Impact Of Covid-19 On HIV viral load monitoring services at Blantyre dream project molecular laboratory
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Date
2021-09-15
Authors
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Publisher
Kamuzu University of Health Sciences
Abstract
This is a quantitative cross sectional study that aims to evaluate the impact of Covid-19 on HIV
viral load monitoring services at Blantyre Dream Project Molecular Laboratory.
Problem
Response to the Covid-19 pandemic has led to management of other infectious diseases like
HIV/AIDS being relegated to a minimal priority. The intense focus on Covid-19 might hinder
the efforts and undo progress made in controlling other infectious diseases including HIV/AIDS.
Routine HIV Viral Load (VL) and Covid-19 testing all are done on the Abbott m2000sp (PCR)
machines with Covid-19 samples being a priority which means they need to be processed
immediately/without delay upon their arrival at the laboratory as per Malawi MoH guidelines on
continuation of HIV services during the Covid-19 pandemic. This put the routine HIV VL testing
at a halt. It is anticipated that this has negatively affected HIV/AIDS services, HIV VL turnaround
times (TAT) and laboratory throughput in particular. Poor HIV viral load monitoring may
lead to high HIV transmission rate, ART regimen resistance and increased HIV/AIDS related
deaths.
Objectives
The primary objective of this study is to evaluate the impact of Covid-19 on HIV viral load
monitoring services at Blantyre Dream Project Molecular Laboratory. Our secondary objectives
are to compare HIV-VL test mean turn-around times before and during the Covid-19 pandemic,
to estimate monthly Laboratory HIV-VL test throughput before and during the Covid-19
pandemic and to determine equipment downtime and factors associated with the equipment
down time.
Methodology
A cross sectional study will be conducted at Blantyre Dream Project Molecular Laboratory one
of the 11 Laboratories in Malawi with the conventional PCR machines which are used for HIV
viral load and Covid-19 testing among other uses. Secondary data from Laboratory Information
Management System (LIMS) of HIV positive individuals on ART who routinely come for viral
load monitoring at this facility will be extracted and reviewed pre and post Covid-19. A total of
544 laboratory records will be reviewed for this study to maintain the 80% study power and 95%
confidence level of the study findings. Data analysis will be performed using STATA version
14.0
We will present summary (Descriptive) statistics and visual/graphical presentation of turnaround
times, overall monthly laboratory throughput, and machine down times. Means and
Standard Deviations (SD) for normally distributed variables will be computed and for skewed
variables, we will present medians and Interquartile ranges (IQR). A t-test will be used to
compare mean turn-around times Pre and Post Covid-19. HIV-VL laboratory monthly
throughput will be assessed by doing a time series analysis between the two processes (ViralLoad Testing and Covid-19 Testing). Results will be presented as contingency tables, pie charts
as well as graphs.
Dissemination
A final copy of this study findings will be made available at COMREC, Ministry of Health, and
Blantyre Dream Molecular Laboratory where the research data will be collected. Results will be
presented at national and international conferences and a manuscript will be prepared for
publishing in a peer-reviewed scientific journal.
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