In order to promote self-sufficiency for the Kayunga District in terms of HIV laboratory monitoring, MUWRP renovated and equipped the Kayunga District Hospital laboratory.Â MUWRP provided a rural energy solution, in-department training to laboratory technicians, task-shifting activities with laboratory assistants and full-time Quality Assurance/Quality Control (QA/QC) staff support supervision.
Starting in October 2007, this renovated laboratory began processing and providing results to all district HIV samples, including hematology, chemistry, CD4 and syphilis tests. Except for the cost of reagents and the QA/QC staff, this laboratory is largely self-sufficient. Because CD4â€™s are not the best indicator of treatment failure, MUWRP began to support routine viral load testing in January 2009 for all ART patients who had been on ART for more than 6 months.
During FY2010, MUWRP converted an underused research field laboratory into a regional QA laboratory with the capacity to test viral loads and perform Elisa confirmatory tests. The addition of routine viral load testing for MUWRPâ€™s patients on ART has led to significant policy changes and patients being switched to second line drugs.
The laboratories described above follow standard operating procedures for all the testing they perform and strictly run controls validation on machines before testing any patient samples.Â Furthermore monthly comparability runs are done between the field laboratories and MUWRPâ€™s research laboratory in Kampala.Â Moreover, on issues pertaining to Quality Control the laboratory is enrolled with the United Kingdom External Quality Assessment Service (UK NEQAS), which sends US samples bimonthly for EQA.
In FY2011 MUWRP intends to continue to provide these QA services as well as routine resistance testing for any ART patient who is under consideration for switching.Â MUWRP also intends to increase the capacity to diagnose TB in adults during FY2011.