BackgroundProvision of quality laboratory services is an essential aspect of a promoting safe motherhood and better outcomes for newborn. Therefore; this study was intended to assess status of focused antenatal care (FANC) laboratory services at public health facilities in Addis Ababa, Ethiopia.MethodsInstitution based, descriptive cross-sectional study was conducted from April to May 2015. The study included 13 randomly selected health facilities and 13 purposively selected laboratory service providers. The status of FANC laboratory service was assessed by using pre-tested structured questionnaire and observation checklist. The study supplemented with qualitative data through in-depth interview of laboratory service providers. The quantitative data were coded and analysed by using SPSS Version 20 software and qualitative data was transcribed, coded, categorized and thematically analysed by the principal investigator.ResultsOnly 5 (38.5 %) out of 13 visited health facilities reported the availability of all types of basic FANC laboratory investigations. Comparing the availability of individual tests in the study facilities, urine dipstick, urine microscopy and stool examination were available in all institutions. However, only 7 (53.8 %) of the health facilities reported the availability of hepatitis B virus screening test. Rapid syphilis (RPR) test was found in 10 (76.9 %) facilities. All laboratory facilities had at least one or more basic FANC laboratory tests interruption for more than a day within the last 1 year due to shortage of reagent and electric power disruption.ConclusionsMajority of the health facilities reported incomplete provision of FANC laboratory investigations. Laboratory supply shortage and electric power disruption were the facilities’ major challenge to screen pregnant women for pregnancy related health conditions. Since such conditions may affect the outcome of pregnancy, therefore extensive efforts should be targeted to avoid services interruption by taking improvement measures including the fulfilment of all FANC laboratory resources.

Background: Bacterial bloodstream infection is the major public health problem which leads to high morbidity and mortality of patients. Early diagnosis and appropriate treatments of bacterial blood stream infections are the best approach to reduce the patients' are becoming worsen conditions and to prevent the developments of drug resistance bacteria. The aim of this study was to determine the bacterial profile of blood stream infections and their antibiotic resistance pattern in Addis Ababa, Ethiopia.Methods: Records of 500 patients blood culture result from Clinical Microbiology laboratory unit of Addis Ababa Regional Laboratory was reviewed from January, 2015 to December, 2016. Data was entered and analysed by using SPSS version 20.0 statistical software and results were expressed using frequency and percentages. Tables and graphs were used to summarize the results. The chi-square test was employed to assess the association between variables. A p-value of less than 0.05 was considered as statistically significant.Results: Out of 500 blood culture results reviewed, among these the frequency of blood culture positive was 164 (32.8%). Out of a total 164 isolates, 127 (77.4%) were gram-positive bacteria and 37 (22.6%) were gram-negative bacteria. The predominant bacteria species isolated comprise Staphylococcus aureus 82 (50.0%), Coagulase negative staphylococci (CONS) 43 (26.21%), Klebisella pneumoniae 23 (14.02%), Escherichia coli 6 (3.6%), Acinobacter baumannii 4 (2.4%), Streptococcus species 3 (1.8%), Pseudomonas aeruginosa 2 (1.2%) and Nesseriae meningitidis 1 (0.6%). Generally, in this study majority of gram-positive isolates showed high resistance to commonly used antimicrobials to Penicillin(83.5%),Trimethoprim-sulphamethoxazole (83.5%), Erythromycin (77.3%), Doxycycline (76.5%), Tetracycline (76.5%), Gentamycin (75.0%), and least resistant to Clindamycin (5.4%) and Chloramphenicol (46.1%) and high resistant gram-negative isolates was seen to Ampcillin (88.5%),Amoxicillinclavulanic acid (80%), Trimethoprim-sulphamethoxazole (80%), Ceftriaxone (77.1%) and least resistant to Ceftriaxone (42.8%) and Cefepime (51.5%). In this study it was also revealed that isolated bacteria species developed multi drug resistance to most of the antibiotics commonly tested. Conclusions:In this study the overall blood culture positive bacterial isolate rate was high (32.8%). The most predominant blood culture isolates were Staphylococcus aureus, Coagulase negative staphylococci and Klepsiella pneumonia. Antibiotic resistances of isolates were alarmingly high so that proper management of patients with blood stream infections needs careful selection of effective antibiotics.

BackgroundImproving the quality of medical laboratory services is a high priority in many countries. However, quality management systems for laboratories in resource-limited settings are often inadequate.ObjectivesThis article shares the experiences, benefits and challenges of the laboratory journey towards accreditation in a primary healthcare laboratory in Addis Ababa, Ethiopia.MethodsA retrospective review of laboratory records in Addis Ketema Health Center was conducted from 2012 to 2015. The study was supplemented by observations from some of the authors of this article who worked in the laboratory.ResultsThe laboratory journey towards accreditation began with a baseline assessment in 2012 using the World Health Organization African Region Stepwise Laboratory Quality Improvement Process Towards Accreditation; the baseline score was 78 points (0 stars). After mentorship support, the laboratory improved to 198 points (3 stars) in 2013 and 249 points (5 stars) in 2014. The laboratory scaled up to International Organization for Standardization 15189 requirements and received limited-scope accreditation for tuberculosis sputum microscopy and hematology tests in 2015. After adopting and implementing the standards, steady improvement was observed in the reliability of the laboratory services. Lack of resources was the major challenge the laboratory encountered.ConclusionEven though a remarkable quality performance improvement was observed over the entire process, inadequate skilled personnel was the major challenge identified in the road towards accreditation. Therefore, an appropriate, workload-based staffing structure should be developed to improve and sustain medical laboratory quality standards in resource-limited settings.

ObjectiveSputum smear microscopy reading errors are likely to result in failure to detect persons with infectious TB. This study was intended to review misdiagnosis of pulmonary TB and associated factors in peripheral laboratories.ResultsDuring the study period 1033 (10.5%) sputum smear positive and 8783 (89.5%) smear negative slides were reported by peripheral laboratories. The slides were re-read by the central referral laboratories (CRLs) as the reference standard reading. Of 1033 positive slides reported by peripheral laboratories, 25 (2.4%) were false positive. Out of 8783 smear negative slides reported by peripheral laboratories, 35 (0.4%) were false negative. The sensitivity, specificity, positive predictive value and negative predictive value of peripheral laboratories were 96.64, 99.72, 97.58, and 99.61% respectively. The peripheral laboratories and CRLs have an observed agreement (Po) of 0.9939. Of 135 peripheral laboratories, 93 (68.9%) read negative and positive slides correctly, 49 (36.3%) did not have lens cleaning tissue papers, 11 (8.1%) lacked frosted slides, and 14 (10.4%) had shortage of reagents. As conclusions, the peripheral laboratories and CRLs had high agreement for sputum smear microscopy reading. However, a few TB cases were misdiagnosed despite having the disease; these individuals might continue to spread the infection in the community.