Laboratory use in Ghana: Physician perception and practice
Laboratory use in Ghana: Physician perception and practice
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DOI：
10.4269/ajtmh.2006.75.526
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发表时间：
2006-09-01
影响因子：
3.3
通讯作者：
Petti, Cathy A.
中科院分区：
文献类型：
--
作者：
Polage, Christopher R.;Bedu-Addo, George;Petti, Cathy A.
在非洲，传染病的临床诊断与误诊和死亡率增加有关，但即使有实验室检测，也仍然没有得到充分利用。我们回顾性地比较了感染诊断、检测结果、抗微生物药物的使用和患者成本与加纳一家教学医院的实验室和医生调查，以评估实验室使用的潜在障碍和对患者的经济影响。实验室的能力很高，但医生的调查结果和客观数据表明，依赖于临床判断和经验疗法。在研究期间，9-15%的疟疾诊断，34-43%的尿路感染（UTIs）和62%的脑膜炎病例得到了异常实验室结果的支持。同期，每个病人每天消耗0.82-2.09单位抗生素，抗生素的病人成本是实验室检测的4.8-21.6倍。医生对诊断检测价值的看法可能是实验室使用的主要障碍，导致药物滥用、不成比例的抗微生物给药和患者成本。
Clinical diagnosis of infectious diseases in Africa has been associated with increased misdiagnosis and mortality, but when laboratory testing is available, it remains underused. We retrospectively compared infectious diagnoses, test results, anti-microbial use, and patient cost with laboratory and physician surveys at a teaching hospital in Ghana to evaluate the potential barriers to laboratory use and financial impact for patients. Laboratory capacity was high, but physician survey results and objective data indicated a reliance on clinical judgment and empirical therapy. For the study period, 9-15% of malaria diagnoses, 34-43% of urinary tract infections (UTIs), and 62% of meningitis cases were supported by abnormal laboratory results. For the same period, 0.82-2.09 units of antibiotics were consumed per patient day, and patient cost for antibiotics was 4.8-21.6 times that of laboratory testing. Physician perception regarding the value of diagnostic testing is potentially a major barrier to laboratory use, resulting in empiricism, disproportionate anti-microbial administration, and cost to patients.