Quality of HIV testing in Kenya in doubt

By Gatonye Gathura


Public HIV testing facilities are staffed with testers who are not proficient, and persistent kit stock outs, according to medical researchers in Nairobi.

The problem of incompetent testing staff had been identified as early as 2007 and a proficiency training scheme put in place but many testers, especially females have never attended.

Experts from the Kenya Medical Research Institute (Kemri) and Jomo Kenyatta University of Agriculture and Technology found many testers of more than five years experience who do not know what is HIV proficiency testing.

“This is not acceptable under all standards,” the researchers write in the East African Medical Journal.

The team had evaluated the HIV proficiency testing programme and stock out of test-kits in 45 facilities in Nairobi County and report a crisis of worrying proportions in both aspects.

“If an HIV testing analyst in Nairobi County, a cosmopolitan city does not know the meaning of proficiency testing what of those in rural Kenya?”

The evaluation was carried out between 2012 and 2014 to test whether the proficiency scheme was improving the quality of HIV testing and counseling services.

On average the researchers found only about 15 per cent of testers consistently attended the proficiency programme between 2012 and 2014.

Justifying the launch of the proficiency testing programme the National HIV Reference Laboratory had in 2012 reported startling levels of incompetence among testers in the public sector.

Among 365 testers distributed across 289 facilities countrywide, 150 were found to read results incorrectly.

In the exercise carried out between March and May 2012, Franklin Kitheka of the National HIV Reference Laboratory says 89 of the testers in the group had no formal or refresher training.

Almost four years later, and a proficiency training programme in place, the Kemri team says nothing seems to have improved and if anything test kit stock outs have increased.

“Our study was able to reveal that despite the stock-outs intervention measures, test kits stock-outs have been persistent and on the rise in HIV testing facilities in Kenya,” wrote the authors.

Poor quality assessment systems, stock outs and incompetent testers, the team say puts into doubt the quality of HIV testing and counseling in Kenya’s public facilities.

Rocket Science

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