The Good, the Bad, and the Unknown: Quality of Clinical Laboratories in Kampala, Uganda
The Good, the Bad, and the Unknown: Quality of Clinical Laboratories in Kampala, Uganda
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DOI：
10.1371/journal.pone.0064661
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发表时间：
2013-05-30
期刊：
影响因子：
3.7
通讯作者：
Amukele, Timothy K.
中科院分区：
文献类型：
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作者：
Elbireer, Ali M.;Jackson, J. Brooks;Amukele, Timothy K.
背景：临床实验室对于解决撒哈拉以南非洲(SSA)高传染性和非传染性疾病的发病率至关重要。然而，最基本的信息，如SSA的临床实验室的数量和质量，是无法获得的。本研究的目的是通过在乌干达坎帕拉的一项初步调查，创建一种在SSA城镇中获取这些信息的实用方法。方法：将坎帕拉市划分为5个部分重叠的区域。每个地区被指派2-3名调查员，他们亲自和徒步确定和调查各自地区的实验室。使用了世界卫生组织-非洲区域(世卫组织/非洲)实验室加强检查表的修订版，以获得坎帕拉市所有临床实验室的质量基准衡量标准。调查员还测量了每个实验室的其他属性，如隶属关系(政府、私立等)、名称(国立医院、地区医院、独立医院等)、工作人员数量和人员类型。结果：调查小组确定并调查了坎帕拉市的954个实验室。96%的实验室是私人的。只有45个实验室(5%)达到或超过了世卫组织/非洲衍生实验室强化工具(1-STAR)所界定的最低质量标准。与其他909个实验室相比，这45个质量较高的实验室平均规模更大，实验室专门工作人员(技术员、抽血员等)的数量也更多。954个实验室中有688个(72%)没有在卫生部注册。结论：这次对坎帕拉临床实验室数量、范围和质量的综合评估是撒哈拉以南非洲地区首次发表的此类调查。调查结果表明，坎帕拉的实验室拥有合格的人员和更高的检测量，往往质量更高。
Background: Clinical laboratories are crucial in addressing the high rates of communicable and non-communicable diseases seen in sub-Saharan Africa (SSA). However, the most basic information, such as the number and quality of clinical laboratories in SSA, is not available. The objective of this study was to create a practical method for obtaining this information in SSA towns and cities using an initial survey in Kampala, Uganda.Methods: Kampala city was divided into 5 partially-overlapping regions. Each region was assigned to 2-3 surveyors who identified and surveyed laboratories in their respective regions; in person and on foot. A modified version of the World Health Organization - African Region (WHO/AFRO) Laboratory Strengthening Checklist was used to obtain baseline measures of quality for all clinical laboratories within Kampala city. The surveyors also measured other attributes of each laboratory, such as their affiliation (government, private etc), designation (national hospital, district hospital, standalone etc), staff numbers, and type of staff.Results: The survey team identified and surveyed 954 laboratories in Kampala city. 96% of laboratories were private. Only 45 (5%) of the laboratories met or surpassed the lowest quality standards defined by the WHO/AFRO-derived laboratory strengthening tool (1-star). These 45 higher-quality laboratories were, on average, larger and had a higher number of laboratory-specific staff (technologists, phlebotomists etc) than the other 909 laboratories. 688 (72%) of the 954 laboratories were not registered with the Ministry of Health (MoH).Conclusions: This comprehensive evaluation of the number, scope, and quality of clinical laboratories in Kampala is the first published survey of its kind in sub-Saharan Africa. The survey findings demonstrated that laboratories in Kampala that had qualified personnel and those that had higher testing volumes, tended to be of higher-quality.