ArticleBMJ innovations2026
Potential of integrated national laboratory information management system in enhancing early HIV care for infants in Malawi: a report.
Article in BMJ innovations, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Initiating and retaining HIV-exposed infants (HEI) on antiretroviral therapy (ART) before 12 weeks of age remains a pressing public health concern in Malawi and other sub-Saharan African countries. Despite its known benefits in reducing mortality and morbidity, challenges persist, including long turnaround times (TAT) for DNA-PCR results, negative caregiver perspectives, and healthcare-worker barriers. This report discusses the potential of integrating different data collection methods in laboratory information systems to reduce TAT between testing and ART initiation. Methods: To address delays in the Malawi National Laboratory Information Management System (NLIMS), we integrated NLIMS into the electronic medical records(EMRs). We conducted this activity between November 2022 and June 2023 at the Elizabeth Glaser Paediatric Aids Foundation (EGPAF) in Malawi. Results: The integrated NLIMS featured offline capabilities, barcode standardization, and efficient order pulling from previously independent workflows. Electronic transmission to EMRs improved the efficiency of transmitting test statuses online. The average TAT decreased by 65 days (from 77 to 12 days) during months with both lower and higher testing volumes ranging from 2,595 to 5,349 samples. Conclusions: Integrating data collection workflows significantly reduced TAT, demonstrating a non-random variation and overall improvement. Future studies should explore algorithms, workflows, and modules that alert healthcare providers and caregivers of the critical therapeutic point before 12 weeks.
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