Evaluation of Turnaround Time for Yellow Fever Testing in Uganda, January 2022–March 2023

Background: Control of yellow fever (YF) outbreaks relies on early detection and response, which requires short laboratory turnaround time (TAT). YF is endemic in Uganda; surveillance is conducted at sentinel health facilities in high-risk areas. TAT targets are defined for three phases: pre-analytic (target ≤7 days), analytic, and post-analytic (target ≤5 days). We performed a baseline assessment to evaluate YF testing TAT, identified the factors causing preanalytical TAT, and improved the proportion of samples received from 0 percent to 80 percent. Methods: For the baseline assessment, the mean and range TAT were calculated from the abstracted data, January 2022-March 2023. We used the 5 Why root cause analysis tool to assess the factors affecting the pre-analytical TAT. Results: For the baseline assessment, in the pre-analytical phase, all samples had TAT >7 days (mean=30 days, range 10-64). In the analytical, 15 (60%) positive samples had TAT >21 days (median=29 days, range 13-50), while 10 (40%) were within the target TAT, all negative samples had TAT ≤7 days (median=7 days, range 3-7 days). In the post-analytical phase, all results were reported within ≤ 1 (mean 0, range of 0-1 day). Conclusion: The highest TAT was observed in the pre-analytical phase and affected all samples; due to delayed sample transport.