Nigerian Laboratory
A NEW study conducted by a group of researchers at the Nigerian Institute of Medical Research, NIMR, has called for concern on the accuracy, reliability and timeliness of clinical results generated in Nigerian laboratories.
The cross sectional study entitled “Establishing an External Quality Assessment Programme in Nigeria” shows that medical laboratories in Nigeria do not attain 5-star grades as recommended by the World Health Organisation, WHO, was conducted in two phases and suggests that presently, the laboratory infrastructure and test quality for all types of clinical laboratories remains weak in Nigeria.
From their findings, the researchers led by the Principal Investigator, Dr. Rosemary Audu of the Department of Human Virology Laboratory, NIMR, Lagos, established that 106 out of the 111 laboratories randomly selected from the six geopolitical zones of the country, attained an average of 65.3 per cent which is equivalent to a 2-star out of the maximum grade of 5 star.
The study therefore shows that despite the fact that the grade attained was by self reporting and not by an audit; it indicates a very poor culture of quality management system prevailing in the Nigerian laboratories.
“Also evident from the assessment was the poor maintenance culture reported by the laboratories as most of them did not have preventive maintenance policy, thereby undermining the quality of results generated by the equipment they use.
According to the researchers, only 27 per cent of the laboratories were registered for HIV, TB and malaria External Quality Assessment Programme, EQAP. They recommended that concerted effort was required to train Nigerian laboratories on quality management system.
The second phase of the study on HIV and TB diagnosis, show that although there was consistent improvement in performance for each of the rounds when some form of training was provided it was not sustained in the last round.
“The major issue with HIV diagnosis was the none use of the national testing algorithm, even though there was a decline from 83 per cent in the 1st round to 47 per cent at the end of the 4th round. The approved algorithm, according to the researchers is serial testing involving the use of determine, unigold and stat – pak.
Recommending the kits be made available to ensure the algorithm is adhered to regularly, the study was to ensure accuracy of test results.
“Challenges observed with TB results showed a high level (20 percent) of false negative results. There were also 8 per cent of reported false positive results which will unduly expose individuals to drugs which are toxic to their systems. Meanwhile patients who require anti -TB drugs are sometimes not privileged to access it due to stock out.”
Calling for urgent need to increase the accuracy of malaria diagnosis by training and retraining of laboratory technicians, the study recommended a dire need to imbibe the culture of quality management system in the Nigerian laboratories if they are to play the strategic role in providing evidence for clinical management of patients especially in the interest of the common man.
The researchers in the second phase followed 44 laboratories out of the 106 (20 per cent Government and 80 per cent private) that completed the questionnaires and indicated interest in participating in the EQAP for the three diseases, Malaria, TB and HIV.
Author: Chief Editor
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