Confronted by the 4.4 per cent prevalence rate of HIV/AIDS in the country and the desire to extend treatment to more infected persons, the Federal Government may adopt a (single) serial rapid testing against the present parallel (two) tests being used.
Informed sources said the move is aimed at reducing the cost of testing and the need to overcome dependence on cold chain to preserve testing kits.
At present, most advanced countries use Enzyme Immunoassays (EIA and Western Blot) technologies.
Although EIA and Western Blotting methods are available in Nigeria, they are more expensive and require refrigerator to be effective. These limit their applications.
However, the reasoning in government is that HIV rapid test, especially using the serial algorithm offers a cheaper and faster alternative. But there is the danger of false negative or false positive result as witnessed in the case of Baby Eniola at the Lagos University Teaching Hospital, Idi – Araba, a few years back.
With a parallel testing method – two kits are used simultaneously with the aim of achieving 100% sensitivity and specificity.
In other word, if Kit A says a sample is tested positive, the same test will be repeated using another kit (Kit B) to confirm before announcing the result.
The parallel testing removes doubt and the possibility of false negative or false positive result.
But with a serial algorithm, a single kit will be adopted and it is only where the test is positive that a confirmation may be required.
However, medical experts have criticised the single test, saying it does not eliminate the likelihood of a false negative or false positive result, especially where the testing kit is not foolproof.
A proposal on the new test procedure – Laboratory Based HIV Rapid Test Validation in Nigeria Phase 1 – put together by the Nigeria HIV Rapid Test Evaluation Working Group in April 2007 has favoured a serial testing because of its rapidity and cheapness.
The group consists of officials of the Federal Ministry of Health, National Agency for the Control of HIV and AIDS, National AIDS and STIs Control Programme, National Agency for Food and Drug Administration and Control, National Institute for Pharmaceutical Research Development, Centers for Disease Control and Prevention, Global AIDS Programme and the World Health Organisation.
According to the group�s report, although conventional wisdom suggests that parallel testing is more accurate than serial testing, the group�s evaluations suggest otherwise.
The report reads, �Conventional wisdom suggests that parallel testing is more accurate than serial testing. This and other evaluations suggest otherwise.
�Several serial testing options provided the highest possible sensitivity and specificity (100%) at nearly half the cost of parallel algorithms.
�Using a serial Algorithm in Nigeria is consistent with WHO recommended strategies for resource-poor settings.
�A serial algorithm using Determine and Stat Park is cost effective; less than one US dollar. This is important when considering the size of the HIV conselling and testing (HCT) programme in Nigeria and the number of tests required to support it.�
Government official are not willing to offer any explanation when contacted on Thursday.
NACA Director-General, Prof. Babatunde Osotimehin, directed our enquiry on the issue to the Federal Ministry of Health.
According to him, it is the FMOH that is handling the issue.
However, the Personal Assistant to the Minister of Health, Dr. Alero Roberts, feigned ignorance of the matter. She promised to ask the NACA DG about it.
But the National Coordinator, National AIDS and STIs Control Programme, Dr. Annette Akinsote, had told our correspondent on the telephone on Wednesday that government had not adopted the serial testing.