Tata Institute of Social Sciences, Mumbai, Maharashtra, India.
ICMR - National AIDS Research Institute, Pune, Maharashtra, India.
Inquiry. 2023 Jan-Dec;60:469580231159493. doi: 10.1177/00469580231159493.
India has been implementing one of the biggest Early Infant Diagnosis (EID) of HIV intervention globally. The turn-around-time (TAT) for EID test is one of the major factors for success of the program. This study was to assess the turnaround time and its determinants. It is a mixed methods study with quantitative analysis of retrospective data (2013-2016) collected from all the 7 Early Infant Diagnosis testing laboratories (called as regional reference laboratories or RRLs) in India and qualitative component that can help explain the determinants of turn-around-time. The retrospective national level data available from the RRLs was analyzed to measure the turn-around-time from the receipt of samples to the dispatch of results and to understand the determinants for the same. The 3 components transport time, testing time, and dispatch time were also calculated. Transport time was analyzed state-wise and the testing time RRL wise to understand disparities, if any. Qualitative interviews with the RRL officials were conducted to understand the underlying determinants of TAT. The Median turn-around-time ranged between 29 and 53 days over the 4 years. Transport time was significantly higher for states without RRL (42 days) than those with RRL (27 days). Testing time varied from RRL to RRL and was associated with incomplete forms, inadequate samples, kits logistics, staff turnover, staff training, and instrument related issues. The TAT is high and can be potentially reduced with interventions, such as decentralization of RRLs; courier systems for sample transport; and ensuring adequate resources at the RRL level.
印度一直在实施全球最大规模的艾滋病早期婴儿诊断（EID）干预措施之一。EID 检测的周转时间（TAT）是该项目成功的主要因素之一。本研究旨在评估周转时间及其决定因素。这是一项混合方法研究，对从印度所有 7 个早期婴儿诊断检测实验室（称为区域参考实验室或 RRL）收集的 2013-2016 年回顾性数据进行定量分析，并进行定性分析以帮助解释周转时间的决定因素。对 RRL 提供的全国性回顾性数据进行分析，以衡量从收到样本到发送结果的周转时间，并了解影响周转时间的因素。还计算了 3 个组成部分的运输时间、检测时间和发送时间。按州分析运输时间，并按 RRL 分析检测时间，以了解是否存在差异。对 RRL 官员进行了定性访谈，以了解 TAT 的潜在决定因素。4 年来，中位数周转时间在 29 至 53 天之间。没有 RRL 的州的运输时间（42 天）明显高于有 RRL 的州（27 天）。检测时间因 RRL 而异，与不完整的表格、样本不足、试剂盒物流、人员流动、人员培训和仪器相关问题有关。TAT 时间较长，可以通过干预措施来降低，例如 RRL 的权力下放；用于样本运输的快递系统；以及确保 RRL 层面有足够的资源。
