Continuous mentorship of laboratories, and training of HIV test providers on the National Algorithm of HIV Rapid Testing and Testing Procedures in the Adamawa Region of Cameroon by Global Health Systems Solutions (GHSS) has brought about a 51% reduction in the number of indeterminate HIV results (from 37 to 18) in that part of the country between October 2020 and March 2021.
According to a Monitoring and Evaluation Report recently prepared by the Organization’s technical team, the Adamawa Region, which is host to some PEPFAR-supported facilities, recorded 37 indeterminate results between October and December 2020. This means that the results were declared neither positive nor negative. Despite the enormous psychological trauma that comes with such a result, the team observed that there was no follow up action of retesting, as recommended by the National Algorithm for HIV Rapid Testing.
In consonance with GHSS’ strive to improve on the quality of laboratory results in resource-poor countries, the Organization embarked on a root cause analysis to identify the reason and to be sure the indeterminate results were not as a result of the testers’ incompetence. The results revealed that majority of HIV test providers did not know the difference between an invalid result and an indeterminate result, and thus, reported invalid results as indeterminate. Meanwhile, some did not also know the measures to take in case of an indeterminate result.
In a bid to remedy the situation, GHSS engaged in the training of HIV test providers on National Algorithm of HIV RT and testing procedures in February 2021, during which major corrective actions were provided. Barely 2 months after the training, the number of indeterminate results reportedly dropped from 37 to 18. Of the 18 indeterminate cases, 7 were successfully contacted for retesting after 3 weeks, while 6 were declared negative and one positive. The positive case was put on treatment.
This reduction in the number of indeterminate cases, was greatly applauded by laboratory supervisors in the Adamawa Region of Cameroon. Meanwhile, the technical team of GHSS has underscored the need for proper follow up of indeterminate cases in the country. This, according to them, will help in clearing the doubt/confusion in patient minds, thereby relieving clients of the psychological/social stress. It will also help in identifying more positive cases being placed on treatment, contributing to the achievement of the 90 90 90 UNAIDS goals.