African Journal of Laboratory Medicine最新文献

{"title":"Genomic analysis of KEL*03 and KEL*04 alleles among Thai blood donors","authors":"O. Nathalang, Panasya Rassuree, K. Intharanut, Wanlapa Chaibangyang, Núria Nogués","doi":"10.4102/ajlm.v13i1.2294","DOIUrl":"https://doi.org/10.4102/ajlm.v13i1.2294","url":null,"abstract":"Background: The Kell blood group system is clinically important in transfusion medicine, particularly in patients with antibodies specific to Kell antigens. To date, genetic variations of the Kell metallo-endopeptidase (KEL) gene among Thai populations remain unknown.Objective: This study aimed to determine the frequencies of KEL*03 and KEL*04 alleles among Thai blood donors using an in-house polymerase chain reaction-sequence-specific primer (PCR-SSP) method.Methods: Blood samples obtained from 805 unrelated central Thai blood donors at a blood bank in Pathumthani, Thailand, from March 2023 to June 2023, were typed for Kpa and Kpb antigens using the column agglutination test, and the results for 400 samples were confirmed using DNA sequencing. A PCR-SSP method was developed to detect the KEL*03 and KEL*04 alleles, and genotyping results were validated using known DNA controls. DNA samples obtained from Thai donors in central (n = 2529), northern (n = 300), and southern (n = 427) Thailand were also genotyped using PCR-SSP for comparison.Results: All 805 (100%) donors had the Kp(a−b+) phenotype. The PCR-SSP genotyping results agreed with the column agglutination test and DNA sequencing. All 3256 Thai blood donors had the homozygous KEL*04/KEL*04 genotype. Frequencies of the KEL*03 and KEL*04 alleles among Thai donors differed significantly from those of Japanese, Native American, South African, Brazilian, Swiss, and German populations.Conclusion: This study found a 100% KEL*04 allele frequency in three Thai populations. These data could provide information on KEL*03 and KEL*04 allele frequencies to estimate the risk of alloimmunisation in Thai populations.What this study adds: This study demonstrates that in-house PCR-SSP can be used to determine KEL*03 and KEL*04 alleles to predict Kpa and Kpb antigens. Even though only homozygous KEL*04/KEL*04 genotypes were found among Thai donor populations, the established PCR-SSP method may be useful for estimating the risk of alloimmunisation in other populations.","PeriodicalId":45412,"journal":{"name":"African Journal of Laboratory Medicine","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2024-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140230981","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fosfomycin susceptibility testing and resistance mechanisms in Enterobacterales in South Africa","authors":"Jessica S. Hurwitz, M. Newton-Foot, K. Nel van Zyl, Pieter Nel","doi":"10.4102/ajlm.v13i1.2252","DOIUrl":"https://doi.org/10.4102/ajlm.v13i1.2252","url":null,"abstract":"Background: Fosfomycin treatment of urinary tract infections is increasingly attractive due to escalating antibiotic resistance rates among urinary pathogens. Standard antibiotic susceptibility testing methods perform poorly for fosfomycin as there is poor correlation between susceptibility results and clinical outcomes in urinary pathogens other than Escherichia coli.Objective: We evaluated the performance of fosfomycin susceptibility testing in E. coli and Klebsiella pneumoniae to determine whether fosfomycin susceptibility is associated with molecular resistance mechanisms.Methods: Forty-six each of E. coli and K. pneumoniae clinical isolates were obtained from a tertiary hospital in South Africa, from 01 June 2017 to 31 January 2018. Agar dilution, disk diffusion, and gradient diffusion were performed and interpreted using the Clinical Laboratory Standards Institute and European Committee on Antimicrobial Susceptibility Testing guidelines. Molecular resistance mechanisms were identified by whole genome sequence analysis.Results: Disk diffusion and gradient diffusion were accurate alternatives for fosfomycin susceptibility testing in E. coli (98% categorical agreement), but not in K. pneumoniae (47% categorical agreement). All E. coli isolates contained at least one resistance mechanism, but only one isolate with a fosA gene was resistant. In K. pneumoniae, 63% (29/46) and 70% (32/46) of isolates were susceptible to fosfomycin, using Clinical Laboratory Standards Institute and European Committee on Antimicrobial Susceptibility Testing breakpoints, respectively, despite all isolates containing a fosA gene and a uhpT mutation.Conclusion: A better understanding of fosfomycin susceptibility and improved antibiotic susceptibility testing tools could improve diagnostic capability and clinical guidelines for fosfomycin treatment of urinary tract infections.What this study adds: This study highlights the importance of adhering to interpretive guidelines when performing antimicrobial susceptibility testing and the need for simplified, accurate and standardised susceptibility testing methodology and interpretation for fosfomycin in Enterobacterales organisms.","PeriodicalId":45412,"journal":{"name":"African Journal of Laboratory Medicine","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2024-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140230419","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sentinel laboratory compliance with best practices in Burkina Faso's antimicrobial resistance surveillance network.","authors":"Dame Yenyetou, Emmanuel Zongo, Emilie Dama, Merci Muhigwa, Issouf Sanou, Charles Sawadogo, Soumaya Ouangraoua, Ibrahim Sangare, Abdoulaye Nikiema, Anicet G Dahourou, Abdoul S Ouedraogo","doi":"10.4102/ajlm.v13i1.2259","DOIUrl":"10.4102/ajlm.v13i1.2259","url":null,"abstract":"<p><strong>Background: </strong>Standardising procedures is the best way to harmonise and strengthen the quality of laboratory-based antimicrobial resistance surveillance. Since 2018, Burkina Faso has developed and disseminated the national manual of procedures for performing antibiotic susceptibility tests in sentinel laboratories within its national antimicrobial resistance surveillance network.</p><p><strong>Objective: </strong>Our study aimed to assess these sentinel laboratories' compliance with good practices for antibiotics susceptibility tests.</p><p><strong>Methods: </strong>Four teams evaluated the antimicrobial resistance sentinel sites laboratories throughout Burkina Faso from 19 to 28 September 2022. Eighteen out of 19 sentinel laboratories were evaluated. A four-member technical committee designed and validated the evaluation tool composed of three Microsoft Excel sheets. The evaluation emphasised quality controls for culture media, antibiotic discs and compliance with antimicrobial susceptibility testing procedures by the laboratories. Excel software was used for data recording and graphs and table design. The free R software version 4.2.0 was used for descriptive statistics. An overall score below 80% was considered noncompliance.</p><p><strong>Results: </strong>Most (83.33%) of the sentinel laboratories conducted at least one quality control activity for culture media, and 66.67% conducted at least one quality control activity for antibiotic discs. Over three-quarters (76.47%) of the laboratories were more than 80% compliant with the modified Kirby Bauer antimicrobial susceptibility testing method.</p><p><strong>Conclusion: </strong>The evaluation revealed the noncompliance of sentinel laboratories with the national procedure manual, particularly in the quality control component.</p><p><strong>What this study adds: </strong>This study has provided baseline data on the sentinel laboratories' compliance with the national antimicrobial susceptibility testing procedures manual, particularly in areas performing quality control checks or meeting quality indicators for culture media and antibiotic discs.</p>","PeriodicalId":45412,"journal":{"name":"African Journal of Laboratory Medicine","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2024-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10839167/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139698550","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":"Fighting cervical cancer in Africa: Taking a closer look at human papillomavirus 35.","authors":"Sophia U Okeke","doi":"10.4102/ajlm.v13i1.2243","DOIUrl":"10.4102/ajlm.v13i1.2243","url":null,"abstract":"","PeriodicalId":45412,"journal":{"name":"African Journal of Laboratory Medicine","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2024-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10839236/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139698612","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 potassium test sample rejections on routine laboratory service, South Africa","authors":"Sarah McAlpine, B. Chale-Matsau","doi":"10.4102/ajlm.v12i1.2239","DOIUrl":"https://doi.org/10.4102/ajlm.v12i1.2239","url":null,"abstract":"Background: Accurate potassium measurements are necessary for effective clinical management of hyperkalaemia. Pre-analytical factors may affect laboratory measurements, leading to erroneous results and inappropriate patient management and negatively impact the efficiency and finances of laboratories and hospitals.Objective: This study evaluated the impact of rejected potassium test requests on laboratory service.Methods: We conducted a retrospective descriptive study to assess potassium test data at a public laboratory in Pretoria, Gauteng, South Africa, using samples collected from an academic hospital, peripheral hospitals, and outpatient clinics between January 2018 to December 2018. We assessed the relationship between reasons for rejection and health facility type, as well as financial implications for the laboratory.Results: The potassium result rejection rate was 15.1% (29 806 samples), out of the 197 405 requests received. The most common reasons for rejection were old sample ( 1 day old) (41.4%; 12 348 rejections) and haemolysis (38.2%; 11 398 rejections). The most frequent reason for rejections at the central, academic hospital was haemolysis (42.0%), while old sample was the most common reason for rejection at peripheral hospitals (43.4%; 4119/9493 requests) and outpatient health facilities (57.2%; 7208/12 605 requests) (p = 0.022). The total cost of potassium sample rejection over the study period was substantial, given the resource constraints in this setting.Conclusion: Peripheral hospitals and outpatient departments accounted for the majority of rejected potassium testing results, possibly resulting from delays in transportation; causing substantial financial impact on the laboratory. Improved sample collection, handling, and expedited transportation are recommended.What this study adds: This study highlights the importance of appropriate sample collection and handling and the undesirable consequences of non-adherence to these pre-analytical considerations.","PeriodicalId":45412,"journal":{"name":"African Journal of Laboratory Medicine","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2023-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138947787","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Critical values notification: A nationwide survey of practices among clinical laboratories across Nigeria.","authors":"Lucius C Imoh, Idris Y Mohammed, Ifeyinwa D Nnakenyi, Ephraim U Egbuagha, Tomisin M Adaja, Chinelo P Onyenekwu","doi":"10.4102/ajlm.v12i1.2249","DOIUrl":"10.4102/ajlm.v12i1.2249","url":null,"abstract":"<p><strong>Background: </strong>Critical value notification (CVN) entails notifying doctors or other laboratory users of aberrant laboratory results that threaten the patient's life and of any values for which reporting delays could negatively impact the patient's health. Critical value notification practices in clinical laboratories in Nigeria and sub-Saharan Africa are largely unknown.</p><p><strong>Objective: </strong>We conducted a nationwide survey to obtain baseline information on CVN practice by Nigeria's laboratories.</p><p><strong>Methods: </strong>This cross-sectional study was conducted among purposively selected secondary- and tertiary-tier, public and private clinical laboratories across northern and southern Nigeria between October 2015 and December 2015. Consenting senior laboratory staff completed and returned a structured questionnaire, that gathered data on respondents' demographics, designations, and institutional characteristics and practices regarding CVN.</p><p><strong>Results: </strong>One hundred and thirty-four laboratories responded to the questionnaires. Only 69 (51.5 %) laboratories practised CVN; only 23 (33.3%) had existing written policies guiding the practice. Most (43; 62.3%) laboratories use similar critical values (CVs) for adult and paediatric populations. Most laboratories (27; 39.1%) obtained their CVs by combining published literature and local opinions from stakeholders. Physical dispatch (42; 60.9%) followed by telephone calls (38; 55.1%) were the most common means of notification. Private laboratories, compared with public hospital laboratories, were likelier to have separate paediatric CV lists (<i>p</i> = 0.019) and practise telephone notifications (<i>p</i> < 0.001).</p><p><strong>Conclusion: </strong>Critical value notification practices vary and are often suboptimal in many clinical laboratories in Nigeria, which is exacerbated by the absence of guiding policies and national recommendations for post-analytical procedures.</p><p><strong>What this study adds: </strong>This study provides baseline information on CVN practice by Nigeria's laboratories. The study explores the causes of practice variations that can serve as a foundation for enhancing critical reporting and post-analytical services, particularly in clinical laboratories in sub-Saharan Africa.</p>","PeriodicalId":45412,"journal":{"name":"African Journal of Laboratory Medicine","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2023-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10729493/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138811827","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":"Bridging the gaps in newborn screening programmes: Challenges and opportunities to detect haemoglobinopathies in Africa.","authors":"Seth Twum, Kwadwo Fosu, Robin A Felder, Kwabena A N Sarpong","doi":"10.4102/ajlm.v12i1.2225","DOIUrl":"10.4102/ajlm.v12i1.2225","url":null,"abstract":"<p><strong>Background: </strong>Haemoglobinopathies, including sickle cell disease and β-thalassaemia, are monogenic disorders with a relatively higher prevalence among malaria-endemic areas in Africa. Despite this prevalence, most African countries lack the necessary resources for diagnosing and managing these debilitating conditions.</p><p><strong>Aim: </strong>This study provides a critical review of newborn screening for detecting haemoglobinopathies in Africa, highlighting challenges and proposing strategies for improved diagnosis and management.</p><p><strong>Methods: </strong>A literature search on haemoglobinopathies in Africa was conducted in PubMed, Google Scholar and ScienceDirect, using specific keywords and Boolean operators, including articles published from January 1981 to December 2022.</p><p><strong>Results: </strong>The data show that sickle cell disease is prevalent among populations in Central and West Africa; however, β-thalassaemia is prevalent among people in the northern parts of Africa. Newborn screening pilot initiatives for haemoglobinopathies were being implemented in Angola, Nigeria, Ghana, the Democratic Republic of Congo and the Republic of Benin. The cost of testing, lack of sufficient and accessible medical records, and inadequacy in healthcare infrastructure pose significant challenges in bridging the gaps in newborn screening. Furthermore, the stigmatisation and lack of awareness of haemoglobinopathies and access to newborn screening programmes pose additional challenges.</p><p><strong>Conclusion: </strong>This review highlights the challenges associated with haemoglobinopathy testing, effective strategies for mitigating these challenges, and future perspectives for expanding efforts toward detecting and managing these disorders across Africa. Providing affordable diagnostic tools, mobile clinics, government subsidies, education campaigns, and the implementation of electronic medical records systems could help bridge the gaps in newborn screening in Africa.</p><p><strong>What this study adds: </strong>The study presents a comprehensive view of newborn screening of haemoglobinopathies in Africa, provides a detailed outline of the challenges faced by newborn screening for haemoglobinopathies in Africa, and offers strategies for better diagnosis and care.</p>","PeriodicalId":45412,"journal":{"name":"African Journal of Laboratory Medicine","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2023-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10729498/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138811826","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 novel software on laboratory expenditure at an academic hospital in South Africa.","authors":"Zoliswa Mayekiso, Kelechi E Oladimeji, Guillermo A Pulido Estrada, Charles Hongoro, Teke R Apalata","doi":"10.4102/ajlm.v12i1.2159","DOIUrl":"10.4102/ajlm.v12i1.2159","url":null,"abstract":"<p><strong>Background: </strong>Countries across the globe report an increase in expenditure associated with medical laboratory testing. In 2020, the United States Department of Health and Human Services reported that laboratory test expenditures increased by $459 million US dollars (USD) from $7.1 billion USD in 2018. In South Africa, laboratory testing expenditure in the public sector increased from $415 million USD in 2014 to $723 million USD in 2021.</p><p><strong>Objective: </strong>This study aimed to evaluate the impact of an innovative software, electronic gatekeeping (EGK), on medical laboratory test expenditures at Nelson Mandela Academic Hospital, in the Eastern Cape, South Africa.</p><p><strong>Methods: </strong>In this cross-sectional study, an interrupted time series analysis technique was used to evaluate trends in expenditure during a 48-month study period. To measure the impact of EGK on laboratory expenditure, we analysed laboratory expenditure over two study periods: a period of 24 months occurring before EGK implementation (01 June 2013 to 31 May 2015) and a period of 24 months occurring during EGK implementation (01 June 2015 to 30 May 2017).</p><p><strong>Results: </strong>There was a significant reduction (211 928 fewer tests) in the number of tests performed during the intervention (434 790) compared to before the intervention (646 718). Laboratory test expenditure was $1 663 756.72 USD before the intervention period and $1 105 036.88 USD during the intervention period, demonstrating a cost savings of $558 719.84 USD.</p><p><strong>Conclusion: </strong>Electronic gatekeeping is a cost-effective intervention for managing medical laboratory expenditures. We recommend that the health sector scale up this intervention nationally.</p><p><strong>What this study adds: </strong>Using an interrupted time series interval, the authors determined that EGK is a cost-effective intervention for managing medical laboratory expenditures at a tertiary hospital. This study's findings can promote and contribute to improved laboratory systems and test investigations.</p>","PeriodicalId":45412,"journal":{"name":"African Journal of Laboratory Medicine","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2023-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10696537/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138499739","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":"Taking the train of digital health and artificial intelligence to improve medical laboratory service in Africa: Key considerations.","authors":"Rajiv Erasmus, Pascale Ondoa","doi":"10.4102/ajlm.v12i1.2329","DOIUrl":"10.4102/ajlm.v12i1.2329","url":null,"abstract":"","PeriodicalId":45412,"journal":{"name":"African Journal of Laboratory Medicine","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2023-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10696532/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138499742","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":"Serum-free light chain test utilisation at a South African academic laboratory and comparison with serum protein electrophoresis results.","authors":"Razia B Banderker, Fatima B Fazel, Annalise E Zemlin, Aye-Aye Khine, Thumeka P Jalavu","doi":"10.4102/ajlm.v12i1.2201","DOIUrl":"10.4102/ajlm.v12i1.2201","url":null,"abstract":"<p><strong>Background: </strong>Serum protein electrophoresis (SPE), urine protein electrophoresis and immunofixation electrophoresis were traditionally utilised for the diagnosis of monoclonal gammopathies. The quantitative serum-free light chain (SFLC) assay is reportedly more sensitive and has been introduced to recent clinical guidelines.</p><p><strong>Objective: </strong>This study aimed to investigate SFLC test utilisation and describe SPE findings in patients with abnormal SFLC ratios.</p><p><strong>Methods: </strong>A retrospective audit of SFLC analyses was conducted in Cape Town, South Africa, from May 2018 to April 2020. Agreement between abnormal SFLC ratios and SPE results was determined in a sub-group of patients screened for monoclonal gammopathies. Serum-free light chains were analysed using Freelite^® Kappa and Lambda assays.</p><p><strong>Results: </strong>Of the 1425 patients included in the audit, 741 (52%) had abnormal SFLC ratios; 636 (45%) had increased and 105 (7%) had decreased SFLC ratios. In a sub-group analysis of 117 new patients with an abnormal SFLC ratio, 57 had a monoclonal protein (M-protein) on SPE (49%), and 60 (51%) did not. Four out of 60 patients without M-protein had a plasma cell dyscrasia, while renal impairment or inflammatory response accounted for the rest. Of the 57 patients with a M-protein and abnormal SFLC ratio, 41 (72%) had a plasma cell dyscrasia, seven (12%) had lymphomas and nine patients (16%) were unclassifiable.</p><p><strong>Conclusion: </strong>Serum-free light chains should be requested when there is a high index of clinical suspicion. Neither SFLC nor SPE should be performed in isolation when screening patients for monoclonal gammopathy, to ensure that no patient is missed.</p><p><strong>What this study adds: </strong>The study adds to the evidence on SFLC test utilisation. Serum protein electrophoresis alone may miss cases of light chain myeloma, while SFLC performed in isolation may produce false positive results in the setting of inflammatory disorders or renal impairment, leading to unnecessary further investigation.</p>","PeriodicalId":45412,"journal":{"name":"African Journal of Laboratory Medicine","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2023-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10696567/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138499741","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}