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肯尼亚部分机构解剖病理学和检验医学诊断服务及基础设施分析。

Analysis of anatomic pathology and laboratory medicine diagnostic services and infrastructure available at a sample of institutions in Kenya.

作者信息

McKenzie Nicholas, Jacobs Jeremy W, Milner Danny A, Eichbaum Quentin

机构信息

Department of Pathology, Microbiology, and Immunology, Vanderbilt University Medical Center, Nashville, TN, United States.

Access to Oncology Medicines (ATOM), Union of International Cancer Control, Geneva, Switzerland.

出版信息

Am J Clin Pathol. 2025 Aug 26;164(2):182-191. doi: 10.1093/ajcp/aqaf021.

Abstract

OBJECTIVE

There is a paucity of data regarding the anatomic and clinical pathology capabilities at hospitals and laboratories across much of Africa, including in Kenya. We aimed to sample institutions in Kenya to identify the available pathology and laboratory diagnostic services.

METHODS

Subject matter experts developed 2 individual surveys assessing anatomic pathology (AP) and clinical pathology (CP), respectively. The surveys were administered to individuals involved in pathology services at hospitals and laboratories across Kenya between June and August 2022 using the American Society for Clinical Pathology email listserv.

RESULTS

Responses from 18 unique laboratories in Kenya were analyzed. Five sites provided AP services, while 17 provided CP services; 4 sites provided both AP and CP services. Cytopathology, autopsy services, and hematopathology services were available at all 5 sites that performed AP; 4 provided surgical pathology services for large resections with margins (80%); and 2 provided services for small biopsies (40%). No location had molecular testing capabilities. Among the 17 sites that provided CP services, most had the capability to perform rapid diagnostic and/or point-of-care testing (n = 14, 82%), chemistry (n = 13, 76%), microbiology (n = 13, 76%), and hematology and/or coagulation (n = 13, 76%). However, cytogenetics and flow cytometry were generally not available (n = 4, 24%).

CONCLUSIONS

These findings demonstrate that, among this sample of institutions in Kenya, basic AP and CP services were frequently available. Conversely, advanced diagnostic modalities were the exception. Strategic investment to improve this capacity could contribute to optimization of the health care system in Kenya.

摘要

目的

在包括肯尼亚在内的非洲大部分地区,关于医院和实验室的解剖学及临床病理学能力的数据匮乏。我们旨在对肯尼亚的机构进行抽样,以确定可用的病理学和实验室诊断服务。

方法

主题专家分别制定了两项独立调查,评估解剖病理学(AP)和临床病理学(CP)。2022年6月至8月期间,通过美国临床病理学会电子邮件列表,对肯尼亚各地医院和实验室中参与病理学服务的人员进行了调查。

结果

对肯尼亚18个不同实验室的回复进行了分析。5个机构提供AP服务,17个提供CP服务;4个机构同时提供AP和CP服务。在所有5个开展AP的机构中,均提供细胞病理学、尸检服务和血液病理学服务;4个机构提供带切缘的大型切除术的外科病理学服务(80%);2个机构提供小活检服务(40%)。没有机构具备分子检测能力。在提供CP服务的17个机构中,大多数有能力进行快速诊断和/或即时检测(n = 14,82%)、化学检测(n = 13,76%)、微生物学检测(n = 13,76%)以及血液学和/或凝血检测(n = 13,76%)。然而,细胞遗传学和流式细胞术检测一般无法提供(n = 4,24%)。

结论

这些发现表明,在肯尼亚的这一样本机构中,基本的AP和CP服务普遍可用。相反,先进的诊断方式则较为少见。对提高这一能力进行战略投资,有助于优化肯尼亚的医疗保健系统。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/170c/12378397/a89b33d88484/aqaf021_fig1.jpg

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