Despite the increase of HIV patient throughput in Morocco, follow up testing (HIV Viral load VL) is still centralised in the National referral laboratory (NRL) as the activity required trained staff and specialised infrastructure.
Patients were often lost due to great distances between testing centre and home as well as delays in returning results.
To follow the dynamic of decentralising HIV treatment and care in Morocco, the NRLH launched a process of strengthening regional laboratory capacities.
In this framework, we assessed factors associated with lab capacities to offer HIV viral load testing, and followed their performance after implementation.
On site visits were performed to the laboratory of the regional laboratory of the Hassan II hospital of Agadir in southern Morocco; this region that accounts the greatest number of HIV positive cases. Using Laboratory assessment tool, the laboratory capacities were evaluated, and gaps related to the facility layout, human resources, training, equipment and reagent were fixed thank to the Global Fund for HIV support.
A follow up the lab performance was set for a period of two months, by retesting all the samples (n = 194) at the NRL. Data were analysed using MedCalc software to calculate the Spearman’s coefficient of rank correlation (rho).
VL results were ranged from 150 to 221 242 copies/ml.
A perfect match of VL results between the measurements at the NRL and at the Agadir regional lab was observed. The observed Spearman correlation index was of 0.98. P < 0, 0001 (95% CI: 0,973 to 0,990).
In the light of these results, HIV VL testing was moved to the periphery and closer to the site of therapeutic management structures. Patients could get their results conveniently and quickly. This experience is worth to reproduce in other regions of the kingdom were HIV prevalence is steadily increasing.