Source: The Standard
13 August, 2011
BY AUGUSTINE ODUOR
It takes a lot of courage for one to go for HIV testing. Even after resolving to go for one, many people have lost courage on their way to testing facilities.
Others have given up taking the HIV test because of the long distances to Voluntary Counselling and Testing Centres (VCT) and the prospects of queuing in public.
Experts and patients have raised concerns over lack of a national guideline on oral HIV testing.
A new oral HIV self-testing technology, which is a move away from the current invasive approach, puts anxiety and the long wait to rest.
The oral testing technology is likely to lead to reduced infections and number of persons put under ARV drugs treatment regime.
The Ora-Quick Rapid Antibody Test kit only requires users to make a swap along the upper and lower gums, with a flat plastic gadget to extract mucosal membrane that contain antibodies.
The specimen is dipped in a small tube with a reactor fluid. And in less than a minute, the gadget shows the test results by drawing two purple lines. After use, the kits can be dumped in the litterbin, as it does not contain bloodstains that could be harmful.
And to confirm results, many private tests can be done in the comfort of one’s room. Dr Peter Cherutich, head of HIV prevention at National Aids and STI Control Programme (Nascop), says just like pregnancy testing kits, oral HIV self-testing kits, like Ora-quick, will soon reduce trips to VCTs and clinics.
“No more walking to a clinic. No more asking for a nurse or a health specialist. Your HIV status lies in your hands, closer to you than before,” he said, adding kits will be bought in pharmacies or distributed at health facilities and carried home for use.
“No needles, no cotton wool or even spirits. No gloves, no disposable containers and incinerators. It cuts down on these costs,” he told The Standard On Saturday at Internews Kenya offices in Nairobi.
Several researches and tests on the new technology have recognised it as an ideal and safe way of testing for the HIV virus.
An evaluation report by Kenya Aids Vaccine Initiative (Kavi), a research unit based at the University of Nairobi, shows that the method has shown excellent performance, comparable to the Determine and SD Bioline test currently in use.
Kavi conducted about 500 tests with Kenyatta National Hospital VCT laboratories.
The May last year field evaluation report seen by The Standard On Saturday reveals, “This performance coupled with the user- friendliness of this kit, suggests that its inclusion in the national HIV testing algorithm will have tremendous impact in scaling up its HIV diagnostic programme.”
This evaluation was not far from findings of the Academic Model Providing Access to Healthcare (Ampath) in partnership with the Moi Teaching and Referral Hospital.
“The assessment carried out by health care workers in various health facilities and capacities conclusively indicated that the Ora-quick device was friendly, convenient, and 80 per cent of the result corresponded with other rapid testing tools,” read the Ampath feedback assessment experience on about 2,500 tests.
Following the two reports, the Ministry of Public Health and Sanitation issued a letter in March, authorising use of the oral test kit.
“The evaluation results show that oral kit is to acceptable quality and meets the requirements for sensitivity and specificity for HIV test use,” read a letter by Jane Wasike, the director, National Public Health Laboratory Services.
However, lack of a guideline for oral HIV testing is the only obstacle that stands between the product and consumers.
The Ora-quick Product Manager Jillani Yawa said the product couldn’t be released into the market without official policy guidelines.
“What we are waiting to know is once we use this oral material, what is next. What is the final test?” said Yawa. Currently, there is only a national guideline for HIV test on blood. Yawa said plans are complete to launch the product. “It is 99 per cent accurate and reliable. Once we get the nod we will establish how much it would be affordably sold to Kenyans,” he said.
Kavi says the Ora-Quick test on oral fluid specimens had both sensitivity and specificity of 100 per cent. This means the oral fluid test had 100 per cent positive and negative predictive values.
However questions have also been raised over consequences of lack of pre-test and post-test counselling. Yawa says counselling instructions will be written on the kit package in English and Kiswahili, complete with a help hotline.
Liverpool VCT already runs the one-to-one youth hotline, which will be printed on the test kit.
If adopted Cherutich says Kenya would be the third country in Africa after Ghana and Botswana to formally use the oral test kit.
In the US, oral HIV test is the main technology. Experts say the failure to undertake HIV tests leads to faster spread of the virus.
Kenya conducts about 1.5 million HIV tests at the antenatal clinics and about one million tests at VCTs. Cherutich says this will rise to about five million tests per year with the new technology.
“HIV prevalence rate in Kenya now stands at 6.3 per cent. If many people would know their status, levels of infections would reduce,” he said.
He said HIV infection responds best to medical treatments if they are begun soon after infection.