An Integrated Sample Referral System for HIV Viral Load and Early Infant Diagnosis in North-Western Province, Zambia—A Retrospective Cross-Sectional Study

Author:

Shempela Doreen Mainza1,Sikalima Jay1,Mwandia Jim1,Mwila Ernest1,Chilyabanyama Rodgers1ORCID,Masona Mike1,Kasonde Cynthia Banda1,Mwandila Andrew1,Kamalamba Hector2,Kasanga Maisa3ORCID,Mutanekelwa Imukusi4ORCID,Mudenda Steward5ORCID,Kandama Franco Jordan1,Cham Fatim6,Njuguna Michael6,McCarrick Paul6,Morrison Linden6,Daka Victor4ORCID,Sichinga Karen1

Affiliation:

1. Churches Health Association of Zambia, Lusaka 10101, Zambia

2. Laboratory Department, Solwezi General Hospital, Solwezi 10101, Zambia

3. Department of Epidemiology and Biostatistics, School of Public Health, Zhengzhou University, Zhengzhou 450001, China

4. Public Health Department, Michael Chilufya Sata School of Medicine, Copperbelt University, Ndola 21692, Zambia

5. Department of Pharmacy, School of Health Sciences, University of Zambia, Lusaka 10101, Zambia

6. Global Fund to Fight AIDS, Tuberculosis and Malaria (GFATM), 1218 Geneva, Switzerland

Abstract

Zambia’s adult HIV prevalence is high at 11% and faces challenges in achieving UNAIDS 95-95-95 targets for HIV, with a national viral load suppression of 86.2% falling short of the required 95%. North-Western Province has the lowest viral load suppression at 77.5%. Our study investigated the role of an integrated sample referral system in optimizing HIV viral load coverage and Early Infant Diagnosis turnaround time in the province. Using electronic data from the DISA Laboratory Information System and Smartcare, a retrospective cross-sectional analysis was conducted, involving 160,922 viral load and Early Infant Diagnosis results. The chi-square test and multiple linear regression were used for analysis. Following the implementation of the integrated sample referral system, viral load coverage consistently increased monthly (p < 0.001), Early Infant Diagnosis turnaround time improved by 47.7%, and sample volume increased by 25%. The study identifies associations between various factors and testing outcomes. These findings demonstrate improvements in viral load coverage and the Early Infant Diagnosis turnaround time and suggest targeting modifiable factors to further optimize the referral system. We recommend continued strengthening of the referral system and more deliberate demand-creation implementation strategies.

Publisher

MDPI AG

Reference32 articles.

1. ZAMPHIA (2023, November 03). Zambia Population-Based HIV/AIDS Impact Assessment, Available online: https://www.cdc.gov/globalhivtb/what-we-do/phia/ZAMPHIA-2021-Summary-Sheet-December-2022.pdf.

2. Socioeconomic consequences of HIV/AIDS in the family system;Taraphdar;Niger. Med. J. J. Niger. Med. Assoc.,2011

3. The impact of HIV/AIDS on families and children—A study in China;Ji;AIDS,2007

4. The Joint United Nations Programme on HIV/AIDS 95–95–95 targets: Worldwide clinical and cost benefits of generic manufacture;Heath;AIDS,2021

5. MOH (2022). Consolidated Guidelines for the Treatment and Prevention of HIV, Guidelines. Lusaka: Government Printers.

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