To Assess Factors Leading to High Rejection of Early Infant Diagnosis and Viral Load Samples in Northern Province of Zambia

Abstract

To determine the rejection rate on dry blood spot and viral load samples submitted to the PCR laboratory between January and February 2018 and to state the factors leading to the high rejection of samples. This was a cross-sectional retrospective study on 644 dry blood spots and 1,665 viral load samples submitted to the PCR laboratory. In total, 29/664 (4.36%) dry blood spot samples were rejected, and 92/1,665 (5.5%) viral load samples were rejected. These rates are very high comparable to <1%, the acceptable range of rejection. The preanalytical factors included incomplete patient data, incomplete clinical history, workload on the part of clinicians, requests made by nonclinical staff, use of improvised laboratory forms, and no orientation of the staff concerning the required information on the Disa electronic system the laboratory uses. The rates of rejection of both types of samples were significantly high (4.36% and 5.5%, respectively), creating prolonged suffering to the patients since they could not be initiated on antiretroviral drugs on time and/or promoting the development of viral resistance.