Lab Matters Winter 2017 - Page 21

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

A Data Management Solution for New Viral Load Labs in Zimbabwe

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

Zimbabwe has joined other countries around the globe in transitioning from targeted to routine viral load ( VL ) monitoring of patients on HIV treatment . The targets proposed by UNAIDS in 2014 , and endorsed by the World Health Organization in 2015 , call for a scale-up of HIV testing so that 90 % of people with HIV are aware of their infection , 90 % of people diagnosed with HIV are linked to antiretroviral treatment ( ART ) and 90 % of those on ART adhere and have undetectable levels of HIV in their blood .

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 :
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