Challenges of Maintaining Good Clinical Laboratory Practices in Low-Resource
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Zhang, Helen L.; Omondi, Michael; Musyoka, Augustine; Afwamba, Isaac A.; Swai, Remigi P.; Karia, Francis; Muiruri, Charles; Reddy, Elizabeth; Crump, John A.; Rubach, Matthew P.

doi:10.1093/ajcp/aqw083

Cited by 20 publications

(11 citation statements)

References 23 publications

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“…12 Diagnostic services are further challenged by poor laboratory infrastructure particularly in resource-limited settings. 13 Limited skilled human resources, lack of equipment, inadequate quality control programs, and weak supply chains for reagents and consumables have also been reported in these settings. 13…”

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confidence: 99%

Toward Improving Accessibility of Point-of-Care Diagnostic Services for Maternal and Child Health in Low- and Middle-Income Countries

2019

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Point-of-care (POC) testing can improve health care provision in settings with limited access to health care services. Access to POC diagnostic services has shown potential to alleviate some diagnostic challenges and delays associated with laboratory-based methods in low- and middle-income countries. Improving accessibility to POC testing (POCT) services during antenatal and perinatal care is among the global health priorities to improve maternal and child health. This review provides insights on the availability of POC testing designed for diagnosing HIV, syphilis, and malaria in pregnancy to improve maternal and child health. In addition, factors such as accessibility of POC testing, training of health work force, and the efficiency of POC testing services delivery in low- and middle-income countries are discussed. A framework to help increase access to POC diagnostic services and improve maternal and child health outcomes in low- and middle-income countries is proposed.

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confidence: 99%

Toward Improving Accessibility of Point-of-Care Diagnostic Services for Maternal and Child Health in Low- and Middle-Income Countries

2019

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“…Together with their supervisors (pathologists at the UoN), the students designed and performed a quality assurance audit and investigated correlation between the spectrum of retinoblastoma histological features and clinical outcome. With respect to the quality assurance project, it is known that laboratories face enormous challenges achieving quality control and assurance in low-resource settings [9]. This student project is an important first step in this direction, and a comprehensive quality control program will be implemented in phase II of the project.…”

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confidence: 99%

Design and Implementation of the Retinoblastoma Collaborative Laboratory

et al. 2016

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Purpose: The purpose of this work was to describe the design and implementation of a digital pathology laboratory, the Retinoblastoma Collaborative Laboratory (RbCoLab) in Kenya. Method: The RbCoLab is a central lab in Nairobi that receives retinoblastoma specimens from all over Kenya. Specimens were processed using evidence-based standard operating procedures. Images were produced by a digital scanner, and pathology reports were disseminated online. Results: The lab implemented standard operating procedures aimed at improving the accuracy, completeness, and timeliness of pathology reports, enhancing the care of Kenyan retinoblastoma patients. Integration of digital technology to support pathology services supported knowledge transfer and skills transfer. A bidirectional educational network of local pathologists and other clinicians in the circle of care of the patients emerged and served to emphasize the clinical importance of cancer pathology at multiple levels of care. A ‘Robin Hood' business model of health care service delivery was developed to support sustainability and scale-up of cancer pathology services. Discussion: The application of evidence-based protocols, comprehensive training, and collaboration were essential to bring improvements to the care of retinoblastoma patients in Kenya. When embraced as an integrated component of retinoblastoma care, digital pathology offers the opportunity for frequent connection and consultation for development of expertise over time.

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“…Currently, widespread application of molecular biology techniques in research, development of diagnostics, and education is costly and often unaffordable for many laboratories and schools especially in resource poor countries. In addition to investments in equipment, the costs of consumable protein and enzyme reagents is a major roadblock to wider dissemination and use of molecular techniques [ 15 , 16 ]. By demonstrating the feasibility of using cellular reagents in lieu of pure enzymes for routine applications, such as nucleic acid synthesis, Gibson assembly of DNA, and nucleic acid diagnostics, such as TaqMan qPCR and LAMP, we have created a relatively inexpensive reagent toolbox.…”

Section: Discussionmentioning

confidence: 99%

“…As a result, the affordability and accessibility of protein reagents can be significantly limited, especially in resource poor or remote settings [ 15 , 16 ]. Conversely, simplification of the production, transportation, and storage of these enzymes and proteins would potentially reduce the cost, time, expertise, and infrastructure needed for application and thereby increase accessibility.…”

Section: Introductionmentioning

confidence: 99%

Cellular reagents for diagnostics and synthetic biology

et al. 2018

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We have found that the overproduction of enzymes in bacteria followed by their lyophilization leads to 'cellular reagents' that can be directly used to carry out numerous molecular biology reactions. We demonstrate the use of cellular reagents in a variety of molecular diagnostics, such as TaqMan qPCR with no diminution in sensitivity, and in synthetic biology cornerstones such as the Gibson assembly of DNA fragments, where new plasmids can be constructed solely based on adding cellular reagents. Cellular reagents have significantly reduced complexity and cost of production, storage and implementation, features that should facilitate accessibility and use in resource-poor conditions.

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Challenges of Maintaining Good Clinical Laboratory Practices in Low-Resource Settings

Abstract: These findings demonstrate that GCLP laboratory service provision in this setting is hampered by delays in biomedical engineer support, delays and extra costs in commodity procurement, low testing throughput, and high personnel turnover.

Cited by 20 publications

References 23 publications

Toward Improving Accessibility of Point-of-Care Diagnostic Services for Maternal and Child Health in Low- and Middle-Income Countries

Toward Improving Accessibility of Point-of-Care Diagnostic Services for Maternal and Child Health in Low- and Middle-Income Countries

Design and Implementation of the Retinoblastoma Collaborative Laboratory

Cellular reagents for diagnostics and synthetic biology

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