The 'Lab in a Bag' PIMA Machine Brings Life-saving Treatment One Step Closer to People Living with HIV

Professional Nurse Counselor (PNC), Angie Satira, walks comfortably with a small canvas bag slung over her shoulder. The bag contains the latest point-of-care technology - a PIMA machine. Little bigger than a large toaster, this machine is designed to provide CD4 results - the measure of a person’s strength of immune system - within twenty minutes. This promises to be a revolution in care for health care workers in the HIV field, such as Angie Satira.

As a PNC working for TB/HIV Care Association, an NGO funded by PEPFAR through CDC, Angie Satira provides HIV counseling and testing and screening for TB and STIs. She is a central part of a mobile team that travels throughout the Cape Town Metro. With a brand new PIMA machine accompanying the team, if someone at a factory or shopping mall tests HIV positive, Angie can provide them with a CD4 result within minutes. This means that if the patient qualifies for antiretroviral treatment (ART), one can start initiating treatment right away. Angie, as trained nurse is also qualified to dispense antiretroviral drugs and to manage patients on treatment.

This simple PIMA machine has eliminated long and tedious steps in the process of initiating patients onto life-saving treatment. It effectively closes many of the gaps through which patients are lost to care. Without a PIMA machine, a patient who tests positive at a clinic or with a mobile team would have blood drawn to be sent away to a lab. In an urban area, the CD4 results will be returned to the clinic or health facility within 24 hours, but patients can still get lost to the system if their phone number or address is incorrect. In rural areas, the waiting period for the CD4 results may be even longer, and there is even more risk of delays in the process of initiating the ARV treatment that they may desperately need. But now this portable laboratory has moved right into the testing site.

All of TB/HIV Care's 26 mobile HIV Counseling Testing teams in 7 districts in 4 high HIV burden provinces of South Africa are now equipped with PIMA machines. This has led to a marked increase in the number of people who have tested positive, and more importantly, being put on treatment as quickly as possible. Other HIV-positive clients already on treatment also visit the mobile team to measure their CD4 counts to ensure their treatment is working. This means that people do not have to wait in queues all day, waiting to be tested and then receiving their results. The local clinic’s workloads are also decreased.

The PIMA machine comes in a small package, but gives a powerful boost to TB/HIV Care Association's ability to provide same day, on site availability of CD4 count, and then immediate referral for antiretroviral treatment.or post-test counseling for all that need it. Anyone testing positive with one of the mobile teams is quickly entered into a system of HIV care and support.