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How reliable are medical lab test results from NG?

I am supposed to be HIV positive, according to three lab test results from Ibadan and Lagos.

In 2003 I received a scholarship to study for Masters Degree in Europe. The Embassy of the country which offered the scholarship requested for a HIV test as part of the visa application process and they directed me to a certain clinic's lab in Ikoyi, Lagos. Today, that clinic is one of the most popular specialist hospitals in NG. I will spare the name here. But it is coming in my upcoming book.

I reported to the clinic for the test, travelling from Ibadan one nice sunny morning. I was filled with happiness about my scholarship and did not see any roadblocks on the way. They drew blood and asked me to go and that I would get a call a few days later with the result. I was not charged for the test; It was paid for by the embassy as a scholarship recipient.

I was not too happy with the delay. I did not want to go home and be burdened with the thought of a HIV lab test result hanging over me. In those days a positive HIV test = death sentence for the person. There were not many drugs available. I left the clinic and asked around where to find a lab to do a quick test. I took a cab to a lab in Victoria Island (I cannot remember the name of the lab now). They did the test; this time I paid for it but it was affordable for me. The lab technologist told me I was HIV positive. There was no paper result printed for me; just a verbal information. I was confused. How come I am positive? I became a shadow of myself while travelling back to Ibadan in a public bus. I got to Ibadan and waited for the "GENUINE" result. After day 2 and no call from the clinic, depression set in. I went for another test at a lab around UI/Bodija axis of Ibadan (I have also forgotten the name of the lab). The result was also positive. That's it, I thought- I am HIV positive. People started noticing sadness in me. I told two close persons at the time what was going on. Both would remember if they read this. I was sad but confused as to how I became HIV positive. I was not playing around with women. But I was barbing my hair regularly in public barber shops where clippers would likely cut people, exposing blood, and no sanitary measures taken before reuse.

After a long (about 5 days) wait I finally got a call from the clinic in Lagos to come for the result of my test. I did not want to go. What was the need? I am already HIV positive.

In the meantime I had received a call from the embassy asking why the delay in the process from my end. I told them I was waiting for the test result.

One of those I confided in about my HIV status urged me to go and I went. The doctor (not a laboratory technologist) called me into his office and broke the news. The result was also positive. However, the doctor told me they would like to repeat the test using a new blood sample and a different technique. He added that the result of the new test would be sent directly to the embassy and I can get my own copy (which I still have till date). I allowed them to take the blood sample again. They had their gloves and every precautionary measures put in place - I did not quite notice the same level of precautions in the first visit. I guess they are now dealing with a HIV patient. I was ashamed, sad, angry, confused, disillusioned and dejected. My first thought was there goes my scholarship. The second thought was is this how I am going to die? I returned to Ibadan.

Next day or so I got a call from the clinic. ''Please proceed to the clinic for your result at your earliest convenience''. This time it was a negative result and boldly stamped with the test method and everything. The doctor told me that the first test was a general test for viruses, not specific for the HIV virus antigen. This time they conducted an ELISA (Enzyme-linked immunosorbent assay), an immunological assay commonly used to measure specific antibodies, antigens, proteins and glycoproteins in biological samples). Back then ELISA that was specific for HIV was not common in NG. Labs just did general viral tests. Most people would suffer from viral diseases such as catarrh or common cold. The catarrh virus was the likely viral antigen all the labs caught in my tests and pronounced me HIV positive. ����

I returned to the embassy; they already had my test result. Long story short, I picked up my passport with the visa and travelled to Europe few weeks later.

19 years later, I have not suffered from HIV; have not taken any HIV drugs; have done multiple blood tests, including for HIV, and have not been admitted for anything related to HIV. The positive diagnoses were FAKE.

So, back to my question. How reliable are the lab test results from Nigeria? Three labs gave me a wrong result. They had all used a wrong (by which I mean a broad test not specific for the need at hand) method. One of the labs self corrected; that was a reputable clinic used by embassies for visa applications that realized they had conducted the wrong test. The others, more like the many ''Obi/ Akin/Daudu and Sons Medical Laboratory'' businesses all over Nigeria. Who knows what they have been diagnosing for people or whether they actually run any tests.

Many people die after diagnosis not due to the disease itself but due to the psychological trauma related to the diagnosis. I lost at least 10 kg in weight within 2 weeks that all of that incidence happened, just from thinking about it alone. If I did not go back to the clinic for the second test, I would probably have died of sadness or of taking a HIV drug that was not necessary. I recognize this happened a long time ago. But my advise to anyone taking a medical test, including DNA test, in a place like NG is to second-guess the result by taking another test at a different facility. Ask about the type of test they are conducting and whether that test is highly specific for the problem at hand. We now have access to the internet. Do some googling about the test and method(s) involved before you delve in.

Trust me, you don't want to experience the experience that I experienced (pun intended) ���

1) First, from my research there are no "medical lab technologists' in Nigeria, that title has been phased out in Nigeria since 2003 as in many advanced countries. What we have in Nigeria are 'Medical Laboratory Scientists' or 'Scientists' according to 2003 MLSCN acts.

2) The test you did in those laboratories in the first instance are not specific HIV tests, they are called Retroviral disease tests (RVD). HIV is just one of the viruses that are 'Retroviral' in nature others include the;

Human T- lymphotrophic virus, Feline Leukemia virus, Rous Sarcoma virus, just to mention a few.

Any of this viruses would elicit a positive rapid RVD test which is usually cheaper and has a shorter turn-around-time (TAT). To specifically detect the HIV you'd have to go further to detect the protein (antigen) specific to the HIV that no other Retoviruses may posess, that's what the ELISA test does, but the drawback about this test is that it more expensive than the conventional rapid RVD serology test.
When a well trained and licensed Medical Laboratory Scientist does the RVD test and it comes out POSITIVE/REACTIVE. He/She reports the test as POSITIVE/REACTIVE TO RVD SEROLOGY, SUBJECT TO CONFIRMATION BY ELISA FOR SPECIFIC HIV ASSAY.
After the ELISA test, a confirmation can then be made.

3) The proliferation of unlicensed medical laboratories that are manned by untrained personnels in this country can be generally attributed to 'politics in the health sector'. There is a lot of politics going on in the health ministry that incapacitates the different councils under the health ministries from performing optimally, at the end the poor patient pays dearly for it.

Let me shock you, do you know that the MEDICAL LABORATORY SCIENCE COUNCIL OF NIGERIA (MLSCN) building in Abuja was not built by Ministry of health (Which is always manned by physician ministers)? Medical Laboratory Scientists built that gigantic council office from the scratch to roof with donations from their salaries and earnings. Despite all the billions budgeted for the health ministry and councils.

In the MLSCN, do you know the politics and bureaucracies involved in getting mobilization fees from the Ministry of health in Abuja before they can go for inspection, sanitization, monitoring, arresting of fake medical laboratory personnels, monitoring of fake importation of IVDs, Quality control, proficiency testing etc?

4) A lot of fake, expired reagents, kits, equipments, IVDs are imported into this country everyday by unscrupulous businessmen who repackage them in their warehouses and sell to unsuspecting medical diagnotic centers and Scientists.
The MLSCN act 2003 empowers Medical LABORATORY SCIENTISTS through their council to regulate importation and production of reagents, IVD kits, medical laboratory equipments etc, but as I speak they are incapacitated because NAFDAC also wants that function for itself, even while they have their hands already filled chasing after drug importers and budding food manufacturers. SON is also there begging for that function which they are clearly not trained for.

Now to the sane mind, who should regulate Medical laboratory kits, IVDs, reagents, is it NAFDAC who is also running after fake drugs and expired food producers or the MLSCN who are specially trained on the usage, procedure and quality control of these Invitro Diagnostics?

I could go on and on, but I'd stop here. Nigeria is nation of square pegs in round holes, and you were simply a victim just like many others.