TRACnet Internet and SMS Technology Improves Time to Antiretroviral Therapy Initiation among HIV-Infected Infants in Rwanda
Published Date:Jul 2016
Source:Pediatr Infect Dis J. 35(7):767-771.
Pubmed Central ID:PMC4925214
Funding:CC999999/Intramural CDC HHS/United States
Delays in testing HIV-exposed infants and obtaining results in resource-limited settings contribute to delays for initiating antiretroviral therapy(ART) in infants. To overcome this challenge, Rwanda expanded its national mobile and internet-based HIV/AIDS informatics system, called TRACnet, to include HIV PCR results in 2010. This study was performed to evaluate the impact of TRACnet technology on the time to delivery of test results and the subsequent initiation of ART in HIV-infected infants.
A retrospective cohort study was conducted on 380 infants who initiated ART in 190 health facilities in Rwanda from March 2010 to June 2013. Program data collected by the TRACnet system was extracted and analyzed.
Since the introduction of TRACnet for processing PCR results, the time to receive results has significantly decreased from a median of 144 days[IQR 121-197] to 23 days[IQR 17-43]. The number of days between PCR sampling and health facility receipt of results decreased substantially from a median of 90 days[IQR 83-158] to 5 days[IQR 2-8]. After receiving PCR results at a health facility, it takes a median of 44 days[IQR 32-77] before ART initiation. Result turnaround time was significantly associated with time to initiating ART(P<0.001). An increased number of staff trained for HIV care and treatment was also significantly associated with decreased time to ART initiation(P=0.004).
The use of mobile technology for communication of HIV PCR results, coupled with well-trained and skilled personnel, can reduce delays in communicating results to providers. Such reductions may improve timely ART initiation in resource-limited settings.
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