A huge number of mistakes, errors and inaccuracies recently detected in patients’ records, have raised the alarm among medical experts.
In the first ever assessment of effectiveness of HIV treatment on the 1.1 million Kenyans on ARVs, researchers say the quality of patient data is extremely poor. This they report has serious implications for individual patients as well as the national response to HIV. “The quality of data is of serious concern,” said Dr Matilu Mwau, of the Kenya Medical Research Institute (Kemri) and study leader.
Working with the National Aids and STI Control Programme, (NASCOP) the researchers evaluated more than 1.1 million viral load (VL) tests done in 2012 -2016. In Kenya, a viral load of under 1000 copies/mL, called suppressed VL is considered medically satisfactory while above that is regarded as elevated VL and should raise a red flag among attending clinicians. Suppressed HIV patients, physicians say are unlikely to suffer ill health or opportunistic infections and are also less likely to transmit the virus to others.
In 2012, Kenya set up a national viral load testing system currently in 2,000 facilities doing 40,000 tests per month with 80 per cent of them done in Kemri.
However, the report appearing in the journal Plos One, shows the data to have been full of errors, inaccuracies and huge gaps. During the study period, the researchers report 539,613 cases of missing data. For example while it is crucial for the sample-taking-clinician to record why a patient is being tested, such data was missing in 235,046 cases.
Between January and March 2016, the authors say 103,012 records did not indicate the sex of the patient while 124,356 samples did not indicate age. The report indicates dozens of cases where children under nine years and men were recorded to have been pregnant patients and in other cases toddlers were reflected to have been on adult doses. From the electronic records the researchers say it was not possible to link repeat patients to their earlier tests, hence negating the primary objective of the whole exercise.
The new report followed a similar one published by Kemri and the University of Oxford in December on malaria data. The report showed out of 5,782 public health facilities, only about 462 are reporting on malaria data as required through a digital platform known as DHIS2.
“These seen alongside the Supreme Court’s nullification of the August presidential elections over data irregularities questions our capacity to handle electronic data,” says Dr Peter Kabunyi, a consultant demographer.