KENYA : Scandale autour des tests de dépistage du sida
http://frequencevih.ca/spip.php?article1171
16 mars 2009
Selon une étude menée sur 6 255 personnes, il savère que des centaines et
peut-être même des milliers de Kényans et dOugandais ont été détectés
porteurs du virus du sida alors quils ne létaient pas et inversement. La
faute en revient à des tests de dépistage pratiqués en quinze minutes dans
des centres spécialisés VCT (conseil et dépistage volontaire). Lerreur,
dans un sens ou dans lautre, concerne 54 % des personnes dépistées. Les
conséquences en sont très graves : le virus continue sa propagation dans la
population, dans la mesure où les personnes, convaincues quelles ne sont
pas malades, mènent une vie sexuelle non protégée.
Les tests de dépistage en question sont très utilisés dans les pays pauvres
parce quils sont bon marché, ils coûtent environ 1 dollar (0,77 euro),
contre 40 dollars (31 euros) pour des tests plus fiables, rapporte The East
African. En outre, les personnes concernées ne font généralement pas de test
de confirmation. Le magazine de Nairobi révèle également quau Kenya le
personnel embauché dans les centres VCT a tout au plus un niveau détudes
secondaire et suit une formation de trois semaines avant dêtre
opérationnel.
Source : http://www.courrierinternational.com/
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Kenya, Uganda VCTs turning in thousands of false HIV-positives
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http://www.theeastafrican.co.ke/news/-/2558/545696/-/rjm3osz/-/index.html
Posted Saturday, March 14 2009 at 00:37
Hundreds or even thousands of Kenyans and Ugandans may have been told
that they are infected with HIV when they are not, thanks to faulty rapid,
15-minute tests administered at VCT centres.
Many others may have wrongly been declared negative, clearing them for
unprotected sex, when they actually are HIV-positive.
That is the worrying conclusion of a study involving 6,255 people carried
out in Uganda and Kenya, which bluntly says that the misuse of rapid tests
at most VCT centres makes them fraught with error and that they cannot by
themselves alone determine whether one is HIV-positive or not.
The three HIV rapid tests which were evaluated in the study, the findings of
which appear in a recent issue of the East African Medical Journal, were
Determine by Abbott Laboratories, Uni-Gold by Trinity Biotech of Ireland and
Capillus, also by Trinity Biotech.
The tests are widely used in poor countries because they are cheap. Each HIV
screening with the tests costs about one dollar, compared with about $40
using the much more reliable PCR test, which is considered the gold
standard.
The East African Medical Journal is published by the Kenya Medical
Association.
In Kenya, according to Dr Peter Cherutich, Assistant Director of Medical
Services at the Ministry of Health and head of HIV prevention at NASCOP, the
National Aids/STI Control Council, the three most used rapid tests are
Determine, Bioline from SD Bioline of South Korea and Uni-Gold. The first
two are usually used as first-line tests while Uni-Gold is confirmatory.
The risk of HIV misdiagnosis using the rapid tests rises substantially when
they are used once, without the benefit of a confirmatory test. This
practice is thought to be rampant, especially at VCT sites outside medical
facilities, which are usually manned by non-medical staff.
In Kenya, according to Dr Cherutich, the requirement for one to work at a
VCT site is a secondary education and three weeks training in the
administration of the tests.
Results from the Kenya-Ugandan study, which involved men aged between 18 and
60 seeking VCT services from a rural village in Masaka and the Kakira sugar
plantation, both in Uganda, as well as a coastal village in Kilifi, and the
Nairobi slum of Kangemi, confirm that there are important issues of quality
assurance and dependability of results obtained using the rapid tests.
When used as a single test in Masaka, for example, Determine was able to
correctly identify only 45.70 per cent of those infected with HIV as
carrying the virus.
This means that out of every 100 HIV-positive people, 54 could actually have
walked out of the VCT centre thinking they were HIV-negative, when in actual
fact they were not, if they were not advised to take a confirmatory test.