A Unit under Ministry of Health and Population has advised a person who was put on anti-retroviral therapy for six years to stop taking life prolonging ARVs on the understanding that they wrongly recorded her as HIV positive.
The Ministry of Health which is investigating the matter has expressed fear that her case could be an issue of failing to adhere to standard operating procedures.
Edna Kapachika, a mother of two boys both born in between the time she was on ARVs, said in an interview that when she went for antenatal clinic at Namadzi Health Centre for her first pregnancy in 2011, medical personnel told her she was HIV negative after tests.
Just like anyone else upon receiving such results, Kapachika, from Katuli Village, Traditional Authority (T/A) Mlumbe in Zomba, was excited and believed she was on a safe journey to motherhood.
The weary-looking Kapachika, who talked to Nation on Sunday in presence of her mother-in-law and her children at her home, said after telling her she was negative, health officials at Namadzi referred her to Namikango Health Centre, close to her home, for further medical care.
There she got the shock of her life and the regret she was to carry for the next six years: “At Namikango, upon examining my health passport, I was told I was HIV positive.
“I could not make out what was happening. But these were medical experts informing me this. I could not even at once imagine Namadzi medical officers gave me correct results orally, but made a mistake in recording the results in the health passport book,” she said.
She said she was put on ARVs, a beginning of a troubled six-year-long journey of taking drugs she believed were meant to fight a virus in her body that never was, exposing herself to side effects of such drugs.
Kapachika said medical staff at blood sample to Zomba Central Hosiptal in the last few months after noting that her husband and the children kept on testing negative and results that came showed she was HIV negative.Namikango decided to take her
After this result, she said, Zomba Central Hospital asked for another blood sample which was sent to Community Health Science Unit (CHSU) under Ministry of Health in Lilongwe.
“The result came in through Namikango and I got the communication on November 30 this year that I am HIV negative and an advice that I should stop taking the ARVs.
“It has been a mixture of feelings, feelings of joy that I am after all fine, but at the same time, that feeling of bitterness looking at what I have gone through in the six years I have been taking the ARVs. I experienced that nasty stigma and wore all sorts of names,” Kapachika said.
She said side effects she experienced included general body pains and dizziness, something that affected execution of her day-to-day.
Kapachika said some people advised her to seek compensation from government or take legal action as she believed Namadzi Health Centre wrongly indicated in her health passport book that she was HIV positive and that there was some sort of negligence at Namikango where she was put on the ARVs.
“Where do I begin from? I just left it. My husband even suggested we sue government. I really wish we could. We have gone through that miserable life, weighed down by it, but I must confess, we have no capacity for such actions,” Kapachika complained.
A Zomba-based non-governmental organisation, Action Hope, which volunteered in.
the woman has been in big shock to learn of his current status.to provide counselling to her.
Action Hope projects manager Paul Sauchi said in an interview the woman feels betrayed that she has been on ARVs for this long and faced stigma.
Sauchi said his organisation has encouraged her to accept it as one of those mistakes and move on with her life, adding it has not been an easy task for them.
Ministry of Health’s HIV and Aids Department said their team was on the ground to check if the service providers who managed the client both at Namadzi and Namikango were trained and certified.
Rose Nyirenda, a director at the department, said only trained and certified service providers are allowed to test and initiate a client on antiretroviral treatment.
Nyirenda disclosed the ministry also had another case in Mulanje, Nkando, last year where a woman was also put on ARVs when she was not positive.
She referred us to public relations officer at Zomba Districh Health Office, Arnold Mnbalira for further details.
But Mnbalira said they were investigating the matter and would call when ready with information.
Some medical experts at College of Medicine (CoM) backed CHSU’s decision to immediately stop the woman from taking the ARVs, arguing people who have been found not to have HIV but had been on HIV treatment must stop the medications immediately.
Professor of Epidemiology and Public Health at CoM, Adamson Muula, said health workers would advise people to stop taking ARVs after the situation has been verified by the Ministry of Health and Population.
“[In such cases] there is just no need for the medicines,” Muula said in a response to a questionnaire.
He explained: “Having an individual who previously tested HIV positive but now or in a subsequent test turns out to be negative and with no evidence of the virus whatsoever is not a usual day event.
“It does not happen every day, every week or every month. But it is not unheard of. And we are not just talking about Malawi only but the world over. The modern day HIV tests are as good as they have ever been.”
But Muula said errors in diagnosis can happen due to many reasons such as poor operator practice-meaning a health worker, who does their job poorly, as human beings bound to error, can contribute to these errors.
“Further, storage of the test kits under less than optimal environments then will be another reason. I know of one report from Malawi where one woman was erroneously diagnosed,” he said.
He said the number of such cases that Malawi has is unknown. He said they may not be many, but without knowing the exact numbers, people should be extremely careful so that people are not unduly alarmed to the extent that those who are positive may start thinking that they are not infected.
Muula further explained that laboratory test kits are made under very strict settings and batches are checked for their functioning.
“However, mistakes can be made. Further, we need to store the test kits under very controlled circumstances.
“People are only diagnosed to be HIV positive (living with HIV) following a positive HIV test result. But the test result can be faulty and this happens rarely. But it does happen. It is a human activity.
“The good thing is that these errors can be minimised through proper training of testing staff, adequate supervision, quality checks and proper storage of test kits,” Muula said.
The medical expert said the current HIV treatment in Malawi is among the best, explaining that regimes, however, are made for the group and some individual may need their own combinations.
For genuine HIV cases, Muula warned that if one stops taking ARVs, their chances of getting Aids goes up.
“I hope people will not unilaterally decide that their HIV test result was wrong. The majority of HIV test results are good,” he said.