Ndulue A.Nwokedi
Management Sciences for Health , Nigeria
Title: Improving Dried Blood Spot Transport Logistics for Early Infant Diagnosis (EID) in Nigeria: The SPEEiD (Strengthening the process and efficiencies of Early infant Diagnosis) Model
Biography
Biography: Ndulue A.Nwokedi
Abstract
Background: WHO recommends that all children exposed to HIV be tested within four to six weeks of birth to ensure that all infected infants are initiated on treatment early. One major challenge with EID of HIV in Nigeria remains the absence of standardized logistic sample transfer systems, resulting in long turnaround times between date of sample collection and date of return of result to the mother-baby pair. The USAID-funded ProACT project implemented by MSH pioneered a unique dried blood spot (DBS) transport model in Nigeria. This model focuses on the transportation of dried blood spot (DBS) samples to regional PCR labs in partnership with the Nigerian Postal Service (NIPOST) utilizing its courier Express Mail Service (EMS). The NIPOST mail route has a network of over 900 post offices and 3,000 postal agencies spread across the country, ensuring coverage of most localities where HIV services are delivered. The objective of this study was to review the effect of utilizing an innovative DBS transport model in improving DBS transportation.
Methods:We carried out a retrospective analysis of logistic data from 177 samples transferred from 28 PMTC sites using the SPEEiD model over a 12 month period from March 2013 to February 2014 in Kwara state, North Central Nigeria
Results: A review of the data showed a reduction in Turnaround Time (TAT) for return of results from 3-6 months to 3-4 weeks utilizing the SPEEiD Model. Results were received for 97% of samples (171/177) transported with this model, compared to 51% previously. The average cost of sample transfer was estimated at between $20-$40 per batch and remains comparatively less expensive to other models by at least 30%.
Conclusions:The MSH SPEEiD model remains an indigenous, cost effective, sustainable, and time sensitive sample transfer model which ensures that exposed infants are able to receive their EID test results quickly. This approach may be easily replicated by other partners within Nigeria and other similar resource limited setting with existing mail infrastructures. This model thus helps to provide a practical solution to DBS sample transfer, which remains one of the major challenges affecting early infant diagnosis of HIV in Nigeria