Original Research

Dried blood spot specimen quality and validation of a new pre-analytical processing method for qualitative HIV-1 PCR, KwaZulu-Natal, South Africa

Kerusha Govender, Raveen Parboosing, Ntombizandile Siyaca, Pravikrishnen Moodley
African Journal of Laboratory Medicine | Vol 5, No 1 | a349 | DOI: https://doi.org/10.4102/ajlm.v5i1.349 | © 2016 Kerusha Govender, Raveen Parboosing, Ntombizandile Siyaca, Pravikrishnen Moodley | This work is licensed under CC Attribution 4.0
Submitted: 03 August 2015 | Published: 25 February 2016

About the author(s)

Kerusha Govender, Department of Virology, Inkosi Albert Luthuli Central Hospital, National Health Laboratory Service, Durban, KwaZulu-Natal and Department of Virology, School of Laboratory Medicine and Medical Sciences, University of KwaZulu-Natal, South Africa
Raveen Parboosing, Department of Virology, Inkosi Albert Luthuli Central Hospital, National Health Laboratory Service, Durban, KwaZulu-Natal and Department of Virology, School of Laboratory Medicine and Medical Sciences, University of KwaZulu-Natal, South Africa
Ntombizandile Siyaca, Department of Virology, Inkosi Albert Luthuli Central Hospital, National Health Laboratory Service, Durban, KwaZulu-Natal, South Africa
Pravikrishnen Moodley, Department of Virology, Inkosi Albert Luthuli Central Hospital, National Health Laboratory Service, Durban, KwaZulu-Natal and Department of Virology, School of Laboratory Medicine and Medical Sciences, University of KwaZulu-Natal, South Africa


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Abstract

Background: Poor quality dried blood spot (DBS) specimens are usually rejected by virology laboratories, affecting early infant diagnosis of HIV. The practice of combining two incompletely-filled DBS in one specimen preparation tube during pre-analytical specimen processing (i.e., the two-spot method) has been implemented to reduce the number of specimens being rejected for insufficient volume.

Objectives: This study analysed laboratory data to describe the quality of DBS specimens and the use of the two-spot method over a one-year period, then validated the two-spot method against the standard (one-spot) method.

Methods: Data on HIV-1 PCR test requests submitted in 2014 to the Department of Virology at Inkosi Albert Luthuli Central Hospital in KwaZulu-Natal province, South Africa were analysed to describe reasons for specimen rejection, as well as results of the two-spot method. The accuracy, lower limit of detection and precision of the two-spot method were assessed.

Results: Of the 88 481 specimens received, 3.7% were rejected for pre-analytical problems. Of those, 48.9% were rejected as a result of insufficient specimen volume. Two health facilities had significantly more specimen rejections than other facilities. The two-spot method prevented 10 504 specimen rejections. The Pearson correlation coefficient comparing the standard to the two-spot method was 0.997.

Conclusions: The two-spot method was comparable with the standard method of pre-analytical specimen processing. Two health facilities were identified for targeted retraining on specimen quality. The two-spot method of DBS specimen processing can be used as an adjunct to retraining, to reduce the number of specimens rejected and improve linkage to care.


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