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

TL;DR

This study examines how long it takes to get DNA-PCR test results for HIV in infants in western Kenya and finds that delays are caused by specimen batching and transport.

Contribution

The study identifies batching and hubbing as key factors increasing DNA-PCR test turnaround times for HIV in infants in Kenya.

Findings

The mean DNA-PCR turnaround time was 46.90 days, with Vihiga County having the shortest time at 33.7 days.

Transport time averaged 16.50 days, with Busia County having the longest transport time at 18.99 days.

Longer turnaround times were attributed to specimen batching and hubbing practices.

Abstract

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.

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.

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.

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.

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.

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

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