A new type of HIV test appears to be dramatically increasing the number of First Nations people getting tested in Saskatchewan. "Dried blood spot testing" is a needle-prick test, which is similar to having a blood sugar test for diabetes. The method is being piloted in First Nations communities as a way to increase the number of number of people getting tested.
Ceal Tournier is the general manager of Saskatoon Tribal Council Health and Family Services, which is leading the project. She said the number of people tested for HIV in STC partner communities in the past six weeks — 114 — is four times higher than the number for the previous six months. The STC is in the process of analyzing the results of the pilot project.
Dr. Ibrahim Khan, the regional medical health officer for First Nations, Inuit Health Branch of Health Canada, said the number of HIV tests performed in Saskatchewan First Nations jurisdictions increased by 11 per cent in 2016. The number of new cases of HIV increased by 10 per cent.
Khan said that in 2016, Saskatchewan had the highest rate of new infections among First Nations people living on-reserve: 45 per 100,000 people. The provincial rate is 16 per 100,000. "The focus in the past couple of years was to improve testing in First Nations because there is a lot of undiagnosed infection in the community," said Khan.
He said the dried blood spot testing was breaking down the barriers to getting tested because people felt more comfortable getting this test than the conventional one. "People felt comfortable doing it, people felt comfortable getting the results, and the timing and the process was easy for them," he said.
"It was non-discriminatory and it was non-judgmental and it was not like the conventional test."
A week after a highly critical Supreme Court decision questioned the reliability of drug and alcohol testing results from a Halifax toxicology lab in a child custody case, it remains unclear whether the province will halt or continue to use the service.
In her ruling, Justice Theresa Forgeron ruled against a motion by the Department of Community Services to have the director of the Central Health Authority’s toxicology lab, Dr. Bassam Nassar, give expert opinion evidence concerning urine testing samples from a Cape Breton father.
"I find that Dr. Nassar’s opinion, respecting the toxicology lab results, is not reliable where the lab is not designated a forensic lab, where the lab is not subject to external proficiency testing or oversight, and where the lab’s adherence to international standards is uncertain," said Forgeron.
The ruling came in the case of a Cape Breton father who wants unsupervised access with his young daughter. The department disagreed, pointing to three urine testing results — taken between April and July 2017 — that indicated the presence of cocaine. The father disputes the results.
As for the health authority’s response to criticisms of its lab, Shauna Thomson, senior director of pathology and laboratory medicine, offered a brief comment. "We have been investigating options related to specific accreditation for our forensic toxicology laboratory as a means to formally recognize our adherence to national and international standards for some time. Our intent is to move this forward as soon as possible," said Thompson.
While Thompson refers to the lab as a forensic lab, Forgeron, in her decision, said the facility is not designated or certified as a forensic lab but as a clinical lab and no application has been made to have the lab certified.
In her decision, Forgeron said the Halifax facility is not subject to any external testing or oversight that could offer independent assurances that it is free of problems that could result in flawed testing. She said the court drew little comfort from the fact the lab is subject to Accreditation Canada, as Nassar admitted to the court that he could not recall anyone from Accreditation Canada ever inspecting the toxicology lab.
The Food and Drug Administration (FDA) recently fast-tracked approval for a blood test that’s said to help detect concussions, but experts say the test’s capabilities are being overstated.
The Brain Trauma Indicator, made by Banyan Biomarkers, received the green light to go on the market in less than six months. That’s a pretty quick timeline for the FDA, which granted its approval under its new Breakthrough Devices Program.
While some experts were impressed by the quick approval duration, others warned that the test isn’t the breakthrough everyone’s been waiting for. In short, it can’t detect concussions. And it’s only meant for adults.
"As with many new medical discoveries, the headlines and the hype can outstrip the reality and I think that has happened here," said Dr. James P. MacDonald, a physician and sports medicine specialist at Nationwide Children’s Hospital in Ohio.
"This new test does not diagnose concussion. It cannot ‘detect’ concussions," MacDonald said. He added that the new device also doesn’t rule out concussions either. "What it does do is help a doctor determine whether a patient may need computed tomography (CT) scans after a head injury to see if an ‘intracranial lesion’ may be visible," he said.