Chikungunya: Few takers for local testing facility

TWO WEEKS after the City-based Choithram Hospital and Research Centre (CHRC) started conducting tests for chikungunya RNA at its microbiology laboratory, there are very few takers for the facility though the City has recently seen an upsurge in cases of the disease.

TWO WEEKS after the City-based Choithram Hospital and Research Centre (CHRC) started conducting tests for chikungunya RNA at its microbiology laboratory, there are very few takers for the facility though the City has recently seen an upsurge in cases of the disease.

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Earlier this month, the Choithram team had confirmed the presence of chikungunya RNA by a direct method with a molecular biology-based test using `Real Time PCR’, becoming only the third facility to conduct tests for ascertaining the disease after NICD (Delhi) and NIV (Pune).

However, even though hospitals – not just government hospitals like MY and District Hospital, but also private hospitals and clinics - are flooded with patients of various kinds of viral infections, health authorities are not approaching the Choithram lab to test the presence of chikungunya RNA.

Government health authorities in the City were sending, and continue to send, samples to National Institute of Communicable Diseases (NICD) – Delhi, though the number has decreased over the past week. This despite the fact that it takes a very long time for test results to come in and when they do come, sometimes taking as long as two months, the patient has been treated and sent home.

“Since the first set of tests conducted on September 4, in which two samples were tested positive, we have conducted about 70 such tests. Of these, 42 have tested positive,” Prof and Head, Microbiology & Immunology Department, Choithram Hospital Dr D S Chitnis said on Wednesday.

‘‘Of these 70 samples, nearly 22-25 per cent samples came from other private hospitals and clinics, but we have not yet received any case from any of the government hospitals,’’ he said. The test costs between Rs 1,200 and Rs 1,500 as the reagents used are costly, he informed.

Dr Chitnis said, “Now that the authorities have admitted that we have an epidemic-like situation in the division, checking of large number of cases during any outbreak can be helpful, as this way the specificity is more.”

MY Hospital Superintendent Dr D K Jain said, “Our hands are tied. We are a government body. If the State asks us to send samples to NICD (Delhi), we do so. If tomorrow, they ask us to send samples to Choithram, we will do that.”

Choithram authorities had informed all concerned local and district level health authorities about the availability of the facility at their lab, however, the higher authorities at State-level have not been informed.

“Of course, we have not informed the State authorities. But now we plan to prepare a full-fledged scientific report for sending it to medical journals and we would also send some samples to NICD, Delhi,” Dr Chitnis said.
Joint Director (health) Dr S K Shrivastava said, “The main reason is its cost. If we are getting it done free of cost at NICD, why should we pay Rs 1,500?”

“Moreover, we go by the government machinery. If tomorrow the State authorities say go to Choithram, we would surely avail the facility,” he said adding, “This does not mean we are being careless. In case of any emergency, if the patient is willing to pay, we would send the sample to Choithram for diagnosis.”

DHMO Dr K K Vijayvergiya echoed similar views about cost factor, saying when a free test was available, why would anybody need a costly one. “And as of today, when we know the prevalence of chikungunya, there is no need of such tests now.” However, when asked if he had informed the higher authorities about the facility available at Indore, he replied in the negative.

Other achievements of the Choithram lab are quantification of other virus such as HIV, HBV and HCV with the real time PCR test. The department also has a facility for detection of bird flu virus. “The question is, if they can accept PCR test for HIV and other such virus, why not for chikungunya?” Dr Chitnis wondered.