global health

Scientists Delight Chikwete( L) and Tinenyasha Dzamatira( R) entering patient clinical and demographic data into the VL Data Management system at Masvingo Provincial Hospital. Results are automatically imported from the Roche Testing Machines

Scientists Jabulani Siyakangekani( L) and Wendy Sanyanga( R) using the Virtual Load Data Management System to enter data results at Chinhoyi Provincial Hospital

by Rutendo Pedzisai, database manager, APHL Zimbabwe and Levi Vere, quality monitoring manager, APHL Zimbabwe

After the development of a national VL Scale-Up Plan in 2016, APHL partnered with the Ministry of Health and Child Care( MoHCC) to establish VL laboratories at six public hospitals in Zimbabwe to provide VL testing assistance. Support included renovation and refurbishment of existing hospital laboratory space, procurement and placement of high throughput VL equipment, reagent and consumables procurement support, transport system and quality management system support.

The partnership has borne fruit. Testing numbers have gone up sharply, from 3,280 tests in July 2016 to over 26,000 per month as of November. This increase in output from the laboratories resulted in an immediate need for increased data management capacity to manage the high volume of information.

To improve data management processes, APHL worked with CDC to design and implement an interim data management solution to help laboratories handle the rapidly increasing volumes of data. Within a six-week period, a test system had been produced using open source tools. After extensive testing, the system was successfully implemented at three testing laboratories which previously did not have any kind of data management system. The interim system will continue to be used while waiting for MoHCC to roll out a comprehensive LIMS system.

Feedback on the new system has been truly phenomenal. Users have commended the system for its simplicity and robustness. Report turnaround time has improved. Importation of sample results from the testing machine to the VL data management system has reduced error-prone data entry processes, eliminated physical registers, helped enforce data quality and overall improved data quality. Laboratory testing time has also improved significantly, from an average of 10 days to 3-5 days. Users are also pleased with the quality of the new patient report, which has made results interpretation easier for all levels of clinical care.

How has the VL data management solution helped in your work and how has it helped in facing data management challenges?

Liberty Havazvidi: Using a program like Excel to manage data is easier due to the speed of recovery of results. Reports are generated quickly and are much more user friendly than previous reports. The new reports offer the clinician more information in terms of passing along results to the patient. It has also greatly helped with data confidentiality issues, since database access is controlled and can be regularly monitored.

Balbina Madimutsa: The system has helped in doing away with manual recording of patient demographics and results in paper-based systems like lab registers. The resulting report is clear and self-explanatory to clinicians.

What is your personal view on the VL scale-up at your site?

Havazvidi: VL scale up in Masvingo Province is a welcome initiative. At the patient level it has meant affordability, unlimited access and better testing turnaround times. Testing coverage has been widened and external quality assurance( EQA) has been extended.

Madimutsa: The scale up has been welcomed eagerly by both clinicians and patients and has necessitated a need to increase the number of staff for data entry and testing.

What do you do love about your job and how has VL testing helped morale in the office?

Havazvidi: The fact that I am a part of a global endeavor that strives to lessen the burden of HIV, and perhaps eradicate it, motivates me to embrace my job. I am trusted to give out a quality result which impacts the livelihood of many people, and adds to the global fight against HIV.

Madimutsa: I like making a difference by providing a service that was previously beyond the reach for most deserving patients who could not afford the cost at private labs.

Personnel— a premium in a resource-limited environment like Zimbabwe— have been able to handle more value-added tasks since the implementation of the data management system. Liberty Havazvidi and Balbina Madimutsa, APHL laboratory mentors at Masvingo Provincial Hospital and Chinhoyi Provincial Hospital respectively, shared their insights on the VL data management system: