Medical Laboratory Services in Africa Deserve More

Clinical Infectious Diseases, May 2006

Adamson S. Muula, Fresier C. Maseko

A PDF file should load here. If you do not see its contents the file may be temporarily unavailable at the journal website or you do not have a PDF plug-in installed and enabled in your browser.

Alternatively, you can download the file locally and open with any standalone PDF reader:

https://cid.oxfordjournals.org/content/42/10/1503.1.full.pdf

Medical Laboratory Services in Africa Deserve More

Adamson S. Muula 0 1 4 5 Fresier C. Maseko 2 3 5 6 0 Department of Epidemiology, University of North Carolina at Chapel Hill 1 Petti CA, Polage CR, Quinn TC, Ronald AR, Sande MA. Laboratory medicine in Africa: a barrier to effective health care. Clin Infect Dis 2006 ; 42:377-8 2 Bates I, Maitland K. Are laboratory services 3 Malawi College of Health Sciences , Lilongwe, Malawi 4 Department of Community Health, University of Malawi College of Medicine , Blantyre 5 Medical Laboratory Services in Africa Deserve More 6 Ecole de sante Publique, Universite Libre de Bruxelles , Brussels, Belgium - To the EditorThe recent review by Petti et al. [1] and the editorial commentary by Bates and Maitland [2] are timely contributions to the literature about the situation regarding inadequate medical laboratory services in Africa, as well as some of reasons behind this situation. The suggestions by Petti and colleagues about how laboratory services may be improved are thought provoking, but evidence from Africa about where implementation of programs has achieved success is difficult to come by. The authors refer several times to situations in which laboratory services continue to be less than acceptable. Interestingly, the British government allocated 950,000 to Malawi in 1998 to improve medical laboratory services [3]. This amount of money is equivalent to 40% of Malawis gross national budget for the 20052006 financial year. Obviously, if the finances necessary to improve laboratory services require such amounts of money, Malawi may not be able to commit the necessary resources to the improvement of laboratory services. We agree with Petti et al. [1] that overreliance on empirical treatment and management of syndromes have contributed to the relegation of laboratory services in many African countries. In Malawi, for instance, syndromic management of sexually transmitted infections, presumptive treatment of malaria in pregnant women, and initial treatment of all cases of fever as if they were due to malaria are the national standards of practice [4]. We suggest that all presumptive and empirical treatment measures be considered temporary and that etiologic diagnosis and treatment be the gold standard. Unfortunately, it is not uncommon for paying clients to access private antenatal clinics and to be provided with presumptive antimalarial therapy as a matter of routine when laboratory investigations could have been conducted first. The lack of continued medical and professional development as a requirement for reregistration of health professionals in some of the developing nations impedes progress in laboratory services [5]. We also suggest that, if some physicians trained in laboratory medicine and pursued that as a profession, changes may occur. The usual practice, however, is for technicianlevel staff to take charge, but in many cases, these leaders cannot stand up effectively enough to influence the medical establishment. The training and recruitment of biomedical technicians for the maintenance and repair of laboratory equipment should also be a matter of priority. Acknowledgments Potential conflicts of interest. A.S.M. is the Lecturer in Community and Public Health at the Malawi College of Medicine, and F.M. is the Senior Lecturer in Medical Sciences at the Malawi College of Health Sciences (MCHS). The MCHS is 1 of only 2 institutions for the training of laboratory technicians in Malawi. To the EditorIn the 1 February 2006 issue of Clinical Infectious Diseases, a timely article by Petti et al. [1] on the need for increased investment in laboratory services in Africa was accompanied by an excellent editorial commentary by Bates and Maitland, who called for laboratories and their advocates to be given a much louder voice on the international health care stage [2, p. 384]. Many have become concerned that laboratory services are the Achilles heel in global efforts to combat HIV infection, tuberculosis, and malaria and the antimicrobial resistance that accompanies them. On 910 May 2005, the American Society of Microbiology (ASM) held a meeting of experts from the United States and other countries to engage in a thoughtful discussion about laboratory infrastructure needs in underresourced countries to support infectious disease prevention and control programs. The meeting focused on (1) the need to increase the awareness of the importance of laboratories to the success of public health programs in underresourced countries and (2) ways to build on existing or planned programs that require a good laboratory system for a programs success. (...truncated)


This is a preview of a remote PDF: https://cid.oxfordjournals.org/content/42/10/1503.1.full.pdf

Adamson S. Muula, Fresier C. Maseko. Medical Laboratory Services in Africa Deserve More, Clinical Infectious Diseases, 2006, pp. 1503-1503, 42/10, DOI: 10.1086/503678