to Malawi’s network for transporting laboratory samples will help people living
with HIV get vital test results quicker. The Elizabeth Glaser Pediatric AIDS
Foundation (EGPAF) plans to work with motorcycle couriers Riders for Health to
expand the laboratory samples transportation network in Malawi.
has no national laboratory sample transportation network. Transport is organized at a district level and may focus on urgent needs like collecting
blood for transfusions. However, many daily laboratory samples are not
systematically collected, brought to the laboratories for testing and returned
in a timely manner.
“Since HIV services require multiple
lab diagnostic tests to initiate, monitor and effectively treat patients on
antiretroviral treatment," explains Nicole Buono, EGPAF country director in Malawi, says, "These services also need a reliable sample transport
mother is told to come in two weeks to the hospital, we intend to make sure
that the results are there on time.”
Riders for Health
of Health has endorsed Riders for Health, an organization which identifies
trains and manages motorcycle couriers to collect and return samples on
specific routes. The model is working well in Rumphi, Mzimba South and other
districts in the northern region of Malawi.
It has also recently
been introduced in Mchinji district, in central Malawi. The samples are
collected from the 14 health facilities, sent to the district hospital and
later transferred to Lilongwe referral hospital, 110 kilometers away.
Eric Mittochi is the Mchinji coordinator for antiretroviral treatment and
prevention of mother to child transmission of HIV. He says: “Previously, a
client would take two to three months to get the results but with Riders for Health,
it takes a week. It is timely and efficient and enhances quality treatment
because some clinical decisions are based on outcome of the results.”
“The system is currently operating in three sites where we are working. In
2014, we would like to sign an agreement with Riders for Health to expand the
laboratory sample transportation systems across our seven project sites.”
three central laboratories to meet targets set in the government’s National
Plan for the elimination of mother to child transmission of HIV.
DNA testing is carried out in these central laboratories. The introduction
of Option B+ means that CD4 testing is not required before starting antiretroviral
therapy among HIV positive pregnant women.
central laboratory and laboratory information management systems still play a
critical role in early infant diagnosis.
National Plan, a new laboratory is proposed at Zomba Central Hospital to cover
the South East zone, which bears Malawi’s highest HIV burden. In this region,
currently only 40 per cent of health facilities are providing early infant
diagnosis services and only about 10 per cent of HIV-exposed infants are tested
for the virus using DNA testing.
Challenges to early infant diagnosis
Peggie Mwandira, manager of Chileka Health Centre in Lilongwe rural, there are
a number of challenges to diagnosing infants early. These include poor
identification of HIV-exposed children; low uptake of HIV testing for children
and stigma and discrimination, which prevent mothers from bringing their
children for testing and treatment.
Some of these
gaps can be addressed by training health workers to provide pediatric HIV and
services in all public health settings, empowering mothers to demand early
infant diagnosis and encouraging community dialogue to minimize stigma and
improving the sample transportation network, EGPAF and Riders for Health will make
it easier for health workers to follow up mothers and infants, by speeding up
the turnaround times for HIV test results.
Owen Nyaka lives in Malawi and is a member of the Key Correspondents network which
focuses on marginalized groups affected by HIV, to report the health and human
rights stories that matter to them. The network is supported by the International HIV/AIDS Alliance.
Image © Nell Freeman for the International HIV/AIDS Alliance