African Journal of Laboratory Medicine最新文献

{"title":"Faecal carriage of multidrug-resistant Enterobacterales in hospitalisaed and outpatient children in northern India: A cross-sectional study.","authors":"Akansha Goyal, Jannatbir Kaur, Sapna Chauhan","doi":"10.4102/ajlm.v15i1.3027","DOIUrl":"10.4102/ajlm.v15i1.3027","url":null,"abstract":"<p><strong>Background: </strong>Asymptomatic intestinal carriage of multidrug-resistant (MDR) Enterobacterales in children is increasingly recognised as an important reservoir for transmission and subsequent infection. However, data from northern India remain limited, warranting evaluation of its burden and associated risk factors.</p><p><strong>Objective: </strong>To determine the prevalence of MDR Enterobacterales carriage among children and to identify associated risk factors, including recent hospitalisation, antimicrobial exposure, and hygiene practices.</p><p><strong>Methods: </strong>This cross-sectional study was conducted at a tertiary care hospital in northern India from January to June 2025. Children aged ≤ 14 years were enrolled after obtaining informed consent from parents or legal guardians. A total of 340 stool samples were processed using standard microbiological methods. Bacterial identification was performed using conventional biochemical tests, and antimicrobial susceptibility testing was carried out according to Clinical and Laboratory Standards Institute guidelines, 2025 edition. Multidrug-resistant was defined as resistance to at least one agent in three or more antimicrobial classes. Demographic and clinical data were analysed using SPSS version 25.0; <i>p</i> < 0.05 was considered statistically significant.</p><p><strong>Results: </strong>Among 340 enrolled children, Enterobacterales were isolated from 309 (90.9%). Multidrug-resistant Enterobacterales were identified in 87 children, yielding a prevalence of 28.2% among Enterobacterales-positive children and 25.6% overall. <i>Escherichia coli</i> (66.7%) and <i>Klebsiella</i> spp. (33.3%) were the predominant MDR organisms. Extended-spectrum β-lactamase production was detected in 18.1% of isolates. Multidrug-resistant carriage was significantly higher among inpatients (<i>p</i> < 0.001).</p><p><strong>Conclusion: </strong>Asymptomatic carriage of MDR Enterobacterales is common, particularly among hospitalised children, highlighting the importance of strengthened antimicrobial stewardship and infection prevention strategies in paediatric care.</p><p><strong>What this study adds: </strong>This study demonstrates a high prevalence of asymptomatic multidrug-resistant Enterobacterales carriage among children in northern India, particularly among hospitalised children, highlighting the need for ongoing surveillance, infection prevention and antimicrobial stewardship.</p>","PeriodicalId":45412,"journal":{"name":"African Journal of Laboratory Medicine","volume":"15 1","pages":"3027"},"PeriodicalIF":1.4,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13444777/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148686175","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":"Expanding access to molecular oncology testing in Africa and lower middle-income countries.","authors":"Sharjeel Chaudhry, Zarmina Ehtesham","doi":"10.4102/ajlm.v15i1.3401","DOIUrl":"10.4102/ajlm.v15i1.3401","url":null,"abstract":"","PeriodicalId":45412,"journal":{"name":"African Journal of Laboratory Medicine","volume":"15 1","pages":"3401"},"PeriodicalIF":1.4,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13443876/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148686194","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":"Artificial intelligence in haematology laboratory diagnosis: Current applications, challenges, and future directions.","authors":"Hussam A Osman","doi":"10.4102/ajlm.v15i1.3130","DOIUrl":"10.4102/ajlm.v15i1.3130","url":null,"abstract":"<p><strong>Background: </strong>Artificial intelligence (AI) is transforming haematology diagnostics by improving accuracy, efficiency, and reproducibility in workflows traditionally reliant on manual microscopy and expert interpretation. Integrating AI into laboratory medicine presents opportunities to enhance diagnostic precision and reduce variability, particularly in resource-limited settings.</p><p><strong>Aim: </strong>This narrative review examines the application of AI across major domains of haematology, morphological diagnosis, flow cytometry, cytogenetics, genomics, and clinical decision support, while addressing ethical, regulatory, and economic considerations relevant to global and African laboratory contexts.</p><p><strong>Methods: </strong>A comprehensive literature search of PubMed, Scopus, Web of Science, and EMBASE identified studies describing or evaluating AI algorithms in haematologic diagnostics, focusing on model performance, validation level, and clinical applicability.</p><p><strong>Results: </strong>Recent studies demonstrate strong performance of deep learning models, particularly convolutional neural networks and hybrid convolutional neural networks-transformer architectures, in automating blood and bone marrow morphology, detecting subtle dysplastic changes, and supporting digital workflows. In flow cytometry, AI enhances automated gating and rare event detection, while cytogenetic and genomic tools aid in karyotyping, variant classification, and structural abnormality recognition. Decision-support systems further assist in diagnostic triage and treatment planning. However, widespread implementation is limited by data heterogeneity, inadequate multicentre validation, and evolving ethical and regulatory frameworks.</p><p><strong>Conclusion: </strong>Advancing AI integration in haematology will require robust validation studies, explainable AI approaches, and equitable adoption strategies. Strengthening African laboratory systems through such innovations offers a pathway toward improved diagnostic capacity and sustainable digital transformation.</p><p><strong>What this study adds: </strong>The current study highlighted that AI is improving haematology laboratory tasks such as cell identification, differential diagnosis assistance, and result interpretation, but still faces challenges in validation, bias, and workflow integration. Future progress depends on stronger external validation, better explainable models, and closer collaboration between laboratory experts and AI specialists.</p>","PeriodicalId":45412,"journal":{"name":"African Journal of Laboratory Medicine","volume":"15 1","pages":"3130"},"PeriodicalIF":1.4,"publicationDate":"2026-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13443926/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148686177","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":"Making every test count: Insights from a test kit efficiency audit.","authors":"Amy O Strydom, Mpho R Maphayi, Chemedzai Chikomba","doi":"10.4102/ajlm.v15i1.3013","DOIUrl":"10.4102/ajlm.v15i1.3013","url":null,"abstract":"<p><strong>Background: </strong>Clinical laboratories face increasing demand for testing while operating within constrained budgets, necessitating efficient resource utilisation. Test kit efficiency, a key parameter in automated laboratories, refers to the appropriate use of reagent kits in a manner that minimises non-billable tests per kit.</p><p><strong>Intervention: </strong>Manufacturer-supplied monthly test kit efficiency data for 96 chemistry analytes, collected between 01 April and 30 September 2023, were assessed retrospectively and compared with their respective benchmark efficiencies. The findings were further compared to those from a previous audit to assess for an improvement or decline in efficiency. Under-performing analytes identified included total protein in cerebrospinal fluid, alkaline phosphatase, glucose, ferritin, direct bilirubin and vancomycin. Root cause analysis and targeted interventions led to improvements in test kit efficiency of 12.6% - 37.7% for each analyte.</p><p><strong>Lessons learnt: </strong>Auditing test kit efficiency data revealed inefficiencies, allowing targeted interventions to optimise kit use and reduce costs without compromising quality. Efficiency was influenced by analytical performance, test kit size and batching practices, underscoring the importance of data-driven decision-making for workflow optimisation and resource management. The audit revealed challenges with inherently inefficient tests, highlighting the need for tailored solutions based on the population served, reagent stability and sample stability.</p><p><strong>Recommendations: </strong>We recommend regular test kit efficiency audits to reduce wastage, optimise workflow and drive quality improvement. Efficiency data can support identification of problematic assays and guide kit size adjustment and batching strategies, while ensuring initiatives remain patient-centred. However, the lack of standardised regulatory guidelines on test kit utilisation remains a key limitation that requires attention.</p><p><strong>What this study adds: </strong>There is limited published evidence on the use of test kit efficiency data to drive quality improvement in clinical chemistry laboratories. This study demonstrates how systematic auditing can identify modifiable inefficiencies and support evidence-based resource optimisation.</p>","PeriodicalId":45412,"journal":{"name":"African Journal of Laboratory Medicine","volume":"15 1","pages":"3013"},"PeriodicalIF":1.4,"publicationDate":"2026-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13443735/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148686225","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":"Can Malawi afford to lose? The definitive cost of 'brain drain' and 'brain waste' in its essential medical laboratory workforce.","authors":"Elias Chipofya","doi":"10.4102/ajlm.v15i1.2958","DOIUrl":"10.4102/ajlm.v15i1.2958","url":null,"abstract":"","PeriodicalId":45412,"journal":{"name":"African Journal of Laboratory Medicine","volume":"15 1","pages":"2958"},"PeriodicalIF":1.4,"publicationDate":"2026-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13443440/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148686204","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":"Array comparative genomic hybridisation in haematological malignancies: A comprehensive review.","authors":"Mona Mohammed Hashim Ellaithi, Hussam Ali Osman","doi":"10.4102/ajlm.v15i1.3117","DOIUrl":"10.4102/ajlm.v15i1.3117","url":null,"abstract":"<p><strong>Background: </strong>Haematologic malignancies have diverse and complex genomic abnormalities, and the correct identification is essential for making the appropriate diagnosis, providing a prognosis, and planning treatment. Improved array comparative genomic hybridisation (array CGH) can provide high-resolution, genome-wide copy number variation detection, and overcomes conventional cytogenetic limitations.</p><p><strong>Aim: </strong>The aim of this study is to determine the role of array CGH in characterising genomic aberrations of haematologic malignancies, focusing on technical advantages, added diagnostic values, and implications for disease reclassification and precision medicine.</p><p><strong>Methods: </strong>A comprehensive literature search of PubMed, Embase, Web of Science, and Scopus was conducted to identify studies evaluating the diagnostic performance and clinical utility of array CGH in haematologic cancers.</p><p><strong>Results: </strong>Array CGH detects genomic alterations at kilobase-level resolution and reveals additional abnormalities in approximately 30% of cases with normal results by conventional cytogenetics. It improves molecular subtyping, identifies novel prognostic marker and, when combined with single nucleotide polymorphism arrays, enables detection of uniparental disomy and copy-neutral loss of heterozygosity, thereby enhancing diagnostic yield.</p><p><strong>Conclusion: </strong>Array CGH detects up to 90% of known genomic abnormalities in haematologic malignancies, and its integration with other genomic platforms will considerably enhance diagnostic precision and clinical care for haematopoietic neoplasms.</p><p><strong>What this study adds: </strong>This review emphasises the important role of array CGH's greater sensitivity to clinically relevant copy number changes compared to routine cytogenetics. Clinical applications of array CGH support precision oncology, especially when combined with single nucleotide polymorphism array or next-generation sequencing technologies.</p>","PeriodicalId":45412,"journal":{"name":"African Journal of Laboratory Medicine","volume":"15 1","pages":"3117"},"PeriodicalIF":1.4,"publicationDate":"2026-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13443834/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148686043","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":"Expression of p53 and p63 proteins and their correlation with histological grades among gastric carcinoma specimens at Mbarara Regional Referral Hospital.","authors":"Lydia Jolly Ninsiima, Abraham Birungi, Richard Kasadha, Michael Junior Mugisa, Leuben Tibenderana, Nicholas Nuwashaba, Saphurah Nabaasa, Hassan Wasswa, Lawrence Amadile, Frank Ssedyabane","doi":"10.4102/ajlm.v15i1.3000","DOIUrl":"10.4102/ajlm.v15i1.3000","url":null,"abstract":"<p><strong>Background: </strong>Gastric carcinoma remains one of the most common and deadly cancers worldwide, especially among older men. In sub-Saharan Africa and Uganda in particular, the diagnostic biomarkers of gastric carcinomas are not well documented; also, limited studies have been conducted in Uganda regarding the prognostic and diagnostic value of p53 and p63 immunohistochemical expression in gastric carcinomas.</p><p><strong>Objective: </strong>We aimed to determine the immunohistochemical expression of p53 and p63 proteins and their correlation with different histological grades among archived gastric carcinoma specimens at Mbarara Regional Referral Hospital.</p><p><strong>Methods: </strong>This was a laboratory-based cross-sectional study. We retrieved 166 archived formalin-fixed paraffin-embedded gastric carcinoma tissue specimens from the histopathology laboratory. They were stained with Harris haematoxylin and eosin stain and subsequently stained with p63 and p53 monoclonal antibody immunohistochemistry.</p><p><strong>Results: </strong>Of the 166 gastric carcinoma specimens retrieved, almost a third of specimens were poorly differentiated (53/166; 32%) although the majority were moderately differentiated (68/166; 41%). P53 expression was 20/45 (44.4%), 27/68 (39.7) and 21/53 (39.6) in well-differentiated, moderately differentiated and poorly differentiated gastric carcinoma. Statistically significant positive correlation was observed between p63 and weak immunohistochemical expression (Spearman rho 0.155, <i>p</i>-value 0.047).</p><p><strong>Conclusion: </strong>P53 expression was more than p63 expression in different histological grades. There was no significant correlation of p53 with different histological grades but significant correlation was observed between p63 and moderately differentiated gastric carcinoma specimens. We recommend a prospective study using advanced molecular tests on fresh gastric carcinoma specimens to assess the prognostic usefulness of p53 and p63 biomarkers.</p><p><strong>What this study adds: </strong>This study provides the first Ugandan data on p53 and p63 expression in gastric carcinoma, highlighting p63's significant correlation with moderately differentiated tumours.</p>","PeriodicalId":45412,"journal":{"name":"African Journal of Laboratory Medicine","volume":"15 1","pages":"3000"},"PeriodicalIF":1.4,"publicationDate":"2026-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13443881/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148686219","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":"Kinetics of anti-SARS-CoV-2 IgG in saliva and serum post infection, and subsequent vaccination in South Africa.","authors":"Maemu P Gededzha, Mixo Sibiya, Celine Pellaton, Kubashni Woeber, Duduzile Nsibande, Nobuhle Mchunu, Brodie Daniels, Terusha Chetty, Reshmi Dassaye, Khanya Mohlabi, Shameem Jaumdally, Keertan Dheda, Ruth Lekalakala, Shabir A Madhi, Elizabeth Mayne, Glenda Gray, Yves Levy, Craig Fenwick, Song Ding, Penny L Moore, Ameena Goga","doi":"10.4102/ajlm.v15i1.3052","DOIUrl":"10.4102/ajlm.v15i1.3052","url":null,"abstract":"<p><strong>Background: </strong>Understanding mucosal immune response to Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and vaccination, and its correlation to systemic responses could improve vaccine development. There is limited data on mucosal and systemic antibody responses to SARS-CoV-2 infection and vaccination in African populations.</p><p><strong>Objective: </strong>This study assessed serum and saliva antibody ratios in a cohort of SARS-CoV-2 infected and vaccinated participants followed up for 12 months.</p><p><strong>Methods: </strong>This longitudinal study comprised of 67 SARS-CoV-2, PCR-confirmed participants who were recruited as part of a COVID-19 Point of Care Study, between January 2021 and September 2022. For this analysis, 254 serum and 214 saliva samples (205 of which were matched), were collected at baseline, 6, 9, and 12 months. Antibodies against Spike (S) and nucleocapsid (N) SARS-CoV-2 were assessed by in-house Luminex assay.</p><p><strong>Results: </strong>Serum and saliva anti-S IgG from were detected for up to 12 months in majority of participants (93.5% and 90%), regardless of vaccination status. There was a concordance between paired serum and saliva antibody in 80.5% anti-S IgG and 41.7% anti-N IgG of samples. There was a weak but significant correlation between the matched serum and saliva samples (<i>ρ</i> = 0.42, <i>p</i> < 0.001 for anti-S and <i>ρ</i> = 0.33, <i>p</i> < 0.001 for anti-N). Longitudinal analysis in participants who were vaccinated with either the Ad26.COV2 or BNT162b2 COVID-19 vaccine after their baseline visit, serum anti-S IgG significantly increased (<i>p</i> = 0.023 and <i>p</i> = 0.038), compared with unvaccinated participants. Breakthrough infections or reinfections were identified in (35/62) 56.5% of vaccinated and unvaccinated participants.</p><p><strong>Conclusion: </strong>This study reports the correlation of the anti-S and anti-N IgG responses in serum and saliva following SARS-CoV-2 infection and subsequent vaccination in low-middle income setting. Furthermore, high breakthroughs and reinfection were reported.</p><p><strong>What this study adds: </strong>The study findings are consistent with those from high-income settings, supporting correlation between systemic and mucosal immunity and booster vaccination as a long-term strategy to control SARS-CoV-2.</p>","PeriodicalId":45412,"journal":{"name":"African Journal of Laboratory Medicine","volume":"15 1","pages":"3052"},"PeriodicalIF":1.4,"publicationDate":"2026-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13347804/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148425319","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":"The colistin resistance pandemic: A dual threat from plasmid-encoded mobilised colistin resistance genes and chromosomal mutations.","authors":"Muzaheed","doi":"10.4102/ajlm.v15i1.3122","DOIUrl":"10.4102/ajlm.v15i1.3122","url":null,"abstract":"<p><strong>Background: </strong>Colistin remains a critical last-line therapeutic option against multidrug-resistant Gram-negative infections; but its utility is threatened increasingly by the global spread resistance determinants. Resistance emerges through two principal genetic pathways: horizontal transmission of <i>mcr</i> genes enabling rapid interspecies dissemination, and vertical chromosomal mutations facilitating clonal expansion.</p><p><strong>Aim: </strong>To compare plasmid-mediated and chromosomal colistin resistance mechanisms and examine their clinical significance, epidemiological implications, diagnostic challenges, and surveillance barriers within a One Health framework.</p><p><strong>Methods: </strong>For this narrative, non-systematic review, searches were conducted in PubMed, MEDLINE, Web of Science, Scopus and African Journals Online (AJOL) to identify studies on colistin resistance, its emergence, clinical implications, and related surveillance and diagnostic barriers.</p><p><strong>Results: </strong>Several genetic determinants influence colistin susceptibility; notably, <i>mcr</i> variants and chromosomal mutations in Lipid A modification genes (e.g., <i>pmrA, pmrB</i> and <i>mgrB</i>) reduce colistin binding and bactericidal activity. In African and other resource-limited settings, limited laboratory infrastructure further complicates detection and surveillance, underscoring the need for context-appropriate diagnostics and antimicrobial stewardship. Collectively, these factors pose major clinical and epidemiological concerns.</p><p><strong>Conclusion: </strong>Although surveillance-driven stewardship may mitigate resistance trends, its effectiveness is constrained by the convergence of colistin and carbapenem resistance, increasing the risk of pan-drug-resistant infections. Rapid field-deployable diagnostics and harmonised global surveillance systems that consider the distinct evolutionary trajectories of plasmid-mediated and chromosomal resistance remain urgently needed.</p><p><strong>What this study adds: </strong>This review highlights the contrasting evolutionary pathways of plasmid-mediated and chromosomal colistin resistance and emphasises the importance of integrated surveillance, diagnostics, and stewardship strategies within a One Health approach.</p>","PeriodicalId":45412,"journal":{"name":"African Journal of Laboratory Medicine","volume":"15 1","pages":"3122"},"PeriodicalIF":1.4,"publicationDate":"2026-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13347744/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148680409","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":"Establishing a sustainable quality management system in a public clinical laboratory: The case of Mbagathi Hospital Laboratory in Kenya.","authors":"Jully A Okonji, Martin K Maitima, Peter K Kariuki, Micheal Mugerwa, Romeo W Kithuka, Maria Landron, Peter L Nyanga, Bonventure Juma, Adolfo Lara, Rufus Nyaga, Elizabeth Hunsperger, Edwin Ochieng, Lucy Maryogo-Robinson, Naomi Lucchi","doi":"10.4102/ajlm.v15i1.3032","DOIUrl":"10.4102/ajlm.v15i1.3032","url":null,"abstract":"<p><strong>Background: </strong>Between 2021 and 2023, the Association of Public Health Laboratories, in collaboration with the US Centers for Disease Control and Prevention in Kenya, initiated a laboratory improvement programme at the Mbagathi Hospital Laboratory by establishing a molecular assay to respond to the SAR-CoV-2 outbreak in the country and a quality management system (QMS) to improve the quality of laboratory services and processes.</p><p><strong>Intervention: </strong>Interventions were implemented through the procurement of molecular equipment, supplies, and staff capacity development through training and mentorship. Baseline, midterm, and end-term assessments were conducted, and data were collected using the World Health Organization Regional Office for Africa, Stepwise Laboratory Improvement Program Towards Accreditation tool, version 2015. Data were collected, analysed, and presented in graphs and tables.</p><p><strong>Lessons learnt: </strong>Transitioning to a self-sustaining model requires both financial autonomy and decentralised leadership. Empowering section heads, as quality leads, ensured operational continuity, even during high-pressure outbreaks. However, significant constraints included intermittent reagent stock-outs due to global supply chain disruptions and high personnel workload during peak pandemic waves. These were mitigated through standardised clinic-laboratory communication and prioritised local service contracts for equipment maintenance.</p><p><strong>Recommendations: </strong>To achieve resilient accreditation, public health facilities should move towards integrated financial models that leverage locally generated revenue. Institutionalising QMS within core hospital governance, rather than as a donor-dependent project, is essential for long-term sustainability in resource-constrained settings.</p><p><strong>What this study adds: </strong>While previous literature has established that QMS improves service delivery, our manuscript is unique in providing a documented roadmap for turning a diagnostic laboratory into a revenue-generating entity that ensures its own supply chain stability. Mbagathi Hospital now serves as a national benchmark, with other county hospitals seeking to emulate its model of efficient resource utilisation.</p>","PeriodicalId":45412,"journal":{"name":"African Journal of Laboratory Medicine","volume":"15 1","pages":"3032"},"PeriodicalIF":1.4,"publicationDate":"2026-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13347982/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148425309","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}