AIRPOP-2 project: evaluation of drone transport

Improving care for newborns and children exposed to HIV in Guinea

Last updated on 09 April 2025

L’essentiel

The aim of the AIRPOP-2 project (Innovative and Rapid Access to Points of Care to Optimise Care for Children Exposed to HIV) is to compare the effectiveness of transporting blood samples by drone compared with road transport for the early detection of HIV in newborns in Guinea, to speed up the initiation of treatment and reduce infant mortality.

AIRPOP-2 project: The challenges of early HIV screening

Every year, 160,000 children are born with HIV, a third of them in West and Central Africa, where the transmission rate is 19.6%. The WHO recommends rapid screening of infants exposed to the virus to initiate treatment before the eighth week of life, as failure to treat leads to increased mortality between two and three months of age. However, in Guinea, where the prevalence of HIV is relatively low (1.7%), screening remains inadequate, not least because of the delays in transporting samples to central laboratories, which can take up to two or three months. This slowness compromises the rapid initiation of treatment for infected infants.

Transport by drone: a promising solution

A pilot study conducted as part of the ANRS 12407 AIRPOP initiation contract demonstrated that the use of drones to transport samples could be an effective, well-accepted and economically viable solution. This project therefore aims to test this approach on a larger scale in twenty Prevention of Mother-to-Child Transmission (PMTCT) sites in Conakry and Boké.

In brief

Investigators
BRETON Guillaume / CISSE Mohamed

Teams
ONG SOLTHIS, Hôpital Donka (Conakry Guinée), University of Lincoln (Royaume Uni), IRD Montpellier, CERFIG Université Gamal Adel Nasser (Conakry Guinée), University of Cincinnati (USA), CHU de Treichville (Abidjan Côte d’Ivoire), ONG Climate Action Accelerator (Genève Suisse)

Status
In progress

Pathology
HIV

Sponsorship
SOLTHIS

Funding
ANRS MIE (call for projects 2024-2)

Objectives and components of the AIRPOP-2 project

The main objective is to measure the impact of drone transport on the accessibility and rapidity of early HIV screening for newborns, by comparing the proportion of children tested and the time taken to deliver the results with the current road transport method. The aim is also to assess the retention of children in the care pathway up to the age of nine months.

The study has several components :

From a clinical and virological point of view, it will analyse the effects of drone transport on the treatment cascade, by measuring the reduction in the time taken to obtain results and its impact on the rapid initiation of treatment.
In terms of implementation, the aim is to test the feasibility of this strategy both in an urban environment, in Conakry, and in a rural area, in Boké. The study will also look at the conditions for wider deployment, considering criteria such as acceptability to the local population and healthcare providers, cost-effectiveness, environmental impact and optimisation of the drone transport network.
Finally, a public health component will explore the possible uses of drones for other medical emergencies, such as the delivery of blood bags or essential medicines.

Methodology of the randomised trial to assess the effectiveness of drones

This project is a multicentre cluster randomised trial with permutation, involving 900 HIV-exposed newborns. The inclusion criteria are infants whose mothers are HIV-1 positive, with a sample taken within 48 hours of delivery. Pregnant women will be offered routine screening in the delivery room, and exposed infants will immediately receive antiretroviral prophylaxis, in line with national guidelines. At birth, at six weeks and at nine months, all infants will have a blood sample taken on blotting paper (DBS), transported by road according to current procedures in the control phase. In the intervention phase, an additional sample will be taken on a microtube and transported immediately to the laboratory by drone. In both groups, the test results will be communicated urgently to the carer and then to the parents as quickly as possible, ideally the same day in the drone group. In the event of a positive test result, antiretroviral treatment will be started immediately.

AIRPOP-2 trial schedule

The project will run for a total of 36 months, with a 12-month preparatory phase followed by a 24-month interventional phase.

Expected results

The expected results are intended to demonstrate the effectiveness of drone transport in reducing the time taken to deliver results and improving access to treatment. This scientific data will be used to support the introduction of a drone transport system in other countries in the region and to obtain Funding for large-scale deployment, through the Global Fund.

Finally, this project could pave the way for the wider use of drones for other urgent medical needs, thereby contributing to the overall improvement of healthcare in Guinea and West Africa.

Discover other research projects funded and/or promoted by the ANRS MIE