Laboratory Use in Ghana: Physician Perception and Practice

Polage, Christopher R.; Bedu-Addo, George; Owusu-Ofori, Alex; Frimpong, Enoch; Lloyd, W. M.; Zurcher, Emily; Hale, DeVon C.; Petti, Cathy A.

doi:10.4269/ajtmh.2006.75.526

Cited by 68 publications

(64 citation statements)

References 31 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Even where laboratory facilities are available, prescribers may be reluctant to use them due to other factors, such as time constraints. In a study in Ghana by Polage et al, for instance, over 90% of physicians indicated that time constraints meant that they rarely ordered tests [49]. Other issues, such as under-staffing, medicine shortages, and a lack of an inventory of a list of medicines from which choices need to be made are some of the factors known to promote irrational prescribing in many developing countries [3].…”

Section: Factors Contributing To the Irrational Use Of Medicinesmentioning

confidence: 99%

Irrational Use of Medicines—A Summary of Key Concepts

Ofori‐Asenso¹,

Agyeman²

2016

Pharmacy

209

201

View full text Add to dashboard Cite

Medicines play an integral part of healthcare delivery. However, they are expensive commodities and account for a significant proportion of overall health expenditure in most countries. Irrational use of medicines is a major challenge facing many health systems across the world. Such practices are likely to lead to poor health delivery that may put patients at risk and result in wastage of scarce resources that could have been used to tackle other pressing health needs. The concept of “rational use of medicine” can at times be confusing and not easily appreciated by patients, healthcare providers, policy makers, or the public, all of whom need to collaborate effectively to address this challenge. In this article, we summarize basic concepts such as rational medicine use, good prescribing and dispensing, and explore some of the factors that contribute to irrational use of medicines as well as potential impacts of such practices. This article has been written with the intention of offering a clear, concise, and easy to understand explanation of basic medicine use concepts for health professionals, patients, policy makers, and the public.

show abstract

Section: Factors Contributing To the Irrational Use Of Medicinesmentioning

confidence: 99%

Irrational Use of Medicines—A Summary of Key Concepts

Ofori‐Asenso¹,

Agyeman²

2016

Pharmacy

209

201

View full text Add to dashboard Cite

show abstract

“…Finally, we only interviewed laboratory and medical staff at a single referral hospital in Malawi, but respondents identified challenges that have been identified in other lowresource laboratory settings. 1,[3][4][5][6]12 The results of this work provide evidence and context for challenges in the laboratory diagnostic process, motivating the development of interventions to improve the laboratory workflow and stature within the hospital. The choice to capture the pre-and post-analytical phases by including providers from the medical ward and laboratory staff, recognizes that challenges at any point in the process, regardless of location, undermine the ability of laboratory testing to improve health-care delivery and health outcomes.…”

Section: Interview 13 (Medical Staff)mentioning

confidence: 99%

“…As a result, diagnoses are often made using less reliable and less valid signals and symptoms. 5 Malaria, for example, is frequently diagnosed based on symptoms instead of a test result, though symptoms may overlap with other diseases. A study of almost 200 health facilities in Uganda found that roughly 25% had a functioning microscope, but in those facilities, only 35% of malaria diagnoses used a malaria slide examination.…”

Section: Introductionmentioning

confidence: 99%

Assessing Perceived Challenges to Laboratory Testing at a Malawian Referral Hospital

Petrose

Fisher

Douglas

et al. 2016

The American Society of Tropical Medicine and Hygiene

View full text Add to dashboard Cite

Abstract. Adequate laboratory infrastructure in sub-Saharan Africa is vital for tackling the burden of infectious diseases such as human immunodeficiency virus and acquired immune deficiency syndrome, malaria, and tuberculosis, yet laboratories are ill-integrated into the diagnostic and care delivery process in low-resource settings. Although much of the literature focuses on disease-specific challenges around laboratory testing, we sought to identify horizontal challenges to the laboratory testing process through interviews with clinicians involved in the diagnostic process. Based on 22 interviews with physicians, nurses, clinical officers, medical students, and laboratory technicians, technologists and supervisors, we identified 12 distinct challenges in the areas of staff, materials, workflow, and the blood bank. These challenges underscore the informational challenges that compound more visible resource shortages in the laboratory testing process, which lend themselves to horizontal strengthening efforts around the diagnostic process.

show abstract

“…We therefore employed a model that allowed us to test diagnostic interventions in health workers, a high-risk sub-population and for post-mortems. Recognizing that diagnostic testing is currently not available to most African patients for a myriad of reasons [8,[36][37][38], we focused on diagnostic interventions that could be feasibly introduced to resource-limited hospitals.…”

Section: Discussionmentioning

confidence: 99%

Diagnostic schemes for reducing epidemic size of african viral hemorrhagic fever outbreaks

Okeke

Manning

2014

J Infect Dev Ctries

View full text Add to dashboard Cite

Introduction: Viral hemorrhagic fever (VHF) outbreaks, with high mortality rates, have often been amplified in African health institutions due to person-to-person transmission via infected body fluids. By collating and analyzing epidemiological data from documented outbreaks, we observed that diagnostic delay contributes to epidemic size for Ebola and Marburg hemorrhagic fever outbreaks. Methodology: We used a susceptible-exposed-infectious-removed (SEIR) model and data from the 1995 outbreak in Kikwit, Democratic Republic of Congo, to simulate Ebola hemorrhagic fever epidemics. Our model allows us to describe the dynamics for hospital staff separately from that for the general population, and to implement health worker-specific interventions. Results: The model illustrates that implementing World Health Organization/US Centers for Disease Control and Prevention guidelines of isolating patients who do not respond to antimalarial and antibacterial chemotherapy reduces total outbreak size, from a median of 236, by 90% or more. Routinely employing diagnostic testing in post-mortems of patients that died of refractory fevers reduces the median outbreak size by a further 60%. Even greater reductions in outbreak size were seen when all febrile patients were tested for endemic infections or when febrile health-care workers were tested. The effect of testing strategies was not impaired by the 1-3 day delay that would occur if testing were performed by a reference laboratory. Conclusion: In addition to improving the quality of care for common causes of febrile infections, increased and strategic use of laboratory diagnostics for fever could reduce the chance of hospital amplification of VHFs in resource-limited African health systems.

show abstract

Laboratory Use in Ghana: Physician Perception and Practice

Cited by 68 publications

References 31 publications

Irrational Use of Medicines—A Summary of Key Concepts

Irrational Use of Medicines—A Summary of Key Concepts

Assessing Perceived Challenges to Laboratory Testing at a Malawian Referral Hospital

Diagnostic schemes for reducing epidemic size of african viral hemorrhagic fever outbreaks

Contact Info

Product

Resources

About