Self-Test: The Fine Line Between Use and Abuse
No doubt, point of care testing (POCT) or home use machines and other Rapid Testing Kits have greatly increased access, reduced turn around time, reduced the cost of medical diagnosis and greatly improved diagnosis of diseases. But there still exists a huge vacuum and drawbacks in the use of their deployment especially as people now see it as stand-alones or alternatives to visiting the medical laboratories or even hospitals for holistic medical assessment.
It is wrong for anyone to think or assume that because of the availability and easy- access to simpler diagnostic methods (especially the Rapid test kits), that there is no need to visit medical laboratories. This is a wrong assertion, because there is a world of difference between confirmatory diagnosis and screening tests.
During my national youth service where I served at a general hospital in Delta state, a patient who was on admission in one of the wards was assessed and the doctor on duty requested for urgent Random Blood Sugar (RBS). She was a known diabetic
Madam Precious (not real name) had been encouraged to buy a self- test machine for monitoring of her sugar level. But that particular evening, something went wrong, maybe with machine
That evening in the hospital, I carried out the RBS test, she was shockingly hypoglycemic (very low sugar level). After inquiring what happened, it was discovered that Madam Precious took insulin without prescription because the machine gave her a value very high, higher than the normal results she usually gets and in addition she was feeling unwell.
Her bad or a faulty machine? ...BOTH
Her bad, because she hadn't visited the hospital for a very long time after buying the glucometer. Whenever the machine gave her a high value, she resorted to self- medication by buying self prescribed drugs in addition to the initial drugs prescribed by the doctor.
However, this fateful day, the machine misbaved without her knowledge, and she wrongfully took the drugs that made her sugar level to drop to coma level.Long story short, the glucometer needed validation and quality control after so many months of continuous use.
Meanwhile, these self tests should be embraced but with caution, it is advised that users should engage the services of a Medical Laboratory Scientist to serve as a guide and consultant for any test, because the consequences of self- test and self-medication can be very costly.
Furthermore, some consequences and drawbacks of self test includes;
1. False Results; false-negative results, especially during the window period of some diseases, (e.g HIV) may lead to false reassurance and could promote sex between discordant partners at the time of highest infectivity;
2.Waiting and seeing the outcome of results can lead to anxiety, apprehension and shock without proper counselling.
3.Self-medications- self test predisposes patients to self-medications, which can be very detrimental.
4.Prone to Errors: errors are inevitable when untrained persons carry out such tests.
5. Faulty machines: these self-test machines can develop faults with out the knowledge of the users.
6. Bad or expired tests kits: Users might not take conisance of expired products, hence wrong diagnosis is inevitable.
7. Failure to detect accurately: Some reactions might need a well trained medical laboratory scientist to detect.
8. Spread of infectious agents; some test require special conditions to be carried out, e.g Safety cabinets , hence doing it at home can lead to exposure to and spread of infectious agents.
9. Also, with self testing;opportunities for counseling, linkage to care, and diagnosis of other infections may be missed.
10. Finally, correct epidemiological information and data of diseases in a particular locality or community can be missed.
1. Proper government regulations; Just like we have on the counter drugs and prescription drugs, it is wise that government makes regulations/ legislations on the tests that should be carried out at home or by self.
2. The public should develop the habit of visiting the laboratory on intervals even if you can do some of these tests yourself.
3. Individuals are encouraged to go for proper counselling and guidance before doing test on your own.
4. Engage the services of a Medical Laboratory Scientist for guidance and information on all tests.
In conclusion, instead of treating yourself, see a doctor for proper assessment; instead of self medications and randomly buying drugs, see a pharmacist.In the same way instead of doing test yourself engage the services of a licensed Medical Laboratory Scientist to serve as a guide and consultant for any test, because the consequences of self test and self medication can be deadly.
Edited by: Chundung Davou