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South Africa: New NHLS system causes delays in HIV, TB and cervical cancer tests

<p>Lungile Thamela</p>


October 7, 2013

Patients in some parts of Johannesburg have had to wait up to a month for vital tests results as the National Health Laboratory Services (NHLS) swtiched to a new system, according to Soweto patients.

The delay has affected HIV, CD4 count, tuberculosis (TB) and pap smear tests. A measure of the immune system’s strength, CD4 count testing is the gateway for most patients living with HIV to start treatment. According to national guidelines, HIV patients must wait until their CD4 counts fall to 350 or below to begin treatment. Under new guidelines introduced on 1 April 2013, pregnant women living with HIV are eligible for antiretroviral treatment regardless of CD4 count as part of prevention of mother-to-child HIV transmission services.

Delays in CD4 count testing can mean patients are loss to follow up, like 51-year-old Benjamin Dube from Mofolo North in Soweto.

According to Democratic Alliance Gauteng caucus leader Jack Bloom, 4,410 HIV patients have been lost to follow up since 2011.

Dube said he went for a CD4 count test in January. He was told to come back for his results two weeks later, but when he returned to the Mofolo clinic he was told his results were not ready. The process of testing and arriving for the test results went on until March, when he gave up.

Mandla Gule, 45, from Mofolo Village waited for one month to receive tests to confirm whether or not he had active TB. Gule is still coughing and has been tested again for TB.

“I was told I to do another TB test,” he said. “This makes me wonder if I will have to wait a long time again.”

Martha Shibur from Mofolo North said she is still waiting for the results of an HIV test she took at the  beginning of August.

“This is frustrating since I don’t know if my results will be positive or negative,” Shibur added.

According to clinic staff, the delay is not a new problem.

“We have been experiencing this problem long time, even though we are always having meetings with the City of Johannesburg district TB coordinator, trying to solve this problem,” said one Mofolo Clinic nurse.

According to City of Johannesburg District TB Coordinator Petunia Nkwako, patients living in areas sending samples to the Chris Hani-Baragwanath Hospital’s NHLS laboratory have been affected by the delay, which has also affected women waiting on results of pap smear tests.

While the NHLS confirmed that patients had been experiencing a delay due to the introduction of a new information management system, the organisation said the delays were less than one month.

According to the NHLS, the delay has been rectified.

“Bara laboratory serves a huge population and… processes about 3000 (test results) a day,” said the NHLS. “An interruption to the system causes delays ,which unfortunately has ripple effects (but) this problem has since been resolved and patients results are dispatched daily.”

The organisation added that many clinicians experienced problems retrieving results due to their unfamiliarity with the new system, called TrakCare, which NHLS said will ultimately enable health care workers to retrieve test results faster than under the old system.



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