RESOURCE-LIMITED MEDICAL LABORATORIES

Resource-Limited Medical Laboratories

Resource-Limited Medical Laboratories

Introduction

This report endorses the author's own views on the subject after taking up a laboratory adviser mission in Africa. Taking the example of laboratory services practice in sub-Saharan countries, it is shown that diagnosis of diseases which require the use of laboratory suffer from lapses in the quality of case-detection and case-reporting. These services lack management and an information system that limits the set up of a laboratory network at national level. An efficient health program set in resource deprived countries would then yield improvements on systems and infrastructure.

Overview

The critical nature of emergency medical services in Saharan and Sub-Saharan Africa is paramount as development during the 21st century is poised to arouse Africa to become a global economic player. Emergency care is akin to emergency medical response teams that can arrive on-site with a laboratory where blood testing, transfusion or mainly diagnosis of communicable diseases is essential. Economic constraints limit the development of such a network within the context of establishing facilities and health structures (Hébert et al., 2004). Poverty is the most quoted reason for the lack of these services as, according to Loefler (1998), there is “shortage of facilities, equipment, dressings and drugs, notably antibiotics.” Supporting variables include overcrowding in populated areas where stand-alone facilities exist, insufficient environmental hygiene conditions conducive to the spread of disease, and insufficient maggot control leading to a large infestation of flies throughout large areas.

As an example, Onwujekwe et al. (2005) observed the relationship between the socio-economic status of a household and diagnosis and treatment in Nigeria. It was seen, as it is the case in most Sub-Saharan countries that poorest people seek care from 'low-level' providers, such as traditional healers and community health workers, due to their severe budget constraints while the least-poor group was more likely to rely on laboratory tests for diagnosis and to visit hospitals when seeking treatment. Improvements in the quality of diagnosis and treatment by the providers would help to redress this inequity, at least in the short- to medium-term.

In general, in poor countries many affected families can hardly afford even the cost of basic laboratory diagnostic tests, and some otherwise treatable conditions may lead to early death in affected patients. Most patients would be treated on the basis of clinical assessment only, since they could not afford the cost. Frustrated by this experience, they abscond or leave against medical advice. So, availability of diagnosis facilities and necessary chemotherapeutic agents at affordable cost are vital for effective management of infections. Some studies like this of Onwujekwe et al. (2005) report that, in a few cases, although laboratory facilities were available, they were not accessible to all patients. Most patients could not afford the costs of confirmatory laboratory tests, which could cause the treatment to be started without pathological confirmation and would enhance the number of misdiagnosed cases to “adverse effects of agents with no clinical benefits at all”. Also worth mentioning is the laboratory work as ...