Expedited Results Delivery Systems using GPRS Technology Significantly Reduce Early Infant Diagnosis Test Turnaround Times

The objective of this study was to quantify the impact of a new technology to communicate the results of an infant HIV diagnostic test on test turnaround time and to quantify the association between late delivery of test results and patient loss to follow-up. We used data collected during a pilot implementation of Global Package Radio Service (GPRS) printers for communicating results in the Mozambique EID program from 2008 through 2010. Our dataset comprised 1,757 patient records, of which 767 were from before and 990 from after implementation of ERDS. We used multivariate logistic regression model to determine the association between late result delivery (more than 30 days between sample collection and result delivery to the health facility) and the probability of result collection by the infant's caregiver. We used a sample selection model to determine the association between late result delivery to the facility and further delay in collection of results by the caregiver. The mean test turnaround time reduced from 68.13 to 41.05 days post-ERDS. Caregivers collected only 665 of the 1757 results (37.8%). After controlling for confounders, the late delivery of results was associated with a reduction of approximately 18% (0.44 vs. 0.36; p-value<0.01) in the probability of results collected by the caregivers (OR=0.67, p-value<0.05). Late delivery of results was also associated with a further average increase in 20.91 days of delay in collection of results (p-value<0.01). EID program managers should further evaluate the cost-effectiveness of operational interventions (e.g. GPRS printers) that reduce delays.