title: Consolidating HIV testing in a public health laboratory for efficient and sustainable early infant diagnosis (EID) in Uganda.
abstract: Uganda introduced an HIV Early Infant Diagnosis (EID) program in 2006, and then worked to improve the laboratory, transportation, and clinical elements. Reported here are the activities involved in setting up a prospective analysis in which the Ministry of Health, with its NGO partners, determined it would be more effective and efficient to consolidate the initial eight-laboratory system for EID testing of HIV dried blood samples offered by two nongovernmental partners operating research facilities into a single well-equipped and staffed laboratory within the Ministry. A retrospective analysis confirmed that redesign reduced overhead cost per PCR test of HIV dried blood samples from US$22.20 to an average of $5. Along with the revamped system of sample collection, transportation, and result communication, Uganda has been able to vastly increase the HIV diagnosis of babies and engagement of them and their mothers in clinical care, including antiretroviral therapy. Uganda reduced turnaround times for results reporting to clinicians from more than a month in 2006 to just 2 weeks by 2014, even as samples tested increased dramatically. The next challenge is overcoming loss of babies and mothers to follow up.
authors: Central Public Health Laboratories, Ministry of Health, 7-11 Buganda Road, Kampala 256 41, Uganda.
authors: Charles
authors: C
authors: Kiyaga
authors: 1] Central Public Health Laboratories, Ministry of Health, 7-11 Buganda Road, Kampala 256 41, Uganda [2] College of Health Sciences, Makerere University, Kampala, Uganda.
authors: Hakim
authors: H
authors: Sendagire
authors: Clinton Foundation Health Access Initiative, Uganda.
authors: Eleanor
authors: E
authors: Joseph
authors: Clinton Foundation Health Access Initiative, Uganda.
authors: Jeff
authors: J
authors: Grosz
authors: Clinton Foundation Health Access Initiative, Uganda.
authors: Ian
authors: I
authors: McConnell
authors: Clinton Foundation Health Access Initiative, Uganda.
authors: Vijay
authors: V
authors: Narayan
authors: Central Public Health Laboratories, Ministry of Health, 7-11 Buganda Road, Kampala 256 41, Uganda.
authors: Godfrey
authors: G
authors: Esiru
authors: Central Public Health Laboratories, Ministry of Health, 7-11 Buganda Road, Kampala 256 41, Uganda.
authors: Peter
authors: P
authors: Elyanu
authors: Central Public Health Laboratories, Ministry of Health, 7-11 Buganda Road, Kampala 256 41, Uganda.
authors: Zainab
authors: Z
authors: Akol
authors: Central Public Health Laboratories, Ministry of Health, 7-11 Buganda Road, Kampala 256 41, Uganda.
authors: Wilford
authors: W
authors: Kirungi
authors: Central Public Health Laboratories, Ministry of Health, 7-11 Buganda Road, Kampala 256 41, Uganda.
authors: Joshua
authors: J
authors: Musinguzi
authors: Central Public Health Laboratories, Ministry of Health, 7-11 Buganda Road, Kampala 256 41, Uganda.
authors: Alex
authors: A
authors: Opio
mesh_terms: D044966:Anti-Retroviral Agents / Q000627:therapeutic use; D042241:Early Diagnosis; D015658:HIV Infections / Q000175:diagnosis* / Q000188:drug therapy / Q000635:transmission; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical; D007753:Laboratories / Q000191:economics / Q000458:organization & administration*; D016133:Polymerase Chain Reaction; D011635:Public Health Administration; D012189:Retrospective Studies; D014454:Uganda
chemical_list: D044966:Anti-Retroviral Agents