Cape Town - Researchers have called for the retraining and upskilling of medical staff who perform HIV tests, following research that showed a significant number of mistakes with HIV testing.
In a study by Medecins Sans Frontiers (MSF) to test the accuracy of the Alere Pima (CD4 count) analyser, researchers found a high proportion of invalid CD4 count test results – suggesting that operators were not skilled enough to operate the device among other problems.
The device, which is also used in South Africa, is an automated analyser intended to measure CD4 count cells in the blood within a few minutes.
The portable device performs a series of checks to ensure all steps of the analysis are completed successfully.
If not, an invalid result is reported.
CD4 count is usually performed for the purposes of detecting treatment failure on HIV-positive people on ARVs or to test their eligibility for treatment.
But according to the research – which appeared in the World Health Organisation Bulletin and was carried out in 39 different sites and in nine countries, including South Africa, India, Kenya, Democratic Republic of Congo and Lesotho between 2011 and 2013 – South Africa was found to be one of the leading nations with inaccurate results.
Of more than 25 000 test records from participating countries, about 3 300 or 13 percent of the results were found to be inaccurate.
India had fewer inaccuracies at only 5 percent, Thailand had 19 percent of errors while South Africa had 12.5 percent, and Malawi had the highest number of invalid test results at 25 percent.
In most countries, users of this device – who were either clinicians, laboratory technicians or lay workers – were significantly more likely to experience invalid results within their first tests.
In South African clinics, errors were significantly less frequent for lay health workers at about 10 percent compared to those of clinicians, which stood at about 20 percent.
Among laboratory technicians the results differed from country to country.
In the study, invalid results were also slightly more in venous blood samples compared to capillary blood samples.
Writing in the bulletin, lead researcher Emmanuel Fajardo said: “In some cases, operators did not know how to interpret the results the testing continued despite clear indication of a problem. This calls for retraining.”
The repeating of invalid tests did not only prolong the testing period, but it was also costly, he said.
Cape Argus