8/2/2019 CD4 CBC Testing

http://slidepdf.com/reader/full/cd4-cbc-testing 1/17

EFFECTIVENESS OF POINTCARECD4/CBC TESTING MACHINES ATHEALTH FACILITIES IN UGANDA

Gloria Kakuru, Annet Nalugo, Albert maganda,Isaac Sebuliba, Alice siimwe, Betty Nsangi,

Robert Iriso, Addy Kekitiinwa © 2011 Baylor College of Medicine

8/2/2019 CD4 CBC Testing

http://slidepdf.com/reader/full/cd4-cbc-testing 2/17

Introduction

Services rendered varies from themost basic at Health Centre Levels Illand IV, through general and regional

referral hospital to national referencelaboratories.

Districts have 1-2 hospitals, 4-5 Health

Centre IV’s and 5-10 HC Ill’s. 60% of Health Centre Ills have

laboratories (600/991).

 © 2011 Baylor College of Medicine

8/2/2019 CD4 CBC Testing

http://slidepdf.com/reader/full/cd4-cbc-testing 3/17

8/2/2019 CD4 CBC Testing

http://slidepdf.com/reader/full/cd4-cbc-testing 4/17

Introduction (3)

Baylor-Uganda procured fourPointCare CD4/CBC testingequipment in 2009 for Kitgum ,

Kilembe mines and Pallisa Hosp,and Kaberamaido HC IV

Dual platform – Total WBC count,

haemoglobin, four-parthaematology differential, CD4

count and CD4 %

8/2/2019 CD4 CBC Testing

http://slidepdf.com/reader/full/cd4-cbc-testing 5/17

Coverage of ART eligibility 2009

 © 2011Baylor College of Medicine

8/2/2019 CD4 CBC Testing

http://slidepdf.com/reader/full/cd4-cbc-testing 6/17

PointCare Now Features

 © 2011 Baylor College of Medicine

•adapted for rural use

Fully automated – No

manual steps for pipetting,incubation, vortexing, etc

Results in 8 minutes; 50samples a day

Flexible power options –

UPS, Battery Pack and SolarPanel for extended battery lifeand battery re-charge

8/2/2019 CD4 CBC Testing

http://slidepdf.com/reader/full/cd4-cbc-testing 7/17

Features (2)

Automated data analysis – No manualgating or interpretation of data

Calibration – Factory calibrated; does notrequire gain adjustments or colour

compensation

Easy and safe to use – full automation andclosed-cap sampling

Minimal operator training Heat-stable reagents to 30°C – no cold

chain shipping

 © 2011 Baylor College of Medicine

8/2/2019 CD4 CBC Testing

http://slidepdf.com/reader/full/cd4-cbc-testing 8/17

Objectives

To determine the effect of

availing on site CD4/ CBC

testing on:number of people initiated on

HAART

time to HAART initiation

 © 2011 Baylor College of Medicine

8/2/2019 CD4 CBC Testing

http://slidepdf.com/reader/full/cd4-cbc-testing 9/17

Materials and Methods Records of CD4 tests done, number of

patients started on HAART andaverage time to initiation of HAART a

year before and after installation of theequipment were compared

Sites: Kaberamaido HCIV, Pallisa and

Kitgum hosp. Kilembe mines hospital Time of comparison: 2008/09 vs

2009/10

 © 2011 Baylor College of Medicine

8/2/2019 CD4 CBC Testing

http://slidepdf.com/reader/full/cd4-cbc-testing 10/17

Adult HAART Initiation

 © 2011 Baylor College of Medicine

0

500

1000

1500

2000

2500

3000

3500

Before After

825990

1698

3294

   N  o .  o  n

   H   A   A   R   T

installation of CD4/CBC machine

Adults Started

Active on HAART

8/2/2019 CD4 CBC Testing

http://slidepdf.com/reader/full/cd4-cbc-testing 11/17

Children HAART Initiation

 © 2011 Baylor College of Medicine

0

50

100

150

200

250

300

350

Before After

22

86

50

339

   N  o .  o  n

   H   A   A   R

   T

Installation of CD4 machine

Chart Title

Children Started

Active on HAART

8/2/2019 CD4 CBC Testing

http://slidepdf.com/reader/full/cd4-cbc-testing 12/17

Time to HAART initiation

7.2

3.6

0

1

2

3

4

5

6

7

8

Months to

HAART

initiation

2008-2009 2009-10

Year of comparison

8/2/2019 CD4 CBC Testing

http://slidepdf.com/reader/full/cd4-cbc-testing 13/17

Other Benefits

EID improved- tagged to CD4 testingand sample transportation

TAT for laboratory investigations Hb 

and CBC Logistics management of supplies,

reagents and commodities improved

Clinic flow synchronised

 © 2011 Baylor College of Medicine

8/2/2019 CD4 CBC Testing

http://slidepdf.com/reader/full/cd4-cbc-testing 14/17

Challenges

Attrition of trained lab staff afterinstallation

Administrative support to keep

equipment running The heavy patient load of the ART

clinic in need of CD4/CBC results

overwhelmed staff members.

 © 2010 Baylor College of Medicine

8/2/2019 CD4 CBC Testing

http://slidepdf.com/reader/full/cd4-cbc-testing 15/17

Conclusions

No of patients initiating HAART didnot change significantly

However no of active clients in careand on HAART increased by 48% foradults and 85% for children

transfer in for better service

Average time to HAART initiationdecreased by 50%

 © 2011 Baylor College of Medicine

8/2/2019 CD4 CBC Testing

http://slidepdf.com/reader/full/cd4-cbc-testing 16/17

Thank you

 © 2010 Baylor College of Medicine

8/2/2019 CD4 CBC Testing

http://slidepdf.com/reader/full/cd4-cbc-testing 17/17

Acknowledgement

CHAI

Abbot Fund

CDC

Baylor Uganda staff

Staff at Kitgum, Pallisa, KilembeMines Hospital and KaberamaidoHC IV & CEO

BIPAI & Baylor Lesotho

 © 2011 Baylor College of Medicine