BACKGROUND: Conducting HIV surveys in resource-limited settings is challenging because of logistics, limited availability of trained personnel, and complexity of testing. We described the procedures and systems deemed critical to ensure high-quality laboratory data in the population-based HIV impact assessments and large-scale household surveys. METHODS: Laboratory professionals were engaged in every stage of the surveys, including protocol development, site assessments, procurement, training, quality assurance, monitoring, analysis, and reporting writing. A tiered network of household, satellite laboratories, and central laboratories, accompanied with trainings, optimized process for blood specimen collection, storage, transport, and real-time monitoring of specimen quality, and test results at each level proved critical in maintaining specimen integrity and high-quality testing. A plausibility review of aggregate merged data was conducted to confirm associations between key variables as a final quality check for quality of laboratory results. RESULTS: Overall, we conducted a hands-on training for 3355 survey staff across 13 surveys, with 160-387 personnel trained per survey on biomarker processes. Extensive training and monitoring demonstrated that overall, 99% of specimens had adequate volume and 99.8% had no hemolysis, indicating high quality. We implemented quality control and proficiency testing for testing, resolved discrepancies, verified >300 Pima CD4 instruments, and monitored user errors. Aggregate data review for plausibility further confirmed the high quality of testing. CONCLUSIONS: Ongoing engagement of laboratory personnel to oversee processes at all levels of the surveys is critical for successful national surveys. High-quality population-based HIV impact assessments laboratory data ensured reliable results and demonstrated the impact of HIV programs in 13 countries.
BACKGROUND: Conducting HIV surveys in resource-limited settings is challenging because of logistics, limited availability of trained personnel, and complexity of testing. We described the procedures and systems deemed critical to ensure high-quality laboratory data in the population-based HIV impact assessments and large-scale household surveys. METHODS: Laboratory professionals were engaged in every stage of the surveys, including protocol development, site assessments, procurement, training, quality assurance, monitoring, analysis, and reporting writing. A tiered network of household, satellite laboratories, and central laboratories, accompanied with trainings, optimized process for blood specimen collection, storage, transport, and real-time monitoring of specimen quality, and test results at each level proved critical in maintaining specimen integrity and high-quality testing. A plausibility review of aggregate merged data was conducted to confirm associations between key variables as a final quality check for quality of laboratory results. RESULTS: Overall, we conducted a hands-on training for 3355 survey staff across 13 surveys, with 160-387 personnel trained per survey on biomarker processes. Extensive training and monitoring demonstrated that overall, 99% of specimens had adequate volume and 99.8% had no hemolysis, indicating high quality. We implemented quality control and proficiency testing for testing, resolved discrepancies, verified >300 Pima CD4 instruments, and monitored user errors. Aggregate data review for plausibility further confirmed the high quality of testing. CONCLUSIONS: Ongoing engagement of laboratory personnel to oversee processes at all levels of the surveys is critical for successful national surveys. High-quality population-based HIV impact assessments laboratory data ensured reliable results and demonstrated the impact of HIV programs in 13 countries.
Authors: Shannon M Farley; Chunhui Wang; Rachel M Bray; Andrea Jane Low; Stephen Delgado; David Hoos; Angela N Kakishozi; Tiffany G Harris; Rose Nyirenda; Nellie Wadonda; Michelle Li; Mbaraka Amuri; James Juma; Nzali Kancheya; Ismela Pietersen; Nicholus Mutenda; Salomo Natanael; Appolonia Aoko; Evelyn W Ngugi; Fred Asiimwe; Shirley Lecher; Jennifer Ward; Prisca Chikwanda; Owen Mugurungi; Brian Moyo; Peter Nkurunziza; Dorothy Aibo; Andrew Kabala; Sam Biraro; Felix Ndagije; Godfrey Musuka; Clement Ndongmo; Judith Shang; Emily K Dokubo; Laura E Dimite; Rachel McCullough-Sanden; Anne-Cecile Bissek; Yimam Getaneh; Frehywot Eshetu; Tepa Nkumbula; Lyson Tenthani; Felix R Kayigamba; Wilford Kirungi; Joshua Musinguzi; Shirish Balachandra; Eugenie Kayirangwa; Ayiyi Ayite; Christine A West; Stephane Bodika; Katrina Sleeman; Hetal K Patel; Kristin Brown; Andrew C Voetsch; Wafaa M El-Sadr; Jessica J Justman Journal: J Int AIDS Soc Date: 2022-09 Impact factor: 6.707
Authors: Robert A Domaoal; Katrina Sleeman; Souleymane Sawadogo; Tafadzwa Dzinamarira; Ndahafa Frans; Saara P Shatumbu; Ligamena N Kakoma; Terthu K Shuumbwa; Mackenzie Hurlston Cox; Sally Stephens; Lydia Nisbet; Melissa Metz; Suzue Saito; Daniel B Williams; Andrew C Voetsch; Hetal K Patel; Bharat S Parekh; Yen T Duong Journal: J Acquir Immune Defic Syndr Date: 2021-08-01 Impact factor: 3.771