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1.
J Glob Infect Dis ; 13(2): 85-90, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34194175

RESUMO

INTRODUCTION: Routine viral load (VL) testing is fraught with challenges in resource-limited settings which lead to longer turnaround times for the return of VL results. We assessed the turnaround times for VL testing and factors associated with long turnaround (>30 days) in Marondera, Zimbabwe, between January and September 2018. METHODS: This was an analytical study of routine program data. Data were extracted from electronic records and paper-based reports at two laboratories and at antiretroviral therapy (ART) facilities. The unit of analysis was the VL sample. Duration (in days) between sample collection and sample testing (pre-test turnaround time), duration between sample testing and receipt of VL result at ART the site (post-test turnaround time), and duration between sample collection and receipt of result at the ART site (overall turnaround time) were calculated. Days on which the VL testing machine was not functional, and workload (number of tests done per month) were used to assess associations. We used binomial log models to assess the factors associated with longer turnaround time. RESULTS: A total of 3348 samples were received at the two VL testing laboratories, and 3313 were tested, of these, 1111 were analyzed for overall turnaround time. Pre-test, post-test, and overall turnaround times were 22 days (interquartile range (IQR): 11-41), 51 days (IQR: 30-89), and 67 days (IQR: 46-100), respectively. Laboratory workload (relative risk [RR]: 1.12, 95% confidence interval [CI]: 1.10-1.14) and machine break down (RR: 1.15, 95% CI: 1.14-1.17) were associated with long turnaround time. CONCLUSIONS: Routine VL turnaround time was long. Decentralizing VL testing and enhancing laboratory capacity may help shorten the turnaround time.

2.
Am J Trop Med Hyg ; 89(4): 709-16, 2013 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-24002485

RESUMO

We conducted direct observation of 23 caregiver-infant pairs for 130 hours and recorded wash-related behaviors to identify pathways of fecal-oral transmission of bacteria among infants. In addition to testing fingers, food, and drinking water of infants, three infants actively ingested 11.3 ± 9.2 (mean ± SD) handfuls of soil and two ingested chicken feces 2 ± 1.4 times in 6 hours. Hand washing with soap was not common and drinking water was contaminated with Escherichia coli in half (12 of 22) of the households. A one-year-old infant ingesting 1 gram of chicken feces in a day and 20 grams of soil from a laundry area of the kitchen yard would consume 4,700,000-23,000,000 and 440-4,240 E. coli, respectively, from these sources. Besides standard wash and nutrition interventions, infants in low-income communities should be protected from exploratory ingestion of chicken feces, soil, and geophagia for optimal child health and growth.


Assuntos
Fezes/microbiologia , Higiene/normas , Adulto , Animais , Galinhas , Pré-Escolar , Exposição Ambiental , Microbiologia Ambiental , Feminino , Humanos , Lactente , Masculino , Fatores de Risco , Solo , Microbiologia do Solo , Adulto Jovem , Zimbábue
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