- Stay Connected
It\'s Forbidden to Forbid!
Il est Interdit d\'Interdire!
SIDA : bagarre autour d’un test de dépistage à Yaoundé
Par pierrem.djongo | Vendredi 15 janvier 2010 | Le Messager
« Je voulais prendre femme. J’ai effectivement choisi une fille. Je vous donne son nom en off, et vous ne publiez pas. L’affaire remonte au 09 novembre 2009 quand ma fiancée et moi nous rendons à l’hôpital central de Yaoundé, pour des examens prénuptiaux. Les infirmiers ont prélevé notre sang et nous ont demandés de revenir quelques jours plus tard .De retour à l’hôpital ce jour-là, je constate quelque chose de curieux. Le résultat d’un seul examen est donné. Le mien. Et il est négatif. Les laborantins nous disent que le sien est indéterminé .Nous repartons pour revenir quelques jours plus tard. Ma fiancée, qui, après 15 minutes sort me dire qu’il semble que cela va durer et que je peux d’abord m’avancer. Elle va rester récupérer son résultat. Mais le second doit attendre. Je ne comprends pas pourquoi. Finalement, j’accepte d’attendre. Entre temps, je me suis déplacé pour l’étranger. Le médecin me fera tenir quelques semaines plus tard, une information d’après laquelle ma fiancée a été examinée par deux grands hôpitaux : l’hôpital gynéco- obstétrique et pédiatrique de Ngousso, et celui de Biyem-assi qui l’ont déclarée séronégative. Les papiers sortis de Ngousso et de Biyem-assi qui affichaient négatif me seront refusés. Pendant mon séjour à l’étranger, je vais convaincre ma fiancée de subir un test de syphilis et de Chlamydiae trachomatis. A côté, je suggérerai au technicien de faire le screening test. Il sera positif. C’est le résultat de l’hôpital central finalement négatif qui me rend curieux. Vous comprenez dès lors qu’il y a eu manipulation. C’est la raison pour laquelle je veux obtenir la vérité ».Valentine nous parle avec hargne. L’homme ne décolère pas. Notre concitoyen pense que l’hôpital lui aurait causé sérieusement du tort, en le trompant sur l’état de santé de sa future épouse. Ce qui nous a amenés, nous autres honnêtes gens à nous poser la question de savoir si notre société a déjà atteint ce degré de corruption et même de méchanceté. Responsabilité oblige, à quel sort seraient désormais voués les milliers de Camerounais qui sont dépistés dans notre hôpital du jour ? Et l’image de marque de notre pays alors ? Il y a de quoi penser aux infirmiers bulgares au pays de Kadhafi. Mais où se trouve la vérité ? La question nous conduit à la porte du Dr Kouanfack, le patron de l’hôpital du jour, qui nous reçoit ce mardi 12 janvier 2010 à 17 heures. « Fiancés ou pas, nous recevons individuellement. Nous sommes astreints à la confidentialité médicale. C’est le malade qui décide de la gestion de son résultat. Si c’est votre femme, elle ne devrait rien vous cacher. Les deux conjoints ont la liberté de dévoiler l’un à l’autre son résultat. » . Monsieur Valentine a particulièrement insisté sur le fait que les numéros portés sur les fiches appartenant à sa fiancée et lui ne se suivent pas arithmétiquement. A cette question, le médecin répond « ça n’a pas d’importance ! Nous numérotons les tests d’après les dispositions professionnelles. L’ordre arithmétique y importe peu. Cette jeune fille était toute souriante pendant que son fiancé se plaignait et se disait même prête à se faire dépister de nouveau. » . Valentine le plaignant a vécu des scènes qui l’ont affectées, à l’instar de ce frère qui a monnayé un faux test à cinq cents mille francs pour faire d’une jeune fille sa victime au nom du mariage. Toute enquête achevée, il serait déconseillé d’entretenir le doute autour des institutions de santé publique. Car même si l’on ne peut pas nier la présence des brebis galeuses, il reste à reconnaître la dimension sacrée de l’hôpital qui doit communiquer pour permettre à chacun de mieux comprendre pour participer à la gestion de la cité.
5 Responses to SIDA : bagarre autour d’un test de dépistage à Yaoundé
You must be logged in to post a comment Login
Loading ...
tino
January 15, 2010 at 12:02 PM
Abstract
Background: Increased access to HIV testing is essential in working towards universal access to HIV prevention and
treatment in resource-limited countries. We here evaluated currently used HIV diagnostic tests and algorithms in Cameroon
for their ability to correctly identify HIV infections.
Methods: We estimated sensitivity, specificity, and positive and negative predictive values of 5 rapid/simple tests, of which
3 were used by the national program, and 2 fourth generation ELISAs. The reference panel included 500 locally collected
samples; 187 HIV -1 M, 10 HIV-1 O, 259 HIV negative and 44 HIV indeterminate plasmas.
Results: None of the 5 rapid assays and only 1 ELISA reached the current WHO/UNAIDS recommendations on performance
of HIV tests of at least 99% sensitivity and 98% specificity. Overall, sensitivities ranged between 94.1% and 100%, while
specificities were 88.0% to 98.8%. The combination of all assays generated up to 9% of samples with indeterminate HIV
status, because they reacted discordantly with at least one of the different tests. Including HIV indeterminate samples in test
efficiency calculations significantly decreased specificities to a range from 77.9% to 98.0%. Finally, two rapid assays failed to
detect all HIV-1 group O variants tested, with one rapid test detecting only 2 out of 10 group O specimens.
Conclusion: In the era of ART scaling-up in Africa, significant proportions of false positive but also false negative results are
still observed with HIV screening tests commonly used in Africa, resulting in inadequate treatment and prevention
strategies. Depending on tests or algorithms used, up to 6% of HIV-1 M and 80% of HIV-1 O infected patients in Cameroon
do not receive ART and adequate counseling to prevent further transmission due to low sensitivities. Also, the use of tests
with low specificities could imply inclusion of up to 12% HIV negative people in ART programs and increase budgets in
addition to inconveniences caused to patients.
Citation: Aghokeng AF, Mpoudi-Ngole E, Dimodi H, Atem-Tambe A, Tongo M, et al. (2009) Inaccurate Diagnosis of HIV-1 Group M and O Is a Key Challenge for
Ongoing Universal Access to Antiretroviral Treatment and HIV Prevention in Cameroon. PLoS ONE 4(11): e7702. doi:10.1371/journal.pone.0007702
Editor: Nitika Pant Pai, McGill University Health Center, Montreal Chest Institute, Canada
Received July 18, 2009; Accepted October 13, 2009; Published November 6, 2009
Copyright: 2009 Aghokeng et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits
unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Funding: This study was supported by grants from the Cameroonian Ministry of Public Health and the French Institut de Recherche pour le Developpement
(IRD). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Competing Interests: The authors have declared that no competing interests exist.
tino
January 15, 2010 at 12:02 PM
Abstract
Background: Increased access to HIV testing is essential in working towards universal access to HIV prevention and
treatment in resource-limited countries. We here evaluated currently used HIV diagnostic tests and algorithms in Cameroon
for their ability to correctly identify HIV infections.
Methods: We estimated sensitivity, specificity, and positive and negative predictive values of 5 rapid/simple tests, of which
3 were used by the national program, and 2 fourth generation ELISAs. The reference panel included 500 locally collected
samples; 187 HIV -1 M, 10 HIV-1 O, 259 HIV negative and 44 HIV indeterminate plasmas.
Results: None of the 5 rapid assays and only 1 ELISA reached the current WHO/UNAIDS recommendations on performance
of HIV tests of at least 99% sensitivity and 98% specificity. Overall, sensitivities ranged between 94.1% and 100%, while
specificities were 88.0% to 98.8%. The combination of all assays generated up to 9% of samples with indeterminate HIV
status, because they reacted discordantly with at least one of the different tests. Including HIV indeterminate samples in test
efficiency calculations significantly decreased specificities to a range from 77.9% to 98.0%. Finally, two rapid assays failed to
detect all HIV-1 group O variants tested, with one rapid test detecting only 2 out of 10 group O specimens.
Conclusion: In the era of ART scaling-up in Africa, significant proportions of false positive but also false negative results are
still observed with HIV screening tests commonly used in Africa, resulting in inadequate treatment and prevention
strategies. Depending on tests or algorithms used, up to 6% of HIV-1 M and 80% of HIV-1 O infected patients in Cameroon
do not receive ART and adequate counseling to prevent further transmission due to low sensitivities. Also, the use of tests
with low specificities could imply inclusion of up to 12% HIV negative people in ART programs and increase budgets in
addition to inconveniences caused to patients.
Citation: Aghokeng AF, Mpoudi-Ngole E, Dimodi H, Atem-Tambe A, Tongo M, et al. (2009) Inaccurate Diagnosis of HIV-1 Group M and O Is a Key Challenge for
Ongoing Universal Access to Antiretroviral Treatment and HIV Prevention in Cameroon. PLoS ONE 4(11): e7702. doi:10.1371/journal.pone.0007702
Editor: Nitika Pant Pai, McGill University Health Center, Montreal Chest Institute, Canada
Received July 18, 2009; Accepted October 13, 2009; Published November 6, 2009
Copyright: 2009 Aghokeng et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits
unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Funding: This study was supported by grants from the Cameroonian Ministry of Public Health and the French Institut de Recherche pour le Developpement
(IRD). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Competing Interests: The authors have declared that no competing interests exist.
tino
January 15, 2010 at 11:54 AM
Inaccurate diagnosis of HIV-1 group M and O is a key challenge for ongoing universal access to
antiretroviral treatment and HIV prevention in Cameroon.
Aghokeng AF, Mpoudi-Ngole E, Dimodi H, Atem-Tambe A, Tongo M, Butel C, Delaporte E, Peeters M.
PLoS One. 2009 ;4:e7702.
Increased access to HIV testing is essential in working towards universal access to HIV prevention and treatment in resource-limited countries. The authors evaluated currently used HIV diagnostic tests and algorithms in Cameroon for their ability to correctly identify HIV infections. They estimated sensitivity, specificity, and positive and negative predictive values of 5 rapid/simple tests, of which 3 were used by the national program, and 2 fourth generation ELISAs. The reference panel included 500 locally collected samples; 187 HIV -1 M, 10 HIV-1 O, 259 HIV negative and 44 HIV indeterminate plasmas. None of the 5 rapid assays and only 1 ELISA reached the current WHO/UNAIDS recommendations on performance of HIV tests of at least 99% sensitivity and 98% specificity. Overall, sensitivities ranged between 94.1% and 100%, while specificities were 88.0% to 98.8%. The combination of all assays generated up to 9% of samples with indeterminate HIV status, because they reacted discordantly with at least one of the different tests. Including HIV indeterminate samples in test efficiency calculations significantly decreased specificities to a range from 77.9% to 98.0%. Finally, two rapid assays failed to detect all HIV-1 group O variants tested, with one rapid test detecting only 2 out of 10 group O specimens. In the era of antiretroviral therapy scaling-up in Africa, significant proportions of false positive but also false negative results are still observed with HIV screening tests commonly used in Africa, resulting in inadequate treatment and prevention strategies. Depending on tests or algorithms used, up to 6% of HIV-1 M and 80% of HIV-1 O infected patients in Cameroon do not receive antiretroviral therapy and adequate counselling to prevent further transmission due to low sensitivities. Also, the use of tests with low specificities could imply inclusion of up to 12% HIV negative people in antiretroviral therapy programs and increase budgets in addition to inconveniences caused to patients.
tino
January 15, 2010 at 11:54 AM
Inaccurate diagnosis of HIV-1 group M and O is a key challenge for ongoing universal access to
antiretroviral treatment and HIV prevention in Cameroon.
Aghokeng AF, Mpoudi-Ngole E, Dimodi H, Atem-Tambe A, Tongo M, Butel C, Delaporte E, Peeters M.
PLoS One. 2009 ;4:e7702.
Increased access to HIV testing is essential in working towards universal access to HIV prevention and treatment in resource-limited countries. The authors evaluated currently used HIV diagnostic tests and algorithms in Cameroon for their ability to correctly identify HIV infections. They estimated sensitivity, specificity, and positive and negative predictive values of 5 rapid/simple tests, of which 3 were used by the national program, and 2 fourth generation ELISAs. The reference panel included 500 locally collected samples; 187 HIV -1 M, 10 HIV-1 O, 259 HIV negative and 44 HIV indeterminate plasmas. None of the 5 rapid assays and only 1 ELISA reached the current WHO/UNAIDS recommendations on performance of HIV tests of at least 99% sensitivity and 98% specificity. Overall, sensitivities ranged between 94.1% and 100%, while specificities were 88.0% to 98.8%. The combination of all assays generated up to 9% of samples with indeterminate HIV status, because they reacted discordantly with at least one of the different tests. Including HIV indeterminate samples in test efficiency calculations significantly decreased specificities to a range from 77.9% to 98.0%. Finally, two rapid assays failed to detect all HIV-1 group O variants tested, with one rapid test detecting only 2 out of 10 group O specimens. In the era of antiretroviral therapy scaling-up in Africa, significant proportions of false positive but also false negative results are still observed with HIV screening tests commonly used in Africa, resulting in inadequate treatment and prevention strategies. Depending on tests or algorithms used, up to 6% of HIV-1 M and 80% of HIV-1 O infected patients in Cameroon do not receive antiretroviral therapy and adequate counselling to prevent further transmission due to low sensitivities. Also, the use of tests with low specificities could imply inclusion of up to 12% HIV negative people in antiretroviral therapy programs and increase budgets in addition to inconveniences caused to patients.
Linda
January 15, 2010 at 9:37 AM
J espere qu’ il ne la pas epousee!
Linda
January 15, 2010 at 9:37 AM
J espere qu’ il ne la pas epousee!
Pat
January 15, 2010 at 7:28 AM
Voila les affaires du Pays. wwoooouuuuaaaaaiiiiihhhh la malchance!!!!
Pat
January 15, 2010 at 7:28 AM
Voila les affaires du Pays. wwoooouuuuaaaaaiiiiihhhh la malchance!!!!
tino
January 15, 2010 at 7:25 AM
la corruption est desormais comme une gangrene qui mine toute la societe camerounaise a tous les echelons malheureusement.
tino
January 15, 2010 at 7:25 AM
la corruption est desormais comme une gangrene qui mine toute la societe camerounaise a tous les echelons malheureusement.