Quality Assurance in Medical Laboratories in Developing Countries: Assessment of Pre-Analytical Errors in a Chemical Pathology Laboratory in a Tertiary Hospital in Nigeria

Igila, Allison Frederick; C., Ojule Aaron

doi:10.31014/aior.1994.03.01.90

Cited by 3 publications

(2 citation statements)

References 8 publications

(10 reference statements)

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“…Moreover, in less-developed areas, blood samples must be collected from surrounding clinics and delivered to a central diagnostic laboratory. These time-consuming sample treatment processes increase the diagnosis-to-treatment interval and impact the accuracy of results due to contamination or hemolysis. , Hence, a rapid and simple plasma separation device that can be employed at the clinic/bedside is highly desirable for accurate point-of-care pathogen diagnostics.…”

Section: Introductionmentioning

confidence: 99%

Ultralow-Fouling Zwitterionic Polyurethane-Modified Membranes for Rapid Separation of Plasma from Whole Blood

et al. 2021

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The separation of plasma from blood cells in whole blood is an essential step for many diagnostic and therapeutic applications. However, the current point-of-care plasma separation approaches have not yet satisfied the need for a rapid, high-flux, and low-cost process. Here, we report a portable, low-cost, disposable membrane-based plasma separation device that enables rapid plasma extraction from whole blood. Rapid separation of plasma can be obtained with a simple three-step operation: blood injection, separation, and plasma collection. Our device benefits from the zwitterionic polyurethane-modified cellulose acetate (PCBU-CA) membrane, which can greatly inhibit the surface fouling of blood cells and membrane flux decline. The zwitterionic coating is stable on the membrane surface during blood filtration and leads to a 60% decrease in surface fibrinogen adsorption than a nonmodified membrane surface. The ultralow-blood-fouling properties of the PCBU-CA membrane enable rapid, continuous separation of plasma: within 10 min, the device can yield 0.5−0.7 mL of plasma from 10 mL of whole blood. The extracted plasma is verified as cell-free, exhibits a low hemoglobin level, and has a high protein recovery. Our PCBU-CA membrane provides a pathway for developing a high-efficiency portable plasma separation device that can reduce the time to diagnosis, allow effective patient care, and eventually reduce hospital costs.

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Section: Introductionmentioning

confidence: 99%

Ultralow-Fouling Zwitterionic Polyurethane-Modified Membranes for Rapid Separation of Plasma from Whole Blood

et al. 2021

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“…However, plasma separation from whole raw blood is still required for POC viral load testing because unwanted cellular contents in the sample, such as hemoglobin and lactoferrin in blood cells, can interfere with nuclear acid polymerases and cause inaccurate quantification [ 6 ]. Currently, blood separation is typically performed in a diagnostic laboratory equipped with a high-speed centrifuge, which is not accessible for many less-developed regions [ 7 , 8 , 9 ].…”

Section: Introductionmentioning

confidence: 99%

Simple Bioparticle Filtration Device Based on an Ultralow-Fouling Zwitterionic Polyurethane Membrane for Rapid Large-Volume Separation of Plasma and Viruses from Whole Blood

Wang,

Seol,

Cheng

et al. 2023

Membranes

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Plasma separation from whole blood is oftent required as an essential first step when performing blood tests with a viral assay. However, developing a point-of-care plasma extraction device with a large output and high virus recovery remains a significant obstacle to the success of on-site viral load tests. Here, we report a portable, easy-to-use, cost-efficient, membrane-filtration-based plasma separation device that enables rapid large-volume plasma extraction from whole blood, designed for point-of-care virus assays. The plasma separation is realized by a low-fouling zwitterionic polyurethane-modified cellulose acetate (PCBU-CA) membrane. The zwitterionic coating on the cellulose acetate membrane can decrease surface protein adsorption by 60% and increase plasma permeation by 46% compared with a pristine membrane. The PCBU-CA membrane, with its ultralow-fouling properties, enables rapid plasma separation. The device can yield a total of 1.33 mL plasma from 10 mL whole blood in 10 min. The extracted plasma is cell-free and exhibits a low hemoglobin level. In addition, our device demonstrated a 57.8% T7 phage recovery in the separated plasma. The results of real-time polymerase chain reaction analysis confirmed that the nucleic acid amplification curve of the plasma extracted by our device is comparable to that obtained by centrifugation. With its high plasma yield and good phage recovery, our plasma separation device provides an excellent replacement for traditional plasma separation protocols for point-of-care virus assays and a broad spectrum of clinical tests.

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Medical Laboratories in Nigeria (Part 1): Assessment of Quality Management Practices and Accreditation Status

Allison,

Ojule,

Allison

2024

EJMED

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Background: Given observed challenges with the quality of results, this study was aimed at assessing the current level of the use of aspects of quality management practices by medical laboratories in the south-south region of Nigeria. Methods: This was a cross-sectional survey of 80 randomly selected medical laboratories from the 6 states of south-south Nigeria. Self-administered questionnaires on aspects of quality management practices were given to selected staff of each laboratory. Results: Out of the 80 questionnaires, only 42 were completed. None (0%) of the laboratories were accredited for quality service delivery. Only 88% of the laboratories were licensed by relevant authorities. 90% of the laboratories used quality control (QC) sera for their operations. 30% used commercial QC. 70 % used unreliable locally-produced QC. 90% reported that their equipment was regularly maintained (66% by Biomedical Engineers and 24% by Medical Laboratory Scientists). 90% of the laboratories claimed to calibrate their equipment regularly by Biomedical Engineers (66%) and Laboratory Scientists (24%). 74% of the laboratories were headed by Laboratory Scientists; 26% by Pathologists. 62% of the laboratories used de-ionized water; 13% distilled water; 7% used both interchangeably. 60% bought their water commercially; 40% produced their water locally. Only 10% of the laboratories had means of monitoring the water quality. Only 21% were enrolled on EQA schemes. 80% bought their reagents in the open market. 90% used the poor-quality national grid as their main source of electricity supply. Only 40% had training/re-training programs for their staff. Only 45% of the laboratories used SOPs in their operations. Conclusion: The results of this study indicate that currently, the majority of the medical laboratories in south-south Nigeria have not sufficiently embraced the use of several aspects of the quality management essentials in their routine operations. This state of affairs is a recipe for unreliable and poor-quality results that may lead to wrong diagnoses and mismanagement of patients.

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Quality Assurance in Medical Laboratories in Developing Countries: Assessment of Pre-Analytical Errors in a Chemical Pathology Laboratory in a Tertiary Hospital in Nigeria

Abstract: The Journal of Health and Medical Sciences is an Open Access publication. It may be read, copied, and distributed free of charge according to the conditions of the Creative Commons Attribution 4.0 International license.

Cited by 3 publications

References 8 publications

Ultralow-Fouling Zwitterionic Polyurethane-Modified Membranes for Rapid Separation of Plasma from Whole Blood

Ultralow-Fouling Zwitterionic Polyurethane-Modified Membranes for Rapid Separation of Plasma from Whole Blood

Simple Bioparticle Filtration Device Based on an Ultralow-Fouling Zwitterionic Polyurethane Membrane for Rapid Large-Volume Separation of Plasma and Viruses from Whole Blood

Medical Laboratories in Nigeria (Part 1): Assessment of Quality Management Practices and Accreditation Status

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