Before you celebrate over those laboratory test results

Health workers at the of the launch of the national early infant diagnostics laboratory, located within the Central Public Health Laboratories on Buganda Road. Photo by Stephen Wandera

What you need to know:

For a laboratory to be accredited, it must meet certain standards, including having qualified staff and equipment, which enhance the efficiency at which they operate.

When Agnes tested HIV positive six months into her marriage, she could hardly believe it.
Before the wedding, she had tested negative for HIV, and her fiancé Peter, had shown her his HIV test results as well, which showed he was also negative. What Agnes did not know was that Peter’s test results had been forged.

He had connived with the laboratory technician to manipulate the HIV test results in his favour.
While Peter forged his HIV test results at the laboratory with the help of medical personnel, others do it at the printing shops in town.

“People come here and tell us to print whatever they want to print, hospital reports inclusive,” confesses Grace Naigaga, who owns a printing shop along Nasser Road in Kampala.
The actions of such unscrupulous individuals can put the lives of innocent and unsuspecting persons in danger.
The frequent reports of substandard health facilities in the country, unprofessional persons running these facilities, and the drive to make as much profit as possible, with little consideration to standards, is one way a person could end up with many forged laboratory test results.

Accredited laboratories
Dorothy Nabbaale, the laboratory manager at International Hospital Kampala, says the solution is in having people to use the services of only accredited laboratories.
“These laboratories are incorruptible because they have a reputation to protect. People who run them know that forging results does not do them any favours but ruins their business,” she says.

And for a laboratory to be accredited, Nabbaale explains that it must meet certain standards, including having qualified staff and equipment, which enhance the efficiency at which such laboratories operate.

Other options
According to Nabbaale, the other options to get accurate laboratory tests include;
•Visiting a licenced hospital. For a hospital to be licenced, all its facilities, including laboratories must be inspected and found to be of the highest quality.
•Back check your results. Go back to the facility where the tests were done to confirm. “Results, especially sensitive results are recorded in the books or computer system at the laboratory where tests are done.
Definitely forged results will not be recorded anywhere,” she Nabbaale.
•Do abrupt tests for there are drugs one can take that conceal the presence of certain viruses or bacteria for a given period of time. “If they refuse with unconvincing reasons, then one has reason to be suspicious,” says Nabbaale.
•Test from more than one laboratory. This gives chance to correct any human error, forgery or technical problems affecting results at a particular laboratory.

How to avoid falling victim to fake lab tests

Dr Sara Nsibirwa, an HIV/Aids specialist and researcher at the Infectious Diseases Institute offers advice on what a person can do to avoid falling victim to such forgeries.

•Check out small details like the reference number on the results form. Use this to back and check with the health facility where the tests were taken. “Results printed at Nasser road will not have reference numbers and if they do, they will not correspond with the records at the health facility,” she says.
•Examine special marks, signs or logos engraved in the results form. Some health facilities have marks which are impossible or at least hard to forge .
•Go and test together. This is especially important for intending couples or any other person who is interested in the other party’s results
•While there, watch out any behaviour that’s suspicious – behaviours like one of you wanting to talk to the doctor or laboratory technician in private.
•Randomly select the laboratory or health facility where you want to test from, to minimise undue advantage of one party against the other.
•Do a repeat test after three months to address challenges that come with the window period for some viruses such as HIV. A window period is that time when a virus, though present in one’s blood, cannot be detected.
Supervision of laboratories in Uganda is done by the Allied Health Professionals Council of Uganda (AHPC). The following are AHPC’s requirement and procedures for opening a health unit.
•The professional opening the facility must be registered with the council.
•Must have a current annual practicing license
•Professionals must have four years and above working experience.
•Must possess a copy of guidelines for private practice.
•Professionals must operate the health unit under their area of specialisation.

What is an accredited laboratory?
According to the College of American Pathologists (CAP), one of the internationally recognised laboratory accrediting organisations, an accredited laboratory is one that is inspected by a private not-for-profit organisation, and has been approved by the Centres for Medicare and Medicaid Services (CMS), and its requirements deemed equivalent or more stringent than CMS’s regulatory requirements. Professionals can only run one health unit.