Nurses union asks members to stop offering HIV tests

Alikungu Mubusia lies on his hospital bed unattended at the Mbagathi Hospital in Nairobi on December 06, 2016. FILE PHOTO | DENNIS ONSONGO | NATION MEDIA GROUP

The nurses union has asked its members not to carry out any HIV tests in hospitals in the wake of a court case in which a medic is charged with wrongfully diagnosing a patient. Should the directive be heeded by all, it could impede the gains the country has made in the war against HIV, as testing services are integral in controlling spread.

Explaining the move, Kenya National Union of Nurses secretary-general Seth Panyako last week said nurses will no longer “participate in any medical activities that are not described in the Nurses’ Act as part of their duties”, and that the union will wait for directions from the Ministry of Health on the matter.

Dr Martin Sirengo, head of the National Aids and STIs Control Programme (Nascop), said he was aware of the union’s move and acknowledged that it had the right to look after the welfare of its members.

The coverage of pregnant women tested for HIV increased from 68 per cent in 2009 to about 92 in 2013, according to data from the Ministry of Health. Over 71 per cent of those who tested positive have been put on antiretroviral therapy.

Discussions have been going on in medical circles about what could go wrong in the testing of HIV patients, with many saying the “misdiagnoses” that are reported often are not so.

During last year’s annual HIV scientific conference in Nairobi, paediatric professor Ruth Nduati of the University of Nairobi stirred debate regarding a possible flaw in the way county governments procure their testing kits.

In the presentation, Prof Nduati showed different brands of HIV testing kits with big margins of errors. “There needs to be consultation,” she said over the matter.

Speaking at the same conference, South African-based researcher Thumbi Ndung’u said it is possible for people who have been initiated on ARVs to suppress the virus so much that the regular tests used in public hospitals would not be able to detect the virus.

VIRUS HIDING

There have been cases where children who were initiated on ARVs early tested negative after some time. For such, samples are sent to South Africa for more complex tests where the virus is usually detected hiding in the bone marrow or the lymphatic nodes and other hideouts in the body.

Dr Patrick Oyaro, the director of Family Aids Care Education Services (Faces), said the union’s move could “hurt” the gains made in the management of HIV in Kenya, and that given the shortage of doctors, nurses, clinical officers and lab technologists have taken up roles such as testing and counselling of patients so that the doctors can be left to handle patients.

In 2004, the Ministry of Health launched a programme called Provider Initiated Counselling, where a health care worker makes a clinical recommendation to a patient to take a test to know their HIV status. With consent, the patient is tested and, depending on the results, put on treatment or counselling.

As the years progressed, the government has limited movement HIV patients in hospitals by providing everything they need, from HIV tests to medication, in one spot.

Dr Oyaro said that has been especially critical for the prevention of mother-to-child transmission, helping Kenya meet the global target of testing more than 90 per cent of pregnant women.

“What works in most facilities now is that the mother does not move from this health care worker to the other,” he said.

The coverage of pregnant women tested for HIV increased from 68 per cent in 2009 to about 92 in 2013, according to data from the Ministry of Health. Over 71 per cent of those who tested positive have been put on antiretroviral therapy.