在显著差异，尤其是在实验室处理时间（步骤3）方面。2011年至2014年周转时间呈下降趋势，不过12月的周转时间仍然较高。与肯尼亚的其他研究相比，这些采用HITSystem的机构的周转时间较短。然而，各实验室之间的显著差异表明需要加强方案和基础设施建设，以确保所有实验室都能提供快速、高质量的服务。
