Early infant diagnosis of HIV infection in Zambia through mobile phone texting of blood test results

Abstract

Objective: To see if, in the diagnosis of infant infection with human immunodeficiency virus (HIV) in Zambia, turnaround times could be reduced by using an automated notification system based on mobile phone texting.

Methods: In Zambia's Southern province, dried samples of blood from infants are sent to regional laboratories to be tested for HIV with polymerase chain reaction (PCR). Turnaround times for the postal notification of the results of such tests to 10 health facilities over 19 months were evaluated by retrospective data collection. These baseline data were used to determine how turnaround times were affected by customized software built to deliver the test results automatically and directly from the processing laboratory to the health facility of sample origin via short message service (SMS) texts. SMS system data were collected over a 7.5-month period for all infant dried blood samples used for HIV testing in the 10 study facilities.

Findings: Mean turnaround time for result notification to a health facility fell from 44.2 days pre-implementation to 26.7 days post-implementation. The reduction in turnaround time was statistically significant in nine (90%) facilities. The mean time to notification of a caregiver also fell significantly, from 66.8 days pre-implementation to 35.0 days post-implementation. Only 0.5% of the texted reports investigated differed from the corresponding paper reports.

Conclusion: The texting of the results of infant HIV tests significantly shortened the times between sample collection and results notification to the relevant health facilities and caregivers.

Figures

Fig. 1

Mobile-phone-based system for infant HIV test result notification, Zambia, 2008–2011

Fig. 2

Pathway for infant HIV test result notification, Zambia, 2008–2011

Fig. 3

Mean turnaround times for infant HIV test result notification to health facility, before and after implementation of mobile-phone-based notification system, Zambia, 2008–2011

Fig. 4

Mean turnaround times for infant HIV test result notification to caregiver, before and after implementation of mobile-phone-based notification system, Zambia, 2008–2011