Impact of SMS/GPRS printers in reducing time to early infant diagnosis compared to routine result reporting: A systematic review and meta-analysis

BACKGROUND: Despite significant gains made towards improving access, early infant diagnosis (EID) testing programs suffer from long test turnaround times that result in substantial loss to follow-up and mortality associated with delays in antiretroviral therapy initiation. These delays in treatment initiation are particularly impactful due to significant HIV-related infant mortality observed by 2-3 months of age. Short message service (SMS) and general packet radio service (GPRS) printers allow test results to be transmitted immediately to health care facilities upon completion of testing in the laboratory. METHODS: We conducted a systematic review and meta-analysis to assess the benefit of using SMS/GPRS printers to increase the efficiency of EID test result delivery compared with traditional courier paper-based results delivery methods. RESULTS: We identified 11 studies contributing data for over 16,000 patients from East and Southern Africa. The test turnaround time from specimen collection to result received at the health care facility with courier paper-based methods was 68.0 days (n=6,835), while the test turnaround time with SMS/GPRS printers was 51.1 days (n=6,711), resulting in a 2.5 week (25%) reduction in turnaround time. CONCLUSIONS: Courier paper-based EID test result delivery methods are estimated to add 2.5 weeks to EID test turnaround times in low resource settings and increase the risk that infants receive test results during or after the early peak of infant mortality. SMS/GPRS result delivery to health care facility printers significantly reduced test turnaround time and may reduce this risk. SMS/GPRS printers should be considered for expedited delivery of EID and other centralized laboratory test results.This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal

• Population(s)
  • Children or Youth (less than 18 years old)
  • General HIV+ population
• Engagement and Care Cascade
  • Linkage/engagement in care
  • Treatment
• Testing
  • Testing