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Reference Manager
BibTeX
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-
1.
Petti CA, Polage CR, Quinn TC, Ronald AR, Sande MA, 2006. Laboratory medicine in Africa: a barrier to effective health care. Clin Infect Dis 42: 377–382.
-
2.
Birx D, de Souza M, Nkengasong JN, 2009. Laboratory challenges in the scaling up of HIV, TB, and malaria programs: the interaction of health and laboratory systems, clinical research, and service delivery. Am J Clin Pathol 131: 849–851.
-
3.
Nankabirwa J, Zurovac D, Njogu JN, Rwakimari JB, Counihan H, Snow RW, Tibenderana JK, 2009. Malaria misdiagnosis in Uganda—implications for policy change. Malar J 8: 66.
-
4.
Wilson D, Howell V, Toppozini C, Dong K, Clark M, Hurtado R, 2011. Against all odds: diagnosing tuberculosis in South Africa. J Infect Dis 204 (Suppl 4): S1102–S1109.
-
5.
Polage CR, Bedu-Addo G, Owusu-Ofori A, Frimpong E, Lloyd W, Zurcher E, Hale D, Petti CA, 2006. Laboratory use in Ghana: physician perception and practice. Am J Trop Med Hyg 75: 526–531.
-
6.
Reyburn H, Mbatia R, Drakeley C, Carneiro I, Mwakasungula E, Mwerinde O, Saganda K, Shao J, Kitua A, Olomi R, Greenwood BM, Whitty CJ, 2004. Overdiagnosis of malaria in patients with severe febrile illness in Tanzania: a prospective study. BMJ 329: 1212.
-
7.
Hawkins RC, 2007. Laboratory turnaround time. Clin Biochem Rev 28: 179.
-
8.
Plebani M, Lippi G, 2011. Closing the brain-to-brain loop in laboratory testing. Clin Chem Lab Med 49: 1131–1133.
-
9.
Manor PG, 1999. Turnaround times in the laboratory: a review of the literature. Clin Lab Sci 12: 85.
-
10.
Ssekabira U, Bukirwa H, Hopkins H, Namagembe A, Weaver MR, Sebuyira LM, Quick L, Staedke S, Yeka A, Kiggundu M, Schneider G, McAdam K, Wabwire-Mangen F, Dorsey G, 2008. Improved malaria case management after integrated team-based training of health care workers in Uganda. Am J Trop Med Hyg 79: 826–833.
-
11.
Kiggundu M, Nsobya SL, Kamya MR, Filler S, Nasr S, Dorsey G, Yeka A, 2011. Evaluation of a comprehensive refresher training program in malaria microscopy covering four districts of Uganda. Am J Trop Med Hyg 84: 820–824.
-
12.
Gwer S, Newton CR, Berkley JA, 2007. Over-diagnosis and co-morbidity of severe malaria in African children: a guide for clinicians. Am J Trop Med Hyg 77 (Suppl): 6–13.
-
13.
Nicastri E, Bevilacqua N, Schepisi MS, Paglia MG, Meschi S, Ame SM, Mohamed JA, Mangi S, Fumakule R, Di Caro A, Capobianchi MR, Kitua A, Molteni F, Racalbuto V, Ippolito G, 2009. Accuracy of malaria diagnosis by microscopy, rapid diagnostic test, and PCR methods and evidence of antimalarial overprescription in non-severe febrile patients in two Tanzanian hospitals. Am J Trop Med Hyg 80: 712–717.
-
14.
Driessen J, Cioffi M, Alide N, Landis-Lewis Z, Gamadzi G, Gadabu OJ, Douglas G, 2013. Modeling return on investment for an electronic medical record system in Lilongwe, Malawi. J Am Med Inform Assoc 20: 743–748.
-
15.
Driessen J, Limula H, Gadabu OJ, Gamadzi G, Chitandale E, Ben-Smith A, Alide N, Douglas G, 2015. Informatics solutions for bridging the gap between clinical and laboratory services in a low-resource setting. Afr J Lab Med 4: 1–7.
-
16.
Crabtree BF, Miller WL, 1999. Doing Qualitative Research. Thousand Oaks, CA: Sage Publications.
| Past two years | Past Year | Past 30 Days | |
|---|---|---|---|
| Abstract Views | 288 | 209 | 33 |
| Full Text Views | 473 | 4 | 0 |
| PDF Downloads | 233 | 8 | 0 |
Assessing Perceived Challenges to Laboratory Testing at a Malawian Referral Hospital
Lia G. Petrose
Lia G. Petrose
Center for Health Informatics for the Underserved, Department of Biomedical Informatics, University of Pittsburgh, Pittsburgh, Pennsylvania; Behavioral and Community Health Sciences, University of Pittsburgh, Pittsburgh, Pennsylvania; School of Public Health and Family Medicine, College of Medicine, University of Malawi, Blantyre, Malawi; Baobab Health Trust, Lilongwe, Malawi; Department of Laboratory Testing, Kamuzu Central Hospital, Lilongwe, Malawi; Department of Health Policy and Management, University of Pittsburgh, Pittsburgh, Pennsylvania
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Arielle M. Fisher
Arielle M. Fisher
Center for Health Informatics for the Underserved, Department of Biomedical Informatics, University of Pittsburgh, Pittsburgh, Pennsylvania; Behavioral and Community Health Sciences, University of Pittsburgh, Pittsburgh, Pennsylvania; School of Public Health and Family Medicine, College of Medicine, University of Malawi, Blantyre, Malawi; Baobab Health Trust, Lilongwe, Malawi; Department of Laboratory Testing, Kamuzu Central Hospital, Lilongwe, Malawi; Department of Health Policy and Management, University of Pittsburgh, Pittsburgh, Pennsylvania
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Gerald P. Douglas
Gerald P. Douglas
Center for Health Informatics for the Underserved, Department of Biomedical Informatics, University of Pittsburgh, Pittsburgh, Pennsylvania; Behavioral and Community Health Sciences, University of Pittsburgh, Pittsburgh, Pennsylvania; School of Public Health and Family Medicine, College of Medicine, University of Malawi, Blantyre, Malawi; Baobab Health Trust, Lilongwe, Malawi; Department of Laboratory Testing, Kamuzu Central Hospital, Lilongwe, Malawi; Department of Health Policy and Management, University of Pittsburgh, Pittsburgh, Pennsylvania
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Martha A. Terry
Martha A. Terry
Center for Health Informatics for the Underserved, Department of Biomedical Informatics, University of Pittsburgh, Pittsburgh, Pennsylvania; Behavioral and Community Health Sciences, University of Pittsburgh, Pittsburgh, Pennsylvania; School of Public Health and Family Medicine, College of Medicine, University of Malawi, Blantyre, Malawi; Baobab Health Trust, Lilongwe, Malawi; Department of Laboratory Testing, Kamuzu Central Hospital, Lilongwe, Malawi; Department of Health Policy and Management, University of Pittsburgh, Pittsburgh, Pennsylvania
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Adamson Muula
Adamson Muula
Center for Health Informatics for the Underserved, Department of Biomedical Informatics, University of Pittsburgh, Pittsburgh, Pennsylvania; Behavioral and Community Health Sciences, University of Pittsburgh, Pittsburgh, Pennsylvania; School of Public Health and Family Medicine, College of Medicine, University of Malawi, Blantyre, Malawi; Baobab Health Trust, Lilongwe, Malawi; Department of Laboratory Testing, Kamuzu Central Hospital, Lilongwe, Malawi; Department of Health Policy and Management, University of Pittsburgh, Pittsburgh, Pennsylvania
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Marlen S. Chawani
Marlen S. Chawani
Center for Health Informatics for the Underserved, Department of Biomedical Informatics, University of Pittsburgh, Pittsburgh, Pennsylvania; Behavioral and Community Health Sciences, University of Pittsburgh, Pittsburgh, Pennsylvania; School of Public Health and Family Medicine, College of Medicine, University of Malawi, Blantyre, Malawi; Baobab Health Trust, Lilongwe, Malawi; Department of Laboratory Testing, Kamuzu Central Hospital, Lilongwe, Malawi; Department of Health Policy and Management, University of Pittsburgh, Pittsburgh, Pennsylvania
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Henry Limula
Henry Limula
Center for Health Informatics for the Underserved, Department of Biomedical Informatics, University of Pittsburgh, Pittsburgh, Pennsylvania; Behavioral and Community Health Sciences, University of Pittsburgh, Pittsburgh, Pennsylvania; School of Public Health and Family Medicine, College of Medicine, University of Malawi, Blantyre, Malawi; Baobab Health Trust, Lilongwe, Malawi; Department of Laboratory Testing, Kamuzu Central Hospital, Lilongwe, Malawi; Department of Health Policy and Management, University of Pittsburgh, Pittsburgh, Pennsylvania
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Julia Driessen
Julia Driessen
Center for Health Informatics for the Underserved, Department of Biomedical Informatics, University of Pittsburgh, Pittsburgh, Pennsylvania; Behavioral and Community Health Sciences, University of Pittsburgh, Pittsburgh, Pennsylvania; School of Public Health and Family Medicine, College of Medicine, University of Malawi, Blantyre, Malawi; Baobab Health Trust, Lilongwe, Malawi; Department of Laboratory Testing, Kamuzu Central Hospital, Lilongwe, Malawi; Department of Health Policy and Management, University of Pittsburgh, Pittsburgh, Pennsylvania
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Adequate laboratory infrastructure in sub-Saharan Africa is vital for tackling the burden of infectious diseases such as human immunodeficiency virus and acquired immune deficiency syndrome, malaria, and tuberculosis, yet laboratories are ill-integrated into the diagnostic and care delivery process in low-resource settings. Although much of the literature focuses on disease-specific challenges around laboratory testing, we sought to identify horizontal challenges to the laboratory testing process through interviews with clinicians involved in the diagnostic process. Based on 22 interviews with physicians, nurses, clinical officers, medical students, and laboratory technicians, technologists and supervisors, we identified 12 distinct challenges in the areas of staff, materials, workflow, and the blood bank. These challenges underscore the informational challenges that compound more visible resource shortages in the laboratory testing process, which lend themselves to horizontal strengthening efforts around the diagnostic process.
Author Notes
Financial support: This study was supported by a pilot grant from the University of Pittsburgh's Central Research Development Fund. This research was funded in part by a training grant from the National Library of Medicine 5 T15 LM007059-28 to the University of Pittsburgh's Biomedical Informatics Training Program.
Authors' addresses: Lia G. Petrose, Arielle M. Fisher, and Gerald P. Douglas, Center for Health Informatics for the Underserved, Department of Biomedical Informatics, University of Pittsburgh, Pittsburgh, PA, E-mails: lgp6@pitt.edu, arf56@pitt.edu, and gdouglas@pitt.edu. Martha A. Terry, Behavioral and Community Health Sciences, University of Pittsburgh, Pittsburgh, PA, E-mail: materry@pitt.edu. Adamson Muula, Department of Public Health, School of Public Health and Family Medicine, College of Medicine, University of Malawi, Blantyre, Malawi, E-mail: amuula@medcol.mw. Marlen S. Chawani, Baobab Health Trust, Lilongwe, Malawi, E-mail: marlen.chawani@baobabhealth.org. Henry Limula, Department of Laboratory Testing, Kamuzu Central Hospital, Lilongwe, Malawi, E-mail: limula2004@yahoo.co.uk. Julia Driessen, Center for Health Informatics for the Underserved, Department of Biomedical Informatics, University of Pittsburgh, Pittsburgh, PA, and Department of Health Policy and Management, University of Pittsburgh, Pittsburgh, PA, E-mail: driessen@pitt.edu.
ProCite
RefWorks
Reference Manager
BibTeX
Zotero
EndNote
-
1.
Petti CA, Polage CR, Quinn TC, Ronald AR, Sande MA, 2006. Laboratory medicine in Africa: a barrier to effective health care. Clin Infect Dis 42: 377–382.
-
2.
Birx D, de Souza M, Nkengasong JN, 2009. Laboratory challenges in the scaling up of HIV, TB, and malaria programs: the interaction of health and laboratory systems, clinical research, and service delivery. Am J Clin Pathol 131: 849–851.
-
3.
Nankabirwa J, Zurovac D, Njogu JN, Rwakimari JB, Counihan H, Snow RW, Tibenderana JK, 2009. Malaria misdiagnosis in Uganda—implications for policy change. Malar J 8: 66.
-
4.
Wilson D, Howell V, Toppozini C, Dong K, Clark M, Hurtado R, 2011. Against all odds: diagnosing tuberculosis in South Africa. J Infect Dis 204 (Suppl 4): S1102–S1109.
-
5.
Polage CR, Bedu-Addo G, Owusu-Ofori A, Frimpong E, Lloyd W, Zurcher E, Hale D, Petti CA, 2006. Laboratory use in Ghana: physician perception and practice. Am J Trop Med Hyg 75: 526–531.
-
6.
Reyburn H, Mbatia R, Drakeley C, Carneiro I, Mwakasungula E, Mwerinde O, Saganda K, Shao J, Kitua A, Olomi R, Greenwood BM, Whitty CJ, 2004. Overdiagnosis of malaria in patients with severe febrile illness in Tanzania: a prospective study. BMJ 329: 1212.
-
7.
Hawkins RC, 2007. Laboratory turnaround time. Clin Biochem Rev 28: 179.
-
8.
Plebani M, Lippi G, 2011. Closing the brain-to-brain loop in laboratory testing. Clin Chem Lab Med 49: 1131–1133.
-
9.
Manor PG, 1999. Turnaround times in the laboratory: a review of the literature. Clin Lab Sci 12: 85.
-
10.
Ssekabira U, Bukirwa H, Hopkins H, Namagembe A, Weaver MR, Sebuyira LM, Quick L, Staedke S, Yeka A, Kiggundu M, Schneider G, McAdam K, Wabwire-Mangen F, Dorsey G, 2008. Improved malaria case management after integrated team-based training of health care workers in Uganda. Am J Trop Med Hyg 79: 826–833.
-
11.
Kiggundu M, Nsobya SL, Kamya MR, Filler S, Nasr S, Dorsey G, Yeka A, 2011. Evaluation of a comprehensive refresher training program in malaria microscopy covering four districts of Uganda. Am J Trop Med Hyg 84: 820–824.
-
12.
Gwer S, Newton CR, Berkley JA, 2007. Over-diagnosis and co-morbidity of severe malaria in African children: a guide for clinicians. Am J Trop Med Hyg 77 (Suppl): 6–13.
-
13.
Nicastri E, Bevilacqua N, Schepisi MS, Paglia MG, Meschi S, Ame SM, Mohamed JA, Mangi S, Fumakule R, Di Caro A, Capobianchi MR, Kitua A, Molteni F, Racalbuto V, Ippolito G, 2009. Accuracy of malaria diagnosis by microscopy, rapid diagnostic test, and PCR methods and evidence of antimalarial overprescription in non-severe febrile patients in two Tanzanian hospitals. Am J Trop Med Hyg 80: 712–717.
-
14.
Driessen J, Cioffi M, Alide N, Landis-Lewis Z, Gamadzi G, Gadabu OJ, Douglas G, 2013. Modeling return on investment for an electronic medical record system in Lilongwe, Malawi. J Am Med Inform Assoc 20: 743–748.
-
15.
Driessen J, Limula H, Gadabu OJ, Gamadzi G, Chitandale E, Ben-Smith A, Alide N, Douglas G, 2015. Informatics solutions for bridging the gap between clinical and laboratory services in a low-resource setting. Afr J Lab Med 4: 1–7.
-
16.
Crabtree BF, Miller WL, 1999. Doing Qualitative Research. Thousand Oaks, CA: Sage Publications.
| Past two years | Past Year | Past 30 Days | |
|---|---|---|---|
| Abstract Views | 288 | 209 | 33 |
| Full Text Views | 473 | 4 | 0 |
| PDF Downloads | 233 | 8 | 0 |