Optimising courier specimen collection time improves patient access to HIV viral load testing in South Africa
Background: South Africa uses a courier network for transporting specimens to public laboratories. After the daily collection of specimens from the facility by the courier, patients not yet attended to are unlikely to receive same-day blood draws, potentially inhibiting access to viral load (VL) tes...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
AOSIS
2022-10-01
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| Series: | African Journal of Laboratory Medicine |
| Subjects: | |
| Online Access: | https://ajlmonline.org/index.php/ajlm/article/view/1725 |
| _version_ | 1797990407285506048 |
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| author | Sarah J. Girdwood Thomas Crompton Naseem Cassim Floyd Olsen Portia Sejake Karidia Diallo Leigh Berrie Dorman Chimhamhiwa Wendy Stevens Brooke Nichols |
| author_facet | Sarah J. Girdwood Thomas Crompton Naseem Cassim Floyd Olsen Portia Sejake Karidia Diallo Leigh Berrie Dorman Chimhamhiwa Wendy Stevens Brooke Nichols |
| author_sort | Sarah J. Girdwood |
| collection | DOAJ |
| description | Background: South Africa uses a courier network for transporting specimens to public laboratories. After the daily collection of specimens from the facility by the courier, patients not yet attended to are unlikely to receive same-day blood draws, potentially inhibiting access to viral load (VL) testing for HIV patients.
Objective: We aimed to design an optimised courier network and assess whether this improves VL testing access.
Methods: We optimised the specimen transport network in South Africa for 4046 facilities (November 2019). For facilities with current specimen transport times (n = 356), we assessed the relationship between specimen transport time and VL testing access (number of annual VL tests per antiretroviral treatment patient) using regression analysis. We compared our optimised transport times with courier collection times to determine the change in access to same-day blood draws.
Results: The number of annual VL tests per antiretroviral treatment patient (1.14, standard deviation: 0.02) was higher at facilities that had courier collection after 13:36 (the average latest collection time) than those that had their last collection before 13:36 (1.06, standard deviation: 0.03), even when adjusted for facility size. Through network optimisation, the average time for specimen transport was delayed to 14:35, resulting in a 6% – 13% increase in patient access to blood draws.
Conclusion: Viral load testing access depends on the time of courier collection at healthcare facilities. Simple solutions are frequently overlooked in the quest to improve healthcare. We demonstrate how simply changing specimen transportation timing could markedly improve access to VL testing. |
| first_indexed | 2024-04-11T08:35:51Z |
| format | Article |
| id | doaj.art-cd1847d2a4a440bc92bcd0b10aa5ec2d |
| institution | Directory Open Access Journal |
| issn | 2225-2002 2225-2010 |
| language | English |
| last_indexed | 2024-04-11T08:35:51Z |
| publishDate | 2022-10-01 |
| publisher | AOSIS |
| record_format | Article |
| series | African Journal of Laboratory Medicine |
| spelling | doaj.art-cd1847d2a4a440bc92bcd0b10aa5ec2d2022-12-22T04:34:20ZengAOSISAfrican Journal of Laboratory Medicine2225-20022225-20102022-10-01111e1e610.4102/ajlm.v11i1.1725402Optimising courier specimen collection time improves patient access to HIV viral load testing in South AfricaSarah J. Girdwood0Thomas Crompton1Naseem Cassim2Floyd Olsen3Portia Sejake4Karidia Diallo5Leigh Berrie6Dorman Chimhamhiwa7Wendy Stevens8Brooke Nichols9Health Economics and Epidemiology Research Office, Department of Internal Medicine, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; and, Department of Medical Microbiology, Amsterdam University Medical Center, Amsterdam, the NetherlandsRight to Care, JohannesburgDepartment of Molecular Medicine and Haematology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; and, National Health Laboratory Service, JohannesburgNational Health Laboratory Service, JohannesburgNational Health Laboratory Service, JohannesburgCenters for Disease Control and Prevention, PretoriaCenters for Disease Control and Prevention, PretoriaRight to Care, JohannesburgDepartment of Molecular Medicine and Haematology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; and, National Health Laboratory Service, JohannesburgHealth Economics and Epidemiology Research Office, Department of Internal Medicine, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; and, Department of Medical Microbiology, Amsterdam University Medical Center, Amsterdam, the Netherlands; and, Department of Global Health and Development, School of Public Health, Boston University, Boston, MassachusettsBackground: South Africa uses a courier network for transporting specimens to public laboratories. After the daily collection of specimens from the facility by the courier, patients not yet attended to are unlikely to receive same-day blood draws, potentially inhibiting access to viral load (VL) testing for HIV patients. Objective: We aimed to design an optimised courier network and assess whether this improves VL testing access. Methods: We optimised the specimen transport network in South Africa for 4046 facilities (November 2019). For facilities with current specimen transport times (n = 356), we assessed the relationship between specimen transport time and VL testing access (number of annual VL tests per antiretroviral treatment patient) using regression analysis. We compared our optimised transport times with courier collection times to determine the change in access to same-day blood draws. Results: The number of annual VL tests per antiretroviral treatment patient (1.14, standard deviation: 0.02) was higher at facilities that had courier collection after 13:36 (the average latest collection time) than those that had their last collection before 13:36 (1.06, standard deviation: 0.03), even when adjusted for facility size. Through network optimisation, the average time for specimen transport was delayed to 14:35, resulting in a 6% – 13% increase in patient access to blood draws. Conclusion: Viral load testing access depends on the time of courier collection at healthcare facilities. Simple solutions are frequently overlooked in the quest to improve healthcare. We demonstrate how simply changing specimen transportation timing could markedly improve access to VL testing.https://ajlmonline.org/index.php/ajlm/article/view/1725hiv viral loadscale-uppatient accesssouth africaspecimen transport |
| spellingShingle | Sarah J. Girdwood Thomas Crompton Naseem Cassim Floyd Olsen Portia Sejake Karidia Diallo Leigh Berrie Dorman Chimhamhiwa Wendy Stevens Brooke Nichols Optimising courier specimen collection time improves patient access to HIV viral load testing in South Africa African Journal of Laboratory Medicine hiv viral load scale-up patient access south africa specimen transport |
| title | Optimising courier specimen collection time improves patient access to HIV viral load testing in South Africa |
| title_full | Optimising courier specimen collection time improves patient access to HIV viral load testing in South Africa |
| title_fullStr | Optimising courier specimen collection time improves patient access to HIV viral load testing in South Africa |
| title_full_unstemmed | Optimising courier specimen collection time improves patient access to HIV viral load testing in South Africa |
| title_short | Optimising courier specimen collection time improves patient access to HIV viral load testing in South Africa |
| title_sort | optimising courier specimen collection time improves patient access to hiv viral load testing in south africa |
| topic | hiv viral load scale-up patient access south africa specimen transport |
| url | https://ajlmonline.org/index.php/ajlm/article/view/1725 |
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