ABSTRACT
Background: In low-resource settings, antimicrobial resistance (AMR) is detected by traditional culture-based methods and ensuring the quality of such services is a challenge. The AMR Scorecard provides laboratories with a technical assessment tool for strengthening the quality of bacterial culture, identification, and antimicrobial testing procedures. Objective: To evaluate the performance of the AMR Scorecard in 11 pilot laboratory evaluations in three countries also assessed with the Stepwise Laboratory Quality Improvement Process Towards Accreditation (SLIPTA) checklist.Methods: Pilot laboratory evaluations were conducted in Cameroon, Ethiopia and Kenya between February 2019 and March 2019. Assessors with previous SLIPTA and microbiology experience were trained. Assessors performed the laboratory assessments using the SLIPTA and AMR Scorecard tools.Results: Weaknesses in technical procedures and the quality management systems were identified in all areas and all laboratories. Safety had the highest mean performance score (SLIPTA: 68%; AMR Scorecard: 73%) while management review had the lowest (SLIPTA: 32%; AMR Scorecard: 8%) across all laboratories. The AMR Scorecard scores were generally consistent with SLIPTA scores. The AMR Scorecard identified technical weaknesses in AMR testing, and SLIPTA identified weaknesses in the quality management systems in the laboratories.Conclusion: Since the AMR Scorecard identified important gaps in AMR testing not detected by SLIPTA, it is recommended that microbiology laboratories use SLIPTA and the AMR Scorecard in parallel when preparing for accreditation. Expanding the use of the AMR Scorecard is a priority to address the need for quality clinical microbiology laboratory services in support of optimal patient care and AMR surveillance.
Subject(s)
Drug Resistance, Microbial , Urine , Blood Cells , Clinical Competence , LaboratoriesABSTRACT
BACKGROUND: Umbilical cord blood analysis may give a clue to the state of health of both pregnant mothers and their neonates. However, there is paucity of literature on some of these indices from our area.OBJECTIVES:This present study determined the red blood indices of maternal and umbilical cord blood in Owerri, Nigeria.METHODS:Pregnant mothers aged 18 - 42 years who booked and received antenatal care until vaginal delivery at the antenatal clinics of two tertiary health care centres in Owerri, Nigeria were divided into five age groups I - V. Maternal blood samples were obtained immediately after delivery of the baby. The umbilical blood samples were collected from the umbilical cord of the baby at the end of the second stage of labour. The haemoglobin (Hb) concentration and packed cell volume (PCV) were determined using standard procedures. The mean corpuscular haemoglobin concentration (MCHC) was calculated mathematically.RESULTS:The result of the cord blood haemoglobin concentration and packed cell volume were significantly higher than the maternal values (14.22 ± 1.25 g/dl versus 11.20 ± 0.92g/d and 42.6 9± 3.80% versus 33.67 ± 2.71% respectively; (P < 0.0001).However, there was no significant differences between cord blood and maternal mean corpuscular haemoglobin concentration (33.24 ±0.23% versus 33.29 ± 0.45 % ;P = 0.310). Furthermore, a positive linear Pearson's correlation was observed between the mean Hb and PCV of cord blood and maternal blood (r=1.11 and r=1.15 respectively <0.0001).CONCLUSION:This result provides a baseline data for further studies on establishing a reference value for maternal and umbilical cord packed cell volume and haemoglobin concentration in our locality
Subject(s)
Blood , Blood Cells , Cues , Erythrocytes , Hematocrit , Nigeria , Umbilical CordABSTRACT
Objectifs : Analyser la prescription; les resultats de l'hemogramme au laboratoire d'Hematologie du CHU de Yopougon. Methodologie: II s'agit d'une etude transversale sur une periode de 3 mois. RESULTATS : AU PLAN EPIDEMIOLOGIQUE ET CLINIQUE : 53pour cent des sujets de notre population d'etude sont de sexe masculin ; 61;5pour cent des sujets sont des adultes et adolescents et 38;3pour cent des enfant ; 95pour cent des prescriptions proviennent du CHU de Yopougon dont 60;5pour cent relevant d'actes externes et 39;5pour cent issus des services d'hospitalisation ; Les services prescripteurs sont surtout les services d'hematologie (41;1pour cent). de pediatrie (14;7pour cent) de medecine (13;6 pour cent) ; Les motifs de prescriptions sont principalement la drepanocytose (25pour cent). le syndrome tumoral(25pour cent); l'anemie (11;1pour cent) et l'hyperthermie (11pour cent) ;L'hemogramme se prescrit sous 2 formes : NG (64;3pour cent); NFS (25;6pour cent) ; 24pour cent des prescriptions ne comportent pas de renseignements epidemiologiques necessaires a une correcte interpretation des resultats. AU PLAN HEMATOLOGIQUE : Les anomalies des GR revelent : 78pour cent d'anemie. Il s'agit d'une anemie franche 7;6(g/dl); normochrome normocytaire (56pour cent). plus frequente chez la femme (62pour cent). Au niveau des GB; nous avons note : 30pour cent d'hyper leucocytose et 10pour cent de leucopenie ; la formule leucocytaire a montre que la neutropenie (22pour cent). l'hyper eosinophilie (13pour cent) et la lymphocytose (8pour cent) sont predominantes. Au niveau des Plaquettes.; la thrombopenie (22pour cent) etait l'anomalie la plus frequente. La repartition des anomalies par tranche d'age a montre que chez les adultes; l'anemie; la neutropenie et la thrombopenie occupent les premieres places avec respectivement 45;6pour cent 15;9pour cent et 14;5pour cent tandis que chez les enfants on a l'anemie (32;4pour cent); l'hyper leucocytose (15;8pour cent) et la thrombopenie (7;5pour cent)