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Motorbikes Speed Up HIV Test Results In Malawi

April 17, 2014

Improvements 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.

Malawi currently 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 system."

“When a 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

The Ministry 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.

Clinician 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.”

Buono adds: “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.”

Laboratory testing

Malawi has three central laboratories to meet targets set in the government’s National Plan for the elimination of mother to child transmission of HIV.

Currently, 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.

However, the central laboratory and laboratory information management systems still play a critical role in early infant diagnosis.

Under the 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

According to 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 discrimination.

And by 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
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