University of Khartoum

Assessment of the Current Situation of Medical Microbiology Laboratories in Nine States in Sudan Compared to International Standards

Assessment of the Current Situation of Medical Microbiology Laboratories in Nine States in Sudan Compared to International Standards

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Title: Assessment of the Current Situation of Medical Microbiology Laboratories in Nine States in Sudan Compared to International Standards
Author: Ismail, Gaafar Mohamed Ibrahim
Abstract: Background: Quality laboratory services can only result when appropriately trained, competent and motivated staff performed analysis, and reporting results. The objectives of this study were to assess the current situation of microbiology laboratories as well as to develop a quality scheme for reliable results. Materials and Methods: This study was conducted in the period 2011–2013. Nine Sudanese States including Khartoum, Northern Kordofan, White Nile, Gazira, Red sea, Gadaref, Kassala, River Nile and Northern State were enrolled. Microbiology laboratories in these States were thoroughly assessed. Technicians, equipments and tests routinely performed in these laboratories were assessed using structured questionnaire. Site visit was done to each laboratory to inspect laboratory design and equipments. Skills of the technicians were assessed by simulated samples containing standard organisms- Gram-negative bacilli (E.coliATCC 25922), Gram-positive cocci (Staph. aureus ATCC 25923), control sample (sterile peptone water) and clinical isolates were re-tested Results: A total of 100 microbiology laboratories were included and were categorized into public or private laboratory. Out of 264 technicians 92% (n=244) were medical laboratory sciences graduates, and 8% (n=20) were non graduates. Of the 264 laboratory personnel, 43% (n=113) were in public laboratories (n=24) and 57% (n=151) in private laboratories (n=76). All laboratories (n=100) were equipped with refrigerators, 99 with incubators, 45 with hot air oven, 35 with water bath, 23 with autoclave and 7 with safety hood. The essential laboratory equipments (6 devices) were available in 3 (25%) public laboratories and 2 (3%) in private laboratories. All laboratories (n=100) have facilities to carry out urine culture, 81 swab culture, 19 blood culture, 12 sputum culture, 22 cerebrospinal fluid culture and 23 other body fluids culture. None of the enrolled laboratories performed full biochemical tests chart for identification of pathogenic isolates. Studies on technician diagnostic skills revealed that 23 of the laboratories (of which 12 were public and 11 privates) gave correct diagnosis for standard bacterial strain of Escherichia coli, 43 laboratories (of which 12 were public and 31 were privates) for Staphylococcus aureus and 90 laboratories (of which 23 were public and 67 privates) for control sample (Sterile peptone water). Re-identification of routine bacterial isolates was done correctly in 43% (n=26) out of 60 laboratories assessed (of which 10 were public and 16 privates). Analysis of the current situation of the microbiology laboratories leads to develop model of quality scheme based on the facilities present in most laboratories, referenced to ISO 15189. Conclusion: Poor performance and deteriorating quality control measures were observed at different levels, including laboratory design, equipments and technicians. Quality control and trained technicians in the field of microbiology are highly recommended in each laboratory.
URI: http://khartoumspace.uofk.edu/handle/123456789/19972
Date: 2016-03-23


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