U.S. Supports the Decentralization of Laboratory Services

Who: Ministry of Health and Child Care

Hon. Minister of Health and Child Care, Dr. David Parirenyatwa

Coordinator of the PMTCT Program,Dr. Angela Mushavi.

PEPFAR/CDC- Mr. Mark Troger and Dr. Shirish Balachandra

PEPFAR Implementing partners for EID laboratory renovations – BRTI

What: The Centers for Disease Control and Prevention (CDC) Zimbabwe, in partnership with the Biomedical Research Institute (BRTI), will hand over a recently renovated Early Infant Diagnosis (EID) laboratory at Mutare provincial hospital to the Ministry of Health and Child Care (MOHCC).  The EID decentralization project was funded by PEPFAR under the Prevention of Mother to Child Transmission (PMTCT) Program through CDC/Zimbabwe and  BRTI.  Another laboratory at Mpilo Provincial Hospital in Bulawayo was successfully renovated and functioning well.  The cost of renovating the two EID laboratories was approximately $75,000. CDC/Zimbabwe provided local technical and administrative support for the project whilst the actual renovations were done by the Public Works Departments in the respective hospitals. The work involved fitting new shelving, air conditioning units, burglar bars, UV film screen and blinds to existing windows, placing suitable doors, replacing damaged vinyl floor tiles with vinyl sheeting, painting and varnishing to existing surfaces as required and replacement of nonfunctional fire extinguisher was completed in January 2014 in Mutare and July 2014 in Bulawayo. Through PEPFAR support, the decentralization of EID testing in Zimbabwe has significantly improved.   Approximately $1,600,000 has been availed for the procurement of EID bundles, transportation of EID samples from collection sites to the decentralized EID laboratories, execution of laboratory tests for HIV diagnosis in infants and the installation/instituting of a two-way mobile Frontline short messaging services (SMS) and result transmission system.

When:           Thursday 4th June 2015; 1100hrs-1400hrs                         

Where:          Mutare Provincial Hospital

Why:              Zimbabwe continues to experience a high prevalence of HIV infections, with an HIV prevalence of 14 % in the general population and an ANC sero-prevalence of 16.1 %. In 2009 it was estimated that 15,000 babies were newly infected with HIV, with more than 90 % of these babies acquiring HIV infection through mother to child transmission.

Mother to child transmission of HIV is the second commonest route of HIV transmission in Zimbabwe and the highest cause of HIV infection among children.  Early diagnosis of HIV in infants is therefore, crucial for reducing HIV-related mortality and morbidity. With many HIV-infected children dying before their second birthday, it is important to receive HIV test results quickly hence, the importance of improving laboratory services.

The PMTCT program is working towards virtual elimination of HIV transmission from mother to child by 2015. Out of a total of 1643 health care facilities countrywide, 1560 ANC sites provide PMTCT services. The introduction of Option B+ by the PMTCT program has led to a marked decrease of HIV positivity rate amongst babies born from HIV positive mothers. The main evidence based indicator is laboratory HIV DNA test results. HIV DNA PCR testing has been provided in the public sector by the Ministry of Health and Child Care through the National Microbiology Reference Laboratory since 2007. The laboratory services directorate has seen a notable increase of tests carried out from 377 tests in 2007 from 12 sites to 50 438 tests in 2014 from 1585 sites thereby putting tremendous pressure on NMRL to cope  with EID. Hence there is need for increased laboratory access for HIV DNA testing of infants.

The HIV deoxyribonucleic acid (DNA) polymerase chain reaction (PCR) testing has now been successfully decentralized to Mutare Provincial Hospital since April 2014 (serving Manicaland and Masvingo provinces) and to Mpilo Central Hospital since September 2014 (serving the Matabeleland North and South Provinces including the City of Bulawayo). From April 2014 to 30 April 2015,10 175 specimens have been processed in Mutare while 5,222 have been processed at Mpilo laboratory from September 2014 to date are 5222.    Currently for both Mutare and Mpilo Hospitals the turnaround time of results is 4 days. The turnaround time at the National Microbiology Reference Laboratory (NMRL) has been reduced to less than 10 days, compared to 8-2 weeks  decentralization of laboratory services.

Both the U.S. and Zimbabwe governments are encouraged about the collaboration to eliminate pediatric HIV transmission through the PMTCT program. PEPFAR has provided $95 million dollars for the response to HIV/AIDS in 2012, 2013, 2014 respectively has pledged a similar amount for 2015.

Donald Mujiri, Public Relations Manager, MOHCC Tel: +263 712867337, dmujiri@gmail.com

Nicole Finnemann, Deputy Public Affairs Officer. E-mail: FinnemannNM@state.gov Tel. +263 4 758800-1, https://zw.usembassy.gov/

Dr. Shirish Balachandra: HIV Care and Treatment, CDC Zimbabwe. E-mail: ymx1@cdc.gov. Tel. +263 4 796040