National Microbiology Reference Laboratory, Harare, Zimbabwe.
Institute of Tropical Medicine, Antwerp, Belgium.
PLoS One. 2019 Aug 8;14(8):e0210136. doi: 10.1371/journal.pone.0210136. eCollection 2019.
Early infant diagnosis (EID) of HIV provides an opportunity for early HIV detection and access to appropriate Antiretroviral treatment (ART). Dried Blood Spot (DBS) samples are used for EID of exposed infants, born to HIV-positive mothers. However, DBS rejection rates in Zimbabwe have been exceeding the target of less than 2% per month set by the National Microbiology Reference Laboratory (NMRL), in Harare. The aim of this study was to determine the DBS sample rejection rate, the reasons for rejection and the possible associations between rejection and level of health facility where the samples were collected. This is an analytical cross-sectional study using routine DBS sample data from the NMRL in Harare, Zimbabwe, between January and December 2017.A total of 34 950 DBS samples were received at the NMRL. Of these, 1291(4%) were rejected. Reasons for rejection were insufficient specimen volume (72%), missing request form (11%), missing sample (6%), cross-contamination (6%), mismatch of information (4%) and clotted sample (1%). Samples collected from clinics/rural health facilities were five times more likely to be rejected compared to those from a central hospital. Rejection rates were above the set target of <2%. The reasons for rejection were 'pre-analytical' errors including labelling errors, missing or inconsistent data, and insufficient blood collected. Samples collected at primary healthcare facilities had higher rejection rates.
早期婴儿艾滋病诊断（EID）为早期发现艾滋病和获得适当的抗逆转录病毒治疗（ART）提供了机会。 干燥血斑（DBS）样本用于诊断 HIV 阳性母亲所生的暴露婴儿。 然而，津巴布韦的 DBS 拒收率一直超过哈拉雷国家微生物学参考实验室（NMRL）设定的每月低于 2％的目标。 本研究的目的是确定 DBS 样本拒收率，拒收的原因以及拒收与样本采集的卫生机构水平之间的可能关联。 这是一项在津巴布韦哈拉雷的 NMRL 进行的分析性横断面研究，使用的是 2017 年 1 月至 12 月的常规 DBS 样本数据。NMRL 共收到 34950 个 DBS 样本。 其中，1291 个（4％）被拒收。 拒收的原因是标本量不足（72％），缺少请求表（11％），缺少样本（6％），交叉污染（6％），信息不匹配（4％）和凝血样本（1％）。 与来自中央医院的样本相比，来自诊所/农村卫生机构的样本被拒收的可能性高 5 倍。 拒收率高于设定的<2％的目标。 拒收的原因是“分析前”错误，包括标签错误，数据缺失或不一致以及收集的血液不足。 在初级保健机构采集的样本拒收率更高。
