CAPACITY OF PUBLIC LABORATORIES IN DIAGNOSING SELECTED PRIORITY AND EPIDEMIC PRONE DISEASES IN OYO STATE, SOUTHWEST NIGERIA

Abstract

Laboratory diagnosis remains a critical component of global communicable disease detection, prevention and control but it is often neglected in Nigeria due to inadequate infrastructure. Although reference laboratories are being established for confirmation of outbreaks of some specific communicable diseases, capacity of laboratories at peripheral hospitals require strengthening so as to meet demands of local health authorities. However, capacities of such hospitals and possible gaps in their functioning are not well documented. Thus, this study was carried out to assess the capacity of hospital-based laboratories to diagnose selected priority and epidemic-prone diseases in Oyo State, Nigeria. A descriptive cross-sectional study was carried out in 17 hospital-based microbiology laboratories in Oyo State. All the functional laboratories in the state were surveyed. A WHO Laboratory Assessment Tool (WHO/LAT) was modified and used to interview one laboratory scientist per facility. The tool was used to collect information on socio-demographics of the participants, laboratory testing capacity, availability of laboratory infrastructures and utilities, laboratory staff supervision practice, number of laboratory personnel and involvement in disease surveillance. Laboratory capacity was assessed on a 100 point scale in which scores were rated low (≤49%), fair (50-79%) and good (≥80%). Data were analysed using descriptive statistics and t-test at p= 0.05. Age and length of service of participants were 42.0 ± 5.1 years and 11.9 ± 8.8 years respectively. Laboratory testing capacity for measles and meningitis was 'low' in all the 17 laboratories but all had 'good capacity' to carry out tests for malaria. More than half (11) of the laboratories had 'low capacity' to test for tuberculosis and 6 had 'fair capacity'. Most (14) laboratories had 'low capacity' to carry out HIV/AIDS tests while 3 had 'fair capacity'. Sixteen of the laboratories had 'low capacity' to test for cholera and one had 'fair capacity'. Seven of the laboratories had poor infrastructure, two had laboratory staff supervision problems and seven had laboratory personnel problems such as insufficient laboratory scientists and technicians. Twelve laboratories had 'fair capacity' in disease surveillance programmes while five of the facilities had 'low capacity'. There was no association between the extra level of training received by laboratory scientists and testing capacity for the selected diseases. The reasons why the laboratories could not carry out WHO standard tests for the selected diseases as reported were inadequate instruments/equipment (17), nonavailability of reagents (16) and clinicians' failure to request for tests (13). Laboratory capacity to carry out tests for most of the selected diseases (malaria, measles, meningitis, cholera, tuberculosis and HIV/AIDS) was very low in Oyo State hospitals. Equipping the laboratories with modem instruments, reagents and the recruitment of more laboratory scientists and technicians are recommended to enable them attain full capacity to provide diagnostic services relating to the selected diseases.