27 January 2012

Narok — Voluntary counselling and testing centres around Kenya are turning people away due to a shortage of HIV testing kits after the recall in December of more than one million faulty HIV tests.

"We have had a shortage of the test kits for the past month and we have had to turn away patients. There are serious gaps with the supply chain and this has led to constant shortages of these crucial commodities," said John Sankok, director of the Christian Missionaries Fellowship, which runs several health clinics in the Rift Valley Province's Narok South District.

"We have had to prioritize and use the kits available for testing expectant mothers, because this is very crucial," he added.

In November, the UN World Health Organization removed the Standard Diagnostics Bioline® HIV 1/2 3.0 Rapid HIV Test Kit from its list of approved rapid test kits with immediate effect; the alert was issued after Bioline failed quality assurance tests.

The Kenyan government has since withdrawn it; an estimated one million kits were in circulation at the time of the recall, about one-tenth of all those available in the country; Tanzania has also banned the tests.

Bioline was used as a confirmatory test, the second conducted during standard HIV testing, which uses three tests - an initial screening test, a confirmatory test and if there is a discrepancy, a third, tie-breaker test.

As a result of the recall, Unigold, the brand used in Kenya as a tie-breaker, now replaces Bioline as the confirmatory test, and the enzyme-linked immunosorbent assay (ELISA) test - which requires a blood sample be sent to a laboratory and takes significantly longer than the rapid tests - becomes the tie-breaker. A brand known as Determine retains its place as the official screening test.

Senior government officials blamed the shortage on congestion at the Mombasa port.

"There have been problems with the port due to slow clearance of cargo occasioned by congestion and this has led to delays in distributing Unigold," said Nicholas Muraguri, head of the National AIDS and Sexually transmitted infections Control Programme. "We, however, expect things to normalize by the end of this month."

Sankok said until the Unigold kits arrive, his clinics and other were stuck. "The HIV testing procedure is such that you cannot do a test if you are missing any of the kits. So until the Unigold gets to the facilities, nothing will happen in terms of HIV testing," he said.

People seeking HIV testing have also expressed frustration with the delays.

"It is very discouraging when you go to the facility when you really want to get tested, then you are turned way and when you return after some time you are turned away again," said Judith*, a VCT client in Narok.