肯尼亚西部婴幼儿脱氧核糖核酸聚合酶链反应检测周转时间及其相关因素评估：一项混合方法研究。

An assessment of turnaround times of infant Deoxyribonucleic acid-Polymerase Chain Reaction testing and the associated factors in Western Kenya: A mixed methods study.

机构信息

School of Public Health and Community Development, Maseno University, Maseno, Kenya.

出版信息

PLoS One. 2024 May 2;19(5):e0302396. doi: 10.1371/journal.pone.0302396. eCollection 2024.

DOI:10.1371/journal.pone.0302396

PMID:38696502

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11065280/

Abstract

INTRODUCTION

The HIV/AIDS continues being a significant global public health priority in the 21st century with social and economic consequences Mother-to-child transmission (MTCT) occurs when an HIV-infected woman passes the virus to her infant and about 90% of these MTCT infections occurs in Africa where children and infants are still dying of HIV. Early definitive diagnosis using Deoxyribonucleic acid reaction of HIV infection in infants is critical to ensuring that HIV-infected infants receive appropriate and timely care and treatment to reduce HIV related morbidity and mortality.

OBJECTIVE

To assess the Infant Deoxyribonucleic acid-Polymerase Chain Reaction (DNA-PCR) Turnaround Time (TAT) of dry blood spots and associated factors in Vihiga, Bungoma, Kakamega and Busia counties, in Kenya.

METHOD

A mixed methods study using a) retrospectively collected data from Ministry of Health Laboratory registers, Early Infant Diagnosis (EID) database from 28 health facilities and b) 9 key informant interviews with laboratory in-charges were conducted. A total of 2,879 HIV exposed babies' data were abstracted from January 2012 to June 2013.

RESULTS

The mean TAT from specimen collection and results received back at the facilities was 46.90 days, Vihiga county having the shortest mean duration at 33.7days and Kakamega county having the longest duration at 51.7days (p = 0.001). In addition, the mean transport time from specimen collection and receipt at Alupe Kenya Medical Research Institute (KEMRI) reference Laboratory was 16.50 days. Vihiga County had the shortest transport time at 13.01 days while Busia had the longest at 18.99 days (p = 0.001). Longer TAT was due to the batching of specimens at the peripheral health facilities and hubbing to the nearest referral hospitals.

CONCLUSION

The TAT for DNA-PCR specimen was 46.90 days with Vihiga County having the shortest TAT due to lack of specimen batching and hubbing.

RECOMMENDATION

Discourage specimen batching/hubbing and support point-of-care early infant diagnosis (EID) tests.

摘要

引言

在 21 世纪，艾滋病毒/艾滋病仍然是全球重大公共卫生重点之一，对社会和经济都有影响。母婴传播（MTCT）是指感染艾滋病毒的妇女将病毒传染给婴儿，而这些 MTCT 感染中有约 90%发生在非洲，那里的儿童和婴儿仍因艾滋病毒而死亡。使用艾滋病毒感染的脱氧核糖核酸反应对婴儿进行早期明确诊断，对于确保感染艾滋病毒的婴儿获得适当和及时的护理和治疗，从而减少与艾滋病毒相关的发病率和死亡率至关重要。

目的

评估肯尼亚 Vihiga、Bungoma、Kakamega 和 Busia 县干血斑的婴儿脱氧核糖核酸-聚合酶链反应（DNA-PCR）周转时间（TAT）及其相关因素。

方法

采用混合方法研究，a）从卫生部实验室登记册和 28 个卫生设施的早期婴儿诊断（EID）数据库中回顾性收集数据，b）对实验室主管进行了 9 次关键知情人访谈。共从 2012 年 1 月至 2013 年 6 月提取了 2879 名艾滋病毒暴露婴儿的数据。

结果

从标本采集到设施收到结果的平均 TAT 为 46.90 天，Vihiga 县的平均时间最短，为 33.7 天，而 Kakamega 县的平均时间最长，为 51.7 天（p = 0.001）。此外，从标本采集到 Alupe 肯尼亚医学研究所（KEMRI）参考实验室收到标本的平均运输时间为 16.50 天。Vihiga 县的运输时间最短，为 13.01 天，而 Busia 县的运输时间最长，为 18.99 天（p = 0.001）。较长的 TAT 是由于在基层卫生设施中对标本进行批量处理，以及将标本送到最近的转诊医院。