Voluntary Counseling and Testing Centres (VCTs) in East Africa are likely to receive a bashing and rejection after revelations came out that they are producing inaccurate HIV/AIDS test results, according to the East African Medical Journal. This shocking revelation came up following a survey conducted in Kenya and Uganda on people aged 18-60 years. BETHSHEBA ACHITSA reports.
The study, carried out in the rural villages of Kakira and Masaka in Uganda, and the coastal villages in Kilifi and Nairobi’s Kangemi neighbourhood in Kenya, show that the 15-minute rapid tests carried out in VCTs may not be reliable as sero-positive people have been given a clean bill of health while non-carriers have been declared to be living with HIV.
According to the research, the rapid tests are widely used in poor countries because they are cheaper. Each rapid test kit ‘Determine, Bioline, Uni-gold’ costs about US$1 as opposed to the much more reliable PCR test that costs about US$40. Whereas Determine and Bioline are usually used as first line tests, Uni-gold is confirmatory. This eye-opening survey confirms that there are important issues of quality assurance attached to the rapid tests that need to be addressed.
When used as a single test in Masaka, Determine was able to identify only 45.7% of those infected by HIV as carrying the virus. This indicated that out of every 100 HIV-positive people, 54 could have walked out of the VCT facility thinking they were HIV-negative. In Kakira, the same test captured only 65.7% of the infections while Capillus captured 86.62% at the same locations.
The Uni-gold test, when administered to the subjects in Nairobi, was found to be only 99.1% accurate, implying that out of every 10,000 HIV-positive persons tested, 87 were wrongly declared HIV-negative.
When two different tests were administered on all the 6,255 subjects surveyed, 131 people had discrepant results; with one being positive and the other negative. When the confirmatory test was used, only 27 were found to carry the virus.
According to Dr Peter Cherutich, a director at Kenya’s National AIDS Control Programme (NASCOP), all one needs to administer HIV tests at a VCT facility in Kenya is a secondary school education and three weeks training in the administration of the tests. This could contribute to the inaccurate HIV test results.
But while one talks about the lack of qualified staff to administer the HIV tests, it is ironic that large numbers of highly qualified health workers go unemployed. Staffing levels at most facilities are only 50% .
Though rapid HIV tests could have been an answer to a situation where people would turn up at VCT centres for the test but never come back for the results, they have done more harm than good to many souls. The fact that they are cheap and easy to use does not mean that this is the only way that people get to know their HIV status.