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Health & Fitness

New portable technology aims to boost HIV diagnosis

A self-testing HIV kit
A self-testing HIV kit. Diagnostics company Abbott has developed the M-Pima analyser that aims to reduce the turnaround time for HIV results. FILE PHOTO | NMG 

Millicent Atieno lost her first-born son in 2018. Before his death, she had noticed that aside from losing weight, the four-month-old baby was also sickly and had been treated multiple times for various infections.

The child was eventually admitted and multiple tests were done. Sadly, the baby died two days later, before all the results were out.

Millicent later found out that her son had been suffering from HIV, which she had unknowingly passed to him at birth.

Irrespective of the disease, infected children can still survive and lead normal lives with prompt diagnosis and treatment for the disease, using recommended antiretroviral drugs (ARVs) that will be taken for life.

For infants less than 18 months, doctors rely on a gold standard virologic test, which looks for HIV in the blood to determine whether the child is positive or negative.

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Despite its significance, this test can only be performed in about 10 public health laboratories across the country.

The thousands of other hospitals without the technology usually have to ferry blood samples to those laboratories and wait for a couple of days, for test results.

This causes delays, which can be detrimental for critically-ill children, as was the case with Millicent's son who died before he could begin treatment for HIV.

A new portable device, known as the Abbott M-PIMA Analyser, could soon offer solutions to these challenges.

The diagnostic tool, which was recently pre-qualified or approved by the World Heath Organisation (WHO), is expected to improve early HIV infant diagnosis by reducing the turn around time for results.

An evaluation study for the digital technology, involving 451 children was conducted by the Kenya Medical Research Institute (Kemri) between 2017 and 2019 in various hospitals across the country.

The research revealed that M-PIMA can give accurate HIV results for infants within 70 minutes, compared to the currently used gold standard test which takes between three and 10 days.

"Every second counts for a sick infant because their condition can deteriorate very fast. So, a diagnosis tool that can give results fast, within the shortest time possible is important," said Dr Matilu Mwau, an infectious disease specialist and deputy director at Kemri who led the study.

Aside from its diagnostic benefits, the new technology also offers hope to the approximately 1.5 million Kenyans suffering from HIV who require viral load tests for effective management of the disease.

Based on the WHO guidelines, all HIV patients receiving ARVs need to undergo the tests, which help in monitoring or assessing the performance of the drugs.

The viral load test measures the amount of HIV in the blood. A low viral load (or volume) indicates that treatment is effective. But a high one shows that medication is not being taken properly, or that the virus is becoming resistant to the ARVs.

Just as early infant diagnosis, the gold standard virology machines that offer HIV viral load tests are found in just 10 laboratories, situated mainly in urban centres. "This means that people in remote and far-flung areas will have their blood samples taken, then go back home and wait for a couple of days before planning another return trip to the hospital to get the results. Some may feel discouraged or tired and never come back," said Dr Mwau who is also a professor in the department of medical microbiology at Jomo Kenyatta University of Agriculture and Technology.

With a turn-around time of just about an hour for the results, Dr Mwau stated that the M-PIMA analyser will make viral load tests more convenient and less cumbersome for patients.

“We evaluated it among 556 adults with HIV and found that it can be relied onto give accurate results fast.”

Compared to the current test, which requires highly skilled professionals with enhanced exposure to laboratory sciences, the novel technology requires minimal training and can thus be used by low-cadre health workers in rural hospitals. It is also a portable device that can be carried around easily.

This helps in enhancing the reach of viral load testing by bringing it closer to those that need the services.

"To effectively manage HIV and lessen its burden in highly affected countries like Kenya, we need technologies that can address existing infrastructural and human resources gaps in rural areas where most people live," said Damian Halloran, the Rapid Diagnostics and Infectious Disease expert at Abbott that developed the M-PIMA analyser.

He noted that having appropriate HIV care technologies is not enough. "Sustained awareness creation is required to enable people understand the significance of recommended HIV tests so they can embrace them."

"We also need to deal with stigma around the disease that makes many people living with HIV to shy away from seeking treatment services."

Effective HIV care approaches will propel Kenya closer towards the attainment of the UNAIDS 90-90-90 targets, which are defined as 90 percent of people living with HIV knowing their status, 90 percent of people who know their status accessing HIV treatment and 90 percent of people accessing HIV treatment achieving viral suppression by 2020.

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