African Journal of Laboratory Medicine最新文献

{"title":"Implementation of the laboratory strategic framework to strengthen health laboratory services in Eastern Mediterranean Region, 2016-2023.","authors":"Fausta S Mosha, Rana Hajjeh, Rachel Ochola, Amany Ghoniem, Yvan J-F Hutin","doi":"10.4102/ajlm.v14i1.2611","DOIUrl":"https://doi.org/10.4102/ajlm.v14i1.2611","url":null,"abstract":"<p><strong>Background: </strong>Laboratories and diagnostics services are critical to universal health coverage and public health response. We assessed the extent of the implementation and functionality of the 2016-2023 Eastern Mediterranean Region (EMR) laboratory strategic framework.</p><p><strong>Intervention: </strong>Documents and reports from World Health Organization country offices were examined between September 2022 and November 2022, supplemented by stakeholder-provided documents, to enhance data collection and reporting across the framework's five goals. An intervention using a performance evaluation scorecard assessed the progress of EMR Member States (MSs) towards strengthening health laboratory services, with findings validated during the December 2022 regional public health laboratory directors' meeting in Egypt.</p><p><strong>Lessons learnt: </strong>We analysed results from 21 of 22 MSs. Three (14%) MSs, all high income, had the capacity to implement all indicators, while only one of five low-income (20%) MSs could not demonstrate any capacity across all five goals evaluated. Irrespective of income category, the least implemented domains were: (1) availability of either or both fully implemented laboratory policy, and (2) a fully implemented integrated national laboratory strategic plan, both of which were implemented in only 50% of MSs.</p><p><strong>Recommendations: </strong>Addressing the identified gaps requires concerted efforts, collaboration, and sustained investment to ensure the delivery of high-quality laboratory services and advance public health outcomes across the EMR. Implementation of laboratory strategies should be coordinated through the specific laboratory department or unit at the Ministry of Health level, above the central public health laboratories and with the support of a national laboratory technical working group.</p><p><strong>What this study adds: </strong>This study revealed substantial gaps in implementing laboratory policies and strategic plans in the EMR, with full implementation achieved by only 50% of MSs. It underscores the necessity for coordinated efforts and sustained investment to enhance laboratory services and promote effective laboratory practices in EMR.</p>","PeriodicalId":45412,"journal":{"name":"African Journal of Laboratory Medicine","volume":"14 1","pages":"2611"},"PeriodicalIF":1.0,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12067354/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144037816","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mitigating the risk of tube shortages: A blood collection tube validation study conducted in South Africa.","authors":"Marizna Korf, Jody Rusch, Aye Aye Khine, Nalene Strauss, Lourens Jacobsz, Annalise E Zemlin, Helena Vreede","doi":"10.4102/ajlm.v14i1.2628","DOIUrl":"https://doi.org/10.4102/ajlm.v14i1.2628","url":null,"abstract":"<p><strong>Background: </strong>The National Health Laboratory Service was using Becton Dickinson (BD) blood drawing tubes and, in 2021, the supplier notified customers of supply challenges, indicating a risk of global shortages.</p><p><strong>Objective: </strong>This study aimed to validate candidate blood collection tubes from four brands (VACUCARE, VACUETTE^®, VACUTEST^®, and V-TUBE^™) compared to BD Vacutainer^® tubes in three National Health Laboratory Service laboratories in Cape Town, South Africa.</p><p><strong>Methods: </strong>Blood was collected from 300 healthy volunteers between October 2021 and November 2021. The technical validation assessed 11 quality indicators, with a sigma metric greater than 4 deemed acceptable. Usability feedback was gathered from phlebotomists. The clinical validation estimated differences in results across 52 clinical chemistry tests, using desirable bias specified by the European Federation of Clinical Chemistry and Laboratory Medicine Biological Variation Database, or Ricos, as acceptance criteria. Analysis was performed on Roche cobas^® 6000 and DiaSorin Liaison^® XL analysers.</p><p><strong>Results: </strong>All VACUCARE tubes exhibited sigma metrics above 4, indicating excellent performance. VACUETTE^® and V-TUBE^™ were not uncapped by all Roche pre-analytical systems. VACUTEST^® caps had rigid rubber, making it more challenging to puncture and detach the tube, which resulted in needle displacement. Both VACUCARE and V-TUBE^™ were reported as user-friendly. All candidate tube analytes showed acceptable clinical performance.</p><p><strong>Conclusion: </strong>VACUCARE, VACUETTE^®, VACUTEST^® and V-TUBE^™ are viable alternatives to BD Vacutainer^®. However, based on the results obtained from the technical validation, VACUCARE was identified as the most suitable interim replacement for BD Vacutainer^® during the shortage.</p><p><strong>What this study adds: </strong>This study addresses a gap in the literature on tube validation and provides valuable insights for clinical laboratories considering a replacement. It also presents an alternative approach to technical validation by utilising sigma metrics.</p>","PeriodicalId":45412,"journal":{"name":"African Journal of Laboratory Medicine","volume":"14 1","pages":"2628"},"PeriodicalIF":1.0,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12067025/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144049955","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic accuracy of real-time polymerase chain reaction assay for the detection of <i>Trichomonas vaginalis</i> in clinical samples: A systematic review and meta-analysis.","authors":"Emmanuel O Babafemi, Benny P Cherian, Khalid Rahman, Gilbert M Mogoko, Oluwatoyin O Abiola","doi":"10.4102/ajlm.v14i1.2522","DOIUrl":"https://doi.org/10.4102/ajlm.v14i1.2522","url":null,"abstract":"<p><strong>Background: </strong>Vaginal trichomoniasis is a highly prevalent parasitic infection associated with HIV acquisition and preterm birth. The 'gold standard' for its diagnosis requires 3-7 days to detect by culture. Rapid and accurate diagnosis, such as by nucleic acid amplification testing, is key to manage the disease, and control and prevent its transmission.</p><p><strong>Aim: </strong>This review aimed to assess the overall accuracy of real-time polymerase chain reaction (RT-PCR)-based assays, for routine diagnosis of <i>Trichomonas vaginalis</i> in clinical vaginal samples from women with symptomatic/asymptomatic trichomoniasis, using Trichomonads culture as the gold standard.</p><p><strong>Methods: </strong>MEDLINE, PubMed, EMBASE, and other sources were used to search for included studies published between 01 January 1995 and 31 July 2023. The search terms 'real-time polymerase chain reaction', 'real-time', 'polymerase chain reaction', '<i>Trichomonas vaginalis</i>', 'trichomonas', 'vaginalis', 'humans', 'rt pcr', 'nucleic acid amplification test', 'NAAT', 'trichomonad culture', 'women' were included. Summary estimates were calculated for the overall accuracy of the assay compared to Trichomonads culture as the reference standard. Meta-analysis was conducted using a bivariate meta-regression model.</p><p><strong>Results: </strong>Twenty-seven eligible studies met our inclusion criteria: sensitivity 99% (95% confidence interval [CI] 99-100), specificity 100% (95% CI 100-100), positive likelihood ratio 350.67 (167.42-734.49), negative likelihood ratio 0.02 (0.01-0.03), diagnostic odds ratio 23 064.05 (95% CI 8532.13-62 346.77), and area under receiver operating characteristics curve 0.99. There was significant heterogeneity in sensitivity and specificity (<i>p</i> < 0.001).</p><p><strong>Conclusion: </strong>Our results suggested that RT-PCR assays could be useful for the diagnosis of vaginal trichomoniasis with high sensitivity and specificity.</p><p><strong>What this study adds: </strong>This article provides a comprehensive review of the effectiveness of RT-PCR assays for the diagnosis of trichomoniasis with high sensitivity and specificity in comparison to other methods in clinical laboratory practice. The goal is to present awareness/evidence that this assay is more accurate and rapid than other techniques.</p>","PeriodicalId":45412,"journal":{"name":"African Journal of Laboratory Medicine","volume":"14 1","pages":"2522"},"PeriodicalIF":1.0,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12067014/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144053416","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Thyroid and reproductive hormonal factors associated with menorrhagia among women in Kenya.","authors":"Phidelis M Marabi, Paul M Kosiyo, Stanslaus K Musyoki, Collins Ouma","doi":"10.4102/ajlm.v14i1.2653","DOIUrl":"https://doi.org/10.4102/ajlm.v14i1.2653","url":null,"abstract":"<p><strong>Background: </strong>Menorrhagia, characterised by menstrual blood loss exceeding 80 mL per cycle, is a common issue in Western Kenya. However, there are insufficient data on how hormonal disorders contribute to its occurrence.</p><p><strong>Objective: </strong>This study aimed to examine the differences and associations between thyroid and reproductive hormone levels in women with menorrhagia versus those without, in Bungoma County, Kenya.</p><p><strong>Methods: </strong>A comparative cross-sectional study was conducted among 428 women (214 with menorrhagia and 214 controls) aged 18-45 years, between 01 December 2022 and 31 September 2023 at Bungoma County Referral Hospital. The analysis included thyroid stimulating hormone, total and free triiodothyronine, thyroxine, follicle stimulating hormone (FSH), luteinising hormone, prolactin, oestrogen, progesterone, and testosterone.</p><p><strong>Results: </strong>Women experiencing menorrhagia had statistically significant increases in levels of FSH (<i>p</i> < 0.0001), oestrogen (<i>p</i> < 0.001), and total testosterone (<i>p</i> < 0.001), while prolactin levels had a statistically significant decrease (<i>p</i> < 0.001) compared to those without menorrhagia. There were no statistically significant differences in total triiodothyronine (<i>p</i> = 0.384), free triiodothyronine (<i>p</i> = 0.610), total thyroxine (<i>p</i> = 0.127), free thyroxine (<i>p</i> = 0.360), or thyroid stimulating (<i>p</i> = 0.118). No associations were found between menorrhagia and either thyroid or reproductive hormones.</p><p><strong>Conclusion: </strong>Elevated levels of FSH, oestrogen, and testosterone, along with reduced prolactin, may serve as potential biomarkers for diagnosing menorrhagia in premenopausal or reproductively aged women. A screening tool that integrates these hormonal markers could improve the accuracy of diagnosis and optimise treatment strategies in primary healthcare settings.</p><p><strong>What this study adds: </strong>The study suggests that levels of FSH, oestrogen, total testosterone, and prolactin differ significantly between women with and without menorrhagia, indicating their potential use in predicting the condition.</p>","PeriodicalId":45412,"journal":{"name":"African Journal of Laboratory Medicine","volume":"14 1","pages":"2653"},"PeriodicalIF":1.0,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12067019/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144033644","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gamma gap and albumin-globulin ratio show poor sensitivity for monoclonal gammopathy screening in South Africa.","authors":"Njabulo Khumalo, Cameron A Francis, Siphiwe M Baloyi, Jody A Rusch","doi":"10.4102/ajlm.v14i1.2505","DOIUrl":"10.4102/ajlm.v14i1.2505","url":null,"abstract":"<p><strong>Background: </strong>Monoclonal gammopathies, including multiple myeloma, present significant challenges in sub-Saharan Africa. Diagnosis is often missed because of limited screening tools. The gamma gap and albumin-globulin ratio (AGR) have been proposed as simple, cost-effective screening methods; however, their utility in settings with prevalent infectious and inflammatory diseases is unclear.</p><p><strong>Objective: </strong>This study evaluated the diagnostic accuracy of gamma gap and AGR in identifying patients who require further investigation for monoclonal gammopathies in South Africa.</p><p><strong>Methods: </strong>A retrospective analysis of 7946 patients who underwent investigations for monoclonal gammopathies at Groote Schuur Hospital, South Africa, between September 2015 and September 2022 was conducted. Patients were classified based on monoclonal protein detection, and the gamma gap, AGR, and multivariable models were evaluated for diagnostic performance.</p><p><strong>Results: </strong>Among the patients (median age: 61 years, 58% female [4632/7946] and 42% [3314/7946] male patients), 1231 had monoclonal proteins. A gamma gap cutoff of 46 g/L identified 35% of monoclonal cases (sensitivity), with 91% specificity and an area under the curve (AUC) of 0.60. The AGR showed a slightly better AUC of 0.63, with 44% sensitivity and 80% specificity at a 0.85 cutoff. Multivariable models incorporating age, sex, and hypogammaglobulinaemia improved performance, with the gamma gap model achieving an AUC of 0.73, improving the sensitivity to 58%, with a specificity of 78%.</p><p><strong>Conclusion: </strong>The gamma gap and AGR showed low sensitivity and moderate specificity in screening for monoclonal gammopathies, highlighting the need for integrated diagnostic approaches combining clinical, demographic, and laboratory data to improve early detection in resource-limited settings.</p><p><strong>What this study adds: </strong>Although cost-effective and widely available, gamma gap and AGR have limited accuracy for screening monoclonal gammopathies when used alone in settings with prevalent infectious and inflammatory diseases. Although the tests are good at ruling out monoclonality, they risk missing many true cases, delaying diagnosis and treatment.</p>","PeriodicalId":45412,"journal":{"name":"African Journal of Laboratory Medicine","volume":"14 1","pages":"2505"},"PeriodicalIF":1.0,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11966717/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143781614","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pseudomonocytosis on a Sysmex XN haematology analyser masking the monocytopenia of hairy cell leukaemia in a South African woman.","authors":"Stephanie J Kennedy, Anne-Cecilia van Marle","doi":"10.4102/ajlm.v14i1.2617","DOIUrl":"10.4102/ajlm.v14i1.2617","url":null,"abstract":"<p><strong>Introduction: </strong>Hairy cell leukaemia (HCL) is a rare B-cell lymphoproliferative disorder characterised by medium-sized villous lymphocytes ('hairy cells') and monocytopenia in the peripheral blood. Automated full blood count (FBC) haematology analysers may spuriously count 'hairy cells' as monocytes, resulting in pseudomonocytosis.</p><p><strong>Case presentation: </strong>A 72-year-old woman presented with symptomatic anaemia and massive splenomegaly to a regional hospital in North West province, South Africa, in June 2023. An FBC and differential count, performed on a Sysmex XN-series haematology analyser, revealed a monocytosis of 42.82 × 10⁹/L. However, a manual differential count, peripheral blood microscopy, and multiparameter flow cytometry confirmed a monocytopenia with numerous 'hairy cells'.</p><p><strong>Management and outcome: </strong>The patient was referred to a tertiary hospital where bone marrow morphology and a <i>BRAFV600E</i> mutation confirmed a diagnosis of HCL. Unfortunately, she demised shortly after admission.</p><p><strong>Conclusion: </strong>Here, we report a case of HCL where a Sysmex XN-series artifactually counted 'hairy cells' as monocytes, masking the characteristic monocytopenia. With the recent introduction of Sysmex XN-series FBC haematology analysers (Sysmex Corporation, Kobe, Japan) in National Health Laboratory Service laboratories across South Africa, we urge operators to be cognisant of the inherent limitations of FBC analysers in generating blood counts.</p><p><strong>What this study adds: </strong>Even modern automated laboratory analysers with advanced technologies have inherent limitations. This case highlights the importance of a manual differential count and peripheral blood smear review in the era of automation.</p>","PeriodicalId":45412,"journal":{"name":"African Journal of Laboratory Medicine","volume":"14 1","pages":"2617"},"PeriodicalIF":1.0,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11967045/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143781615","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of obesity with hyperuricaemia among HIV-positive patients on antiretroviral therapy in South-Western Uganda.","authors":"Simon P Rugera, Hope Mudondo, Jazira Tumusiime, Rahma Udu, Ritah Kiconco, Sylvia A Lumumba, Charles N Bagenda","doi":"10.4102/ajlm.v14i1.2565","DOIUrl":"10.4102/ajlm.v14i1.2565","url":null,"abstract":"<p><strong>Background: </strong>Hyperuricaemia is a risk factor for gout and independently predicts hypertension, diabetes, and chronic kidney disease development. While elevated uric acid levels occur in HIV patients, and weight gain is linked to dolutegravir-based therapy, data on the obesity-hyperuricaemia relationship in this population remain limited.</p><p><strong>Objective: </strong>The objective of our study was to evaluate the association between obesity and hyperuricaemia among HIV-positive patients on antiretroviral therapy in South-Western Uganda.</p><p><strong>Methods: </strong>Between April 2024 and June 2024, this study conducted a secondary analysis of data on uric acid level and factors associated with obesity from a 2023 cross-sectional study of HIV-positive participants. We used logistic regression to assess the factors associated with hyperuricaemia, and receiver operating characteristic curve analysis to assess the predictive performance of body mass index for hyperuricaemia.</p><p><strong>Results: </strong>Among 328 participants, hyperuricaemia prevalence was 23.48% (95% confidence interval [CI]: 19.19-28.39%) higher in male participants (31.6%) than female participants (20.0%, <i>p</i> = 0.023). Overweight (adjusted odds ratio [aOR]: 2.01; 95% CI: 1.01-4.00; <i>p</i> = 0.046), obesity (aOR: 2.50; 95% CI: 1.09-5.73, <i>p</i> = 0.030), and male gender (aOR: 2.31; 95% CI: 1.07-5.01, <i>p</i> = 0.033) were significantly associated with hyperuricaemia.</p><p><strong>Conclusion: </strong>Our findings indicate a relationship between hyperuricaemia and obesity in HIV patients on antiretroviral therapy in Uganda. Nationwide studies using primary data are needed to better understand this relationship's epidemiological spread.</p><p><strong>What this study adds: </strong>This study is the first to link obesity with hyperuricaemia among HIV-positive Ugandans on antiretroviral therapy, highlighting obesity as a key metabolic complication of HIV treatment.</p>","PeriodicalId":45412,"journal":{"name":"African Journal of Laboratory Medicine","volume":"14 1","pages":"2565"},"PeriodicalIF":1.0,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11886560/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143587561","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of chromogenic and cysteine lactose electrolyte deficient agar for identification of uropathogens in Gujarat, India.","authors":"Nisha Vadivelu, Rashmika D Parmar, Hitesh Shingala, Krunal D Mehta","doi":"10.4102/ajlm.v14i1.2551","DOIUrl":"10.4102/ajlm.v14i1.2551","url":null,"abstract":"<p><strong>Background: </strong>Urinary tract infections (UTIs) are prevalent bacterial infections, necessitating rapid and accurate diagnosis for timely treatment. Conventional culture techniques, such as cystine lactose electrolyte deficient (CLED) agar, can delay treatment and contribute to inappropriate antibiotic use. Not much is known about alternatives such as chromogenic UTI agar.</p><p><strong>Objective: </strong>The study aimed to assess the performance of chromogenic UTI agar compared to conventional methods for identifying uropathogens, especially in polymicrobial infections, and to determine its sensitivity, specificity, time efficiency, and cost-effectiveness for UTI diagnosis.</p><p><strong>Methods: </strong>An observational cross-sectional study was conducted from March 2024 to June 2024 in the Microbiology Department of M.P. Shah Government Medical College in Jamnagar, Gujarat, India. Urine samples from patients with suspected UTIs (<i>n</i> = 250) were processed using both chromogenic UTI agar and CLED agar. The performance of chromogenic UTI agar was assessed for pathogen identification, detection of polymicrobial infections, time to results, and cost-effectiveness.</p><p><strong>Results: </strong>Chromogenic UTI agar detected single bacterial growth in 63/250 (25.2%) samples, and mixed bacterial growth in 24/250 (9.6%) samples, whereas CLED agar showed single bacterial growth in 67/250 (26.8%) samples and mixed bacterial growth in 10/250 (4%). The chromogenic medium provided preliminary results 5.5 h earlier (<i>p</i> < 0.001) and final results 24 h earlier (<i>p</i> < 0.001) than conventional methods. Cost analysis revealed a 33% reduction per-test cost using chromogenic UTI agar (<i>p</i> < 0.001).</p><p><strong>Conclusion: </strong>Chromogenic UTI agar demonstrated excellent performance in the rapid and accurate diagnosis of UTIs, including improved detection of polymicrobial infections.</p><p><strong>What this study adds: </strong>When it comes to diagnosing UTIs, chromogenic UTI agar has several benefits over traditional techniques, such as high accuracy, enhanced detection of polymicrobial infections, and cost-effectiveness. The research backs up the inclusion of chromogenic medium in standard UTI diagnosis procedures.</p>","PeriodicalId":45412,"journal":{"name":"African Journal of Laboratory Medicine","volume":"14 1","pages":"2551"},"PeriodicalIF":1.0,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11886582/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143587565","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of viral load on sample pooling for reverse-transcription polymerase chain reaction detection-based diagnosis of coronavirus disease 2019 in Nigeria.","authors":"Timan T Eliya, Elvis E Isere, Bassey Emmana, Chukwuebuka Ugwu, Jonathan Kushim, Precious Ishaku, Aisha E Ibrahim, John S Bimba","doi":"10.4102/ajlm.v14i1.2514","DOIUrl":"10.4102/ajlm.v14i1.2514","url":null,"abstract":"<p><strong>Background: </strong>The coronavirus disease 2019 (COVID-19) pandemic strained diagnostic testing capacities globally, particularly in low- and middle-income countries like Nigeria. Reverse-transcription polymerase chain reaction (RT-PCR) remains the gold standard for COVID-19 detection, but limited testing resources caused bottlenecks in Nigeria's response during the pandemic. Sample pooling offers a cost-effective strategy to enhance testing capacity during future outbreaks.</p><p><strong>Objective: </strong>This study determined the maximum number of COVID-19 samples that can be pooled for RT-PCR testing in Nigeria without compromising the detection sensitivity of a single positive sample.</p><p><strong>Methods: </strong>A total of 1222 nasopharyngeal samples from symptomatic COVID-19 patients in Nasarawa State, Nigeria, collected between March 2021 and August 2022, were retrieved from the laboratory biorepository and analysed from November 2022 to February 2023. These included five positive samples with cycle threshold (Ct) values ranging from ≤ 20 to 40, and 1217 negative samples. Positive samples were pooled with negative ones at increasing dilution ratios (1:4-1:64), to assess detection sensitivity on the GeneXpert platform.</p><p><strong>Results: </strong>A positive sample with a Ct value ≤ 25 could be pooled with up to 64 negative samples while maintaining a detectable positive result. However, samples with Ct values of 36-40 could only be pooled with a maximum of eight negative samples. Higher Ct values reduced pooling effectiveness.</p><p><strong>Conclusion: </strong>Sample pooling is a feasible method for scaling up COVID-19 RT-PCR testing in resource-limited settings like Nigeria. The Ct value is critical in determining optimal pool sizes for accurate detection.</p><p><strong>What this study adds: </strong>The findings provide critical guidelines for determining the optimal pool sizes based on Ct values, aiding in effective COVID-19 testing strategies. By optimising sample pooling based on viral load, health authorities can improve their response to future COVID-19 outbreaks and similar public health emergencies.</p>","PeriodicalId":45412,"journal":{"name":"African Journal of Laboratory Medicine","volume":"14 1","pages":"2514"},"PeriodicalIF":1.0,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11886559/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143587569","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Flow cytometric characterisation of acute leukaemia in adolescent and adult Ethiopians.","authors":"Jemal Alemu, Balako Gumi, Aster Tsegaye, Abdulaziz Sherif, Fisihatsion Tadesse, Amha Gebremedhin, Rawleigh Howe","doi":"10.4102/ajlm.v14i1.2394","DOIUrl":"10.4102/ajlm.v14i1.2394","url":null,"abstract":"<p><strong>Background: </strong>Flow cytometric characterisation of acute leukaemia is a key diagnostic approach for clinical management of patients, but is minimally practised in resource-constrained settings like Ethiopia.</p><p><strong>Objective: </strong>This study aimed to determine the immunophenotypes of acute leukaemia by flow cytometry at Tikur Anbessa Specialised Hospital, Addis Ababa, Ethiopia.</p><p><strong>Methods: </strong>A cross-sectional study was conducted on adolescent and adult inpatients consecutively admitted from April 2019 to June 2021. Peripheral blood samples were stained for surface and cytoplasmic markers, and analysed by four-colour flow cytometry.</p><p><strong>Results: </strong>Of 140 cases aged 13 years to 76 years, 74 (53%) were men and 66 (47%) were women, 68 (49%) had acute lymphocytic leukaemia (ALL), 65 (46 %) had acute myelogenous leukaemia (AML), and 7 (5.0%) had acute leukaemia non-otherwise specified. Acute lymphocytic leukaemia was more common among adolescent and male cases; AML was more common among adult and female cases. Among ALL subtypes, B-cell acute lymphocytic leukaemia cases (73.5%) were more common than T-cell acute lymphocytic leukaemia (26.5%). A subset of acute leukaemia, CD19+/CD56+ AML was identified in 3 cases (6% of AML). Of the B-cell ALL cases, 21 (42%) were CD34+/CD10+/CD66c+, 10% were CD34+/CD10+/CD66c-, 32% were CD34-/CD10+, and 6% were CD34+/CD10-. An unexpectedly high number of T-cell ALL cases that lacked surface CD3 were observed to have significantly higher levels of aberrantly expressed myeloid markers.</p><p><strong>Conclusion: </strong>We observed multiple phenotypes identifying subtypes of acute leukaemia cases, extending our previous studies in Ethiopia.</p><p><strong>What this study adds: </strong>This study extends previous studies by describing phenotypically defined subsets of ALL and AML which, in addition to diagnosis, may have useful prognostic value for clinicians.</p>","PeriodicalId":45412,"journal":{"name":"African Journal of Laboratory Medicine","volume":"14 1","pages":"2394"},"PeriodicalIF":1.0,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11830883/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143449629","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}