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AIDS Research and Treatment
Volume 2017, Article ID 2572594, 8 pages
https://doi.org/10.1155/2017/2572594
Research Article

Assessing Very Early Infant Diagnosis Turnaround Times: Findings from a Birth Testing Pilot in Lesotho

1Elizabeth Glaser Pediatric AIDS Foundation, Project SOAR (Supporting Operational AIDS Research), Washington, DC, USA
2Department of Epidemiology and Biostatistics, Milken Institute School of Public Health, George Washington University, Washington, DC, USA
3Elizabeth Glaser Pediatric AIDS Foundation, Project SOAR (Supporting Operational AIDS Research), Maseru, Lesotho
4Ministry of Health, Maseru, Lesotho
5Centre for International Health, University of Bergen, Bergen, Norway

Correspondence should be addressed to Michelle M. Gill; gro.sdiadep@lligm

Received 4 September 2017; Accepted 14 November 2017; Published 19 December 2017

Academic Editor: Robert R. Redfield

Copyright © 2017 Michelle M. Gill et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Very early infant diagnosis (VEID) (testing within two weeks of life), combined with rapid treatment initiation, could reduce early infant mortality. Our study evaluated turnaround time (TAT) to receipt of infants’ HIV test results and ART initiation if HIV-infected, with and without birth testing availability. Data from facility records and national databases were collected for 12 facilities offering VEID, as part of an observational prospective cohort study, and 10 noncohort facilities. HIV-exposed infants born in January–June 2016 and any cohort infant diagnosed as HIV-infected at birth or six weeks were included. The median TAT from blood draw to caregiver result receipt was 76.5 days at birth and 63 and 70 days at six weeks at cohort and noncohort facilities, respectively. HIV-exposed infants tested at birth were approximately one month younger when their caregivers received results versus those tested at six weeks. Infants diagnosed at birth initiated ART about two months earlier (median 6.4 weeks old) than those identified at six weeks (median 14.8 weeks). However, the long TAT for testing at both birth and six weeks illustrates the prolonged process for specimen transport and result return that could compromise the effectiveness of adding VEID to existing overburdened EID systems.