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Laboratory diagnostics performance in Uganda: A survey of test availability and constraints
Abstract
Introduction: Clinical laboratory services are a critical component of the health system for effective disease diagnosis, treatment, control and prevention. However, many laboratories in Sub-Saharan Africa remain dysfunctional. This study assessed the functionality of laboratories based on test menus and the associated constraints in Uganda.
Methods: This cross-sectional quantitative study involved an assessment of 100 laboratories randomly selected in 20 districts from four regions of the country. The laboratory in charge and managers in each of the selected laboratories were interviewed. Data was analyzed using Excel and STATA 14.
Results: Most health center III laboratories can conduct basic urine (84.2%, 48/57) and stool analysis (63.2%, 36/57) with a few exceptions due to non- functioning equipment and lack of reagents. All the Health center IV laboratories conducted HIV tests, malaria and pregnancy tests. None of the Health center IV laboratories performed pneumonia (blood/sputum culture tests) and ulcer (H pylori tests), electrolytes tests and only 1/18 (5.6%) performed chemistry tests; this was due to non-functioning equipment, lack of equipment, reagents and limited staff skills. Almost all tests supposed to be conducted at hospital-level laboratories, were conducted except for chemistry (73.7%, 14/19) and electrolytes (47.4%, 9/19) tests. Full blood count tests were missing in 25% (4/16) of the hub laboratories mainly due to lack of equipment. The majority (62.5%, 10/16) of the hubs routinely refer specimens for tests that are supposed to be carried out in these laboratories due to lack of reagents (70.0%, 7/10) and non-functional equipment (60.0%, 6/10). Hub laboratories lacked a list of essential supplies.
Conclusion: Most laboratories performed well for the common tests. However, many laboratories did not meet testing requirements for the advanced tests due to non-functioning equipment, lack of equipment and reagents. Therefore, there is a need to provide equipment to laboratories, repair the non-functional ones and develop an essential list of supplies for the hub laboratories.
