Analysis of anatomic pathology and laboratory medicine diagnostic services and infrastructure available at a sample of institutions in Kenya.

Abstract

Objective: There is a paucity of data regarding the anatomic and clinical pathology capabilities at hospitals and laboratories across much of Africa, including in Kenya. We aimed to sample institutions in Kenya to identify the available pathology and laboratory diagnostic services.

Methods: Subject matter experts developed 2 individual surveys assessing anatomic pathology (AP) and clinical pathology (CP), respectively. The surveys were administered to individuals involved in pathology services at hospitals and laboratories across Kenya between June and August 2022 using the American Society for Clinical Pathology email listserv.

Results: Responses from 18 unique laboratories in Kenya were analyzed. Five sites provided AP services, while 17 provided CP services; 4 sites provided both AP and CP services. Cytopathology, autopsy services, and hematopathology services were available at all 5 sites that performed AP; 4 provided surgical pathology services for large resections with margins (80%); and 2 provided services for small biopsies (40%). No location had molecular testing capabilities. Among the 17 sites that provided CP services, most had the capability to perform rapid diagnostic and/or point-of-care testing (n = 14, 82%), chemistry (n = 13, 76%), microbiology (n = 13, 76%), and hematology and/or coagulation (n = 13, 76%). However, cytogenetics and flow cytometry were generally not available (n = 4, 24%).

Conclusions: These findings demonstrate that, among this sample of institutions in Kenya, basic AP and CP services were frequently available. Conversely, advanced diagnostic modalities were the exception. Strategic investment to improve this capacity could contribute to optimization of the health care system in Kenya.