Laboratory medicine in Africa: a barrier to effective health care
Abstract
Providing health care in sub-Saharan Africa is a complex problem. Recent reports call for more resources to assist in the prevention and treatment of infectious diseases that affect this population, but policy makers, clinicians, and the public frequently fail to understand that diagnosis is essential to the prevention and treatment of disease. Access to reliable diagnostic testing is severely limited in this region, and misdiagnosis commonly occurs. Understandably, allocation of resources to diagnostic laboratory testing has not been a priority for resource-limited health care systems, but unreliable and inaccurate laboratory diagnostic testing leads to unnecessary expenditures in a region already plagued by resource shortages, promotes the perception that laboratory testing is unhelpful, and compromises patient care. We explore the barriers to implementing consistent testing within this region and illustrate the need for a more comprehensive approach to the diagnosis of infectious diseases, with an emphasis on making laboratory testing a higher priority.
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In low-resource settings, differences in antibiotic prophylaxis and treatment, cesarean delivery practices, HIV prevalence, access to microbiology testing, antimicrobial stewardship and infection control practices may lead to differences in infection incidence, microbiology, and antimicrobial resistance.
“In low-resource settings, differences in antibiotic prophylaxis and treatment, cesarean delivery practices, human immunodeficiency virus (HIV) prevalence, access to microbiology testing, antimicrobial stewardship and infection control practices may lead to differences in infection incidence, microbiology, and antimicrobial resistance.[4, 5, 9, 10]”
From Antimicrobial-resistant infections among postpartum women at a Ugandan referral hospital (2017) · cites this paper as [9]
Lack of trained healthcare workers and weak laboratory and infection control capacity may contribute to healthcare-associated transmission of ESBL-E to pregnant and post-partum women.
“Another possible explanation is that the lack of trained healthcare workers (Kimang'a, 2012) and weak laboratory and infection control capacity (Petti et al., 2006) may contribute to healthcare-associated transmission of ESBL-E to pregnant and post-partum women.”
From Maternal colonization or infection with extended-spectrum beta-lactamase-producing Enterobacteriaceae in Africa: A systematic review and meta-analysis (2017) · cites this paper as Petti et al., 2006
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“In low-resource settings, differences in antibiotic prophylaxis and treatment, cesarean delivery practices, human immunodeficiency virus (HIV) prevalence, access to microbiology testing, antimicrobial stewardship and infection control practices may lead to differences in infection incidence, microbiology, and antimicr…”
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“Discerning CNS aetiology thus becomes a challenging task that impedes appropriate and timely treatment of patients, allows for over-treatment with empirical broad-spectrum drugs, and adds to the burden of disease and the spread of antimicrobial resistance [2, 8–11].”
- Authors
- Petti, C. A., Polage, C. R., Quinn, T. C., Ronald, A. R., & Sande, M. A.
- Affiliations
- University of Utah (US)
- ARUP Laboratories (United States) (US)
- National Institutes of Health (US)
- University of Manitoba (CA)
- Corresponding author
- Petti, C. A.
- Venue
- Clinical Infectious Diseases
- Publisher
- Oxford University Press (OUP)
- Published
- 2006-02-01
- Volume
- 42
- Issue
- 3
- Pages
- 377-382
- ISSN
- 1058-4838 (ISSN-L)
- 1537-6591
- OpenAlex
- W2127274540
- Cited by
- 749
- References
- 1
- Citations by year
- 2026: 24 · 2025: 22 · 2024: 39 · 2023: 36 · 2022: 45 · 2021: 42 · 2020: 63 · 2019: 34 · 2018: 41 · 2017: 41 · 2016: 46 · 2015: 49 · 2014: 56 · 2013: 30 · 2012: 39
- FWCI
- 15.69
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Clinical Infectious Diseases (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Pfizer
- National Institutes of Health
- Topics
- Health Sciences › Medicine › Physiology › Clinical Laboratory Practices and Quality Control
- Physical Sciences › Engineering › Biomedical Engineering › Biosensors and Analytical Detection
- Health Sciences › Health Professions › Health Information Management › Global Health and Epidemiology
- Keywords
- clinical pathology, diagnostic testing, infectious diseases, sub-Saharan Africa, misdiagnosis, barriers to testing, healthcare resource allocation
- MeSH terms
- Communicable Diseases, Delivery of Health Care, Humans, Laboratories, Socioeconomic Factors, Africa South of the Sahara
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