Hospitals in shortage of Hepatitis B test kits, reagents and diagnostic machines

HEALTH   

Some health facilities across the country cannot conduct Hepatitis B testing because screening machines have broken down. Other facilities lack test kits and reagents, laboratory technologists have revealed.

Hepatitis B is a viral infection that causes inflammation (swelling) of the liver. Experts warn that if not treated early, it progresses into a chronic disease with complications such as liver cancer, liver scarring (cirrhosis) and liver failure.

No reagents

Masindi regional hospital received a new chemistry machine that performs liver function tests in February this year, but health workers cannot conduct tests due to lack of reagents.

The head of laboratory services at the hospital, Daniel Okullo, says the facility cannot refer samples for liver function tests to Kiryandongo regional hospital which is the nearest facility because they too are facing the same challenges. Similarly, Hoima regional hospital cannot support them because of stock-outs of reagents.

 "Our hands are tied and we cannot do much for the patients. Consequently, patients are being advised to do the tests in private clinics and then come back with the results," Okullo notes.

Additionally, the facility cannot conduct confirmatory tests (surface core antigen) for people who are Hepatitis B positive because of reagent stock-outs. In the meantime, the patients are referred to private laboratories which charge highly.

Fort Portal regional referral hospital is in a similar dilemma. The facility has not conducted confirmatory tests since November 2019 due to shortage of reagents says Moses Mukembo, a senior technologist in-charge of laboratory services at the hospital. The patients are compelled to pay about sh40, 000 for the same services in the private wing of the hospital.

Kiryandongo regional hospital is not any better. Laboratory technologists have resorted to sending blood samples for confirmatory and liver function tests to Central Public Laboratories (CPL) in Butabika Kampala because they lack reagents, says the hospital superintendent, Dr Godfrey Kisembo.   

No Hepatitis B test kits       

Mary Amanziru, the laboratory technician at Arua regional referral hospital says the Hepatitis B screening activities stalled due to a shortage of test kits. As such, the facility depends on donations from good samaritans to conduct screening, yet they receive many patients requiring the services.

Additionally, Mukembo says Fort Portal hospital ran out of testing kits at the beginning of this year.

"We have not restocked Hepatitis screening kits although we have been receiving phone calls from the coordinator at Central Public Health Laboratories (CPHL) saying that they are planning to send them," he notes. As a result, patients only access the services in the hospital's private wing at a subsidized fee of sh7, 000.

Sources also revealed that Gulu regional referral hospital is grappling with stock-out of testing kits. Tentatively, people who want to screen for Hepatitis B are forced to buy test kits from pharmacies.

Testing machines break down

Isaac Ekeu the laboratory technician at Serere health centre IV in Serere district says they have not conducted liver function tests for the last seven years following the breakdown of the Humastar 80 machine.

"We now collect the samples and send them to Soroti regional referral hospital for screening. The results are later returned to the health facility where patients pick them."

Ekeu says they do not expect the machine to be repaired soon since implementing partners at TASO Soroti have expressed shortage of funds.  

But Timothy Otala of TASO Uganda -Soroti, denies receiving any communication about the breakdown of the machine.

Similarly, Dr Kisembo says the equipment for conducting liver function tests at Kiryandongo hospital is old and needs replacement.

 "The machine only runs one route of samples for the entire day which is rather frustrating," he notes.

Health Ministry officials speak out

The Permanent Secretary at the Ministry of Health, Dr Diana Atwine says the ministry cannot provide enough reagents for liver function tests due to budgetary constraints.

"The budget that is allocated for laboratory reagents is always so minimal. When they supply the reagents, they get finished so fast and do not last up to the end of the financial year," she notes.

A total of sh10b is allocated annually to run Hepatitis B activities, says Dr Alfred Driwale, the programme manager United National Expanded Programme on Immunization (UNEPI) at the health ministry.

The money is used to purchase medicines, reagents, vaccines and also caters for the training of health workers.

Dr Atwine, however, says that should not be an excuse to stop Hepatitis B care. The samples can be conveyed to Central Public Health Laboratories in Butabika for screening.

She says broken down machines will be serviced. Apart from carrying out liver function tests, the chemistry machines are used to conduct other tests such as kidney function.

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