Tucci Jonathan, Jacobs Jeremy W, Ibrahim Zainab U, Yusuf Aminu A, Umar Ali Bala, Milner Danny A, Eichbaum Quentin
Department of Pathology, Microbiology, and Immunology, Vanderbilt University Medical Center, Nashville, TN, US.
Department of Chemical Pathology, Faculty of Clinical Sciences, College of Health Sciences, Bayero University, Kano, Nigeria.
Am J Clin Pathol. 2025 Apr 19;163(4):586-600. doi: 10.1093/ajcp/aqae156.
The paucity of data regarding the availability and extent of diagnostic medical services across sub-Saharan Africa hinders appropriate allocation of resources to improve health care in these regions. We assessed anatomic pathology (AP) and clinical pathology (CP) services in Nigeria, one of the most populous and fastest-growing countries in the world.
Two individual surveys (AP focused and CP focused) were developed by subject matter experts and administered to individuals involved in pathology and laboratory medicine diagnostic services at hospitals and laboratories across Nigeria between June and August 2022 using the American Society for Clinical Pathology email listserv.
A total of 75 responses (29 AP and 46 CP) were received from 48 unique laboratories. Twenty-four sites provided AP services and 35 provided CP services. Eleven respondents performed both AP and CP services. Among AP services, basic surgical and cytopathology capabilities were available at most sites; however, the availability of automated technologies (eg, automated sample processing and staining) was more variable. Advanced diagnostic techniques, (eg, immunohistochemistry, human papillomavirus testing, molecular diagnostics) were rarely performed. The most frequently available CP services included hematology, microbiology, and chemistry. Microbiology services appeared to be among the most robust laboratory medicine services, particularly parasitology and bacteriology testing. Similar to AP services, more advanced diagnostic assays, such as flow cytometry, cytogenetics, and molecular testing, were largely unavailable.
These findings augment earlier studies and identify gaps that should be prioritized from a policy perspective to improve medical services and the overall health care infrastructure in Nigeria.
撒哈拉以南非洲地区诊断性医疗服务的可及性和范围的数据匮乏,阻碍了在这些地区合理分配资源以改善医疗保健。我们评估了尼日利亚的解剖病理学(AP)和临床病理学(CP)服务,该国是世界上人口最多且增长最快的国家之一。
由主题专家制定了两项单独的调查(一项聚焦于AP,另一项聚焦于CP),并于2022年6月至8月期间通过美国临床病理学会的电子邮件列表,将其发放给尼日利亚各地医院和实验室中参与病理学和检验医学诊断服务的人员。
共收到来自48个不同实验室的75份回复(29份关于AP,46份关于CP)。24个机构提供AP服务,35个机构提供CP服务。11名受访者同时提供AP和CP服务。在AP服务中,大多数机构具备基本的外科病理学和细胞病理学能力;然而,自动化技术(如自动化样本处理和染色)的可及性差异更大。先进的诊断技术(如免疫组织化学、人乳头瘤病毒检测、分子诊断)很少开展。最常见的CP服务包括血液学、微生物学和化学。微生物学服务似乎是最完善的检验医学服务之一,尤其是寄生虫学和细菌学检测。与AP服务类似,更先进的诊断检测,如流式细胞术、细胞遗传学和分子检测,大多无法提供。
这些发现补充了早期研究,并确定了从政策角度应优先考虑的差距,以改善尼日利亚的医疗服务和整体医疗保健基础设施。