Missed diagnostic opportunities within South Africa's early infant diagnosis program, 2010-2015

dc.contributor.authorMazanderani, Ahmad Haeri
dc.contributor.authorMoyo, Faith
dc.contributor.authorSherman, Gayle G.
dc.date.accessioned2017-08-10T09:25:47Z
dc.date.available2017-08-10T09:25:47Z
dc.date.issued2017-05-11
dc.descriptionS1 File. National MDO data 2010-2015. MDO, Missed Diagnostic Opportunitiesen_ZA
dc.description.abstractBACKGROUND : Samples submitted for HIV PCR testing that fail to yield a positive or negative result represent missed diagnostic opportunities. We describe HIV PCR test rejections and indeterminate results, and the associated delay in diagnosis, within South Africa's early infant diagnosis (EID) program from 2010 to 2015. METHODS : HIV PCR test data from January 2010 to December 2015 were extracted from the National Health Laboratory Service Corporate Data Warehouse, a central data repository of all registered test-sets within the public health sector in South Africa, by laboratory number, result, date, facility, and testing laboratory. Samples that failed to yield either a positive or negative result were categorized according to the rejection code on the laboratory information system, and descriptive analysis performed using Microsoft Excel. Delay in diagnosis was calculated for patients who had a missed diagnostic opportunity registered between January 2013 and December 2015 by means of a patient linking-algorithm employing demographic details. RESULTS : Between 2010 and 2015, 2 178 582 samples were registered for HIV PCR testing of which 6.2% (n = 134 339) failed to yield either a positive or negative result, decreasing proportionally from 7.0% (n = 20 556) in 2010 to 4.4% (n = 21 388) in 2015 (p<0.001). Amongst 76 972 coded missed diagnostic opportunities, 49 585 (64.4%) were a result of pre-analytical error and 27 387 (35.6%) analytical error. Amongst 49 694 patients searched for follow-up results, 16 895 (34.0%) had at least one subsequent HIV PCR test registered after a median of 29 days (IQR: 13±57), of which 8.4% tested positive compared with 3.6% of all samples submitted for the same period. CONCLUSIONS : Routine laboratory data provides the opportunity for near real-time surveillance and quality improvement within the EID program. Delay in diagnosis and wastage of resources associated with missed diagnostic opportunities must be addressed and infants actively followedup as South Africa works towards elimination of mother-to-child transmission.en_ZA
dc.description.departmentMedical Virologyen_ZA
dc.description.librarianam2017en_ZA
dc.description.sponsorshipThis work was supported by Discovery Foundation www.tshikululu.org.za), AHM, and United Nations Children's Fund (www.unicef.org), GGS as well as UNICEF for partially funding this work.en_ZA
dc.description.urihttp://www.plosone.orgen_ZA
dc.identifier.citationHaeri Mazanderani A, Moyo F, Sherman GG (2017) Missed diagnostic opportunities within South Africa's early infant diagnosis program, 2010±2015. PLoS ONE 12(5): e0177173. https:// DOI.org/ 10.1371/journal.pone.0177173.en_ZA
dc.identifier.issn1932-6203 (online)
dc.identifier.other10.1371/journal.pone.0177173
dc.identifier.urihttp://hdl.handle.net/2263/61610
dc.language.isoenen_ZA
dc.publisherPublic Library of Scienceen_ZA
dc.rights© 2017 Haeri Mazanderani et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.en_ZA
dc.subjectDiagnosisen_ZA
dc.subjectHIV PCR testingen_ZA
dc.subjectSouth Africa (SA)en_ZA
dc.subjectMother to child transmission (PMTCT)en_ZA
dc.subjectHuman immunodeficiency virus (HIV)en_ZA
dc.subjectPolymerase chain reaction (PCR)en_ZA
dc.titleMissed diagnostic opportunities within South Africa's early infant diagnosis program, 2010-2015en_ZA
dc.typeArticleen_ZA

Files

Original bundle

Now showing 1 - 2 of 2
Loading...
Thumbnail Image
Name:
Mazanderani_Missed_2017.pdf
Size:
1012.79 KB
Format:
Adobe Portable Document Format
Description:
Article
Loading...
Thumbnail Image
Name:
Mazanderani_MissedFileS1_2017.xlsx
Size:
6.21 MB
Format:
Microsoft Excel XML
Description:
File S1

License bundle

Now showing 1 - 1 of 1
Loading...
Thumbnail Image
Name:
license.txt
Size:
1.75 KB
Format:
Item-specific license agreed upon to submission
Description: