During the COVID 19 pandemic, round-the-clock demand for COVID -19 laboratory tests exceeded capacity, placing a significant burden on laboratory staff and infrastructure. The use of laboratory information management systems (LIMS) to streamline all phases of laboratory testing (preanalytical, analytical, and postanalytical) has become inevitable. The objective of this study is to describe the architecture, implementation, and requirements of PlaCARD, a software platform for managing patient registration, medical specimens, and diagnostic data flow, as well as reporting and authentication of diagnostic results during the 2019 coronavirus pandemic (COVID -19) in Cameroon. Building on its experience with biosurveillance, CPC developed an open-source, real-time digital health platform with web and mobile applications called PlaCARD to improve the efficiency and timing of disease-related interventions. PlaCARD was quickly adapted to the decentralization strategy of the COVID 19 testing in Cameroon and, after specific user training, was deployed in all COVID 19 diagnostic laboratories and the regional emergency operations center. Overall, 71% of samples tested for COVID 19 by molecular diagnostics in Cameroon from 05 March 2020 to 31 October 2021 were entered into PlaCARD. The median turnaround time for providing results was 2 days [0–2.3] before April 2021 and decreased to 1 day [1– 1] after the introduction of SMS result notification in PlaCARD. The integration of LIMS and workflow management into a single comprehensive software platform (PlaCARD) has strengthened COVID 19 surveillance capabilities in Cameroon. PlaCARD has demonstrated that it can be used as a LIMS for managing and securing test data during an outbreak.
BackgroundAs many longitudinal studies, follow-up in the ANRS-PEDIACAM study is disrupted by repeated absences of participants to scheduled visits. This lead to missing data which influence the quality of results. We describe reasons for participants absence or non-compliance (NC) and assess the influence of phone call reminders (CR) on retention in care.MethodsFrom November 2007 to 2011, 611 infants divided in three groups were included and followed in three referral hospital in Cameroon: HIV-infected children followed from the first week of life or not but diagnosed before seven month of life (n=210), HIV-uninfected children born to HIV-infected (HEU) (n=205) mothers or not (HUU) (n=196). From 2014 to 2017, CR were reinforced to record reasons of missing visits. we used frequency, chi-square or Fisher test for categorical variables; means, median (IQR) and non-parametric Kruskal Wallis test for continuous variables. A multistate transition modelling approach was used to analyse the retention care cascade. The R software was used to perform all statistical analysis.ResultsDuring the study period, 45.1% (246/546) of children were NC at least once of which 16.3% (25/153), 58% (116/200), 54.4% (105/193) respectively among HIV-infected, HEU and HUU-children. Among NC, 69.5% (171/246) has been reachable at least once and 22.2% (38/171) of them returned to follow-up after a median delay of 32 days (IQR: [2.0 – 110]); 44.4% (109/246) were not seen throughout the study period (HIV-infected: 12/153, HEU-children: 57/200, HUU-children: 40/193). A total of 276 reasons have been reported among 54%(115/213) of the NC, mainly related to delocalisation (30.4%), lack of time (23.6%), wish to stop follow-up (11.6%), travelling (9.8%), schooling (9.4%), forgetting (7.2%). Comparing before and after period, CR allowed to divided by three adjusted relative risk ratio to miss one clinical visit (RRR [CI]: 0.35[0.24 – 0.52]), However CR effect was not significant among children who are non-compliant.ConclusionOur finding suggest that maternal HIV and socio-economic status are related to attendance of children in HIV care. Also, the CR are an effective strategy to improve attendance. However, to make this strategy effective for children who are non-compliant, it needs to be strengthened by community monitoring.
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