RESUMEN
Introduction: Across the globe, nurses and midwives play a crucial role in providing care to patients in healthcare facilities. They often contact the patient, providing direct care as directed by medical doctors or clinical officers. Traditionally, the role of nurses and midwives in the clinical diagnosis process is to coordinate the clinical diagnosis process-which includes laboratory diagnosis requests-from diagnosticians to the clinical laboratory. In these settings, these diagnosticians are general or specialist medical doctors. However, in some regions in sub-Saharan Africa (SSA), nurses and midwives are primary diagnosticians in healthcare facilities. Methodology: We present a perspective on the role of nurses and midwives in medical laboratory investigations in SSA. We highlight how, on top of nursing and midwifery roles, nurses take up the role of diagnosticians in facilities where doctors are few or are absent and what key issues are worth consideration. Furthermore, we present how efficient collaboration between nursing midwifery and medical laboratory diagnostic systems facilitates effective patient management. Conclusion: Emphasizing training on laboratory test utilization for nurses and midwives in SSA is vital for enhancing healthcare outcomes.
RESUMEN
Background: Trypanosomes are protozoan flagellates that cause human African trypanosomiasis (HAT) and African animal trypanosomiasis (AAT). HAT is caused by Trypanosoma brucei rhodesiense in East and Central Africa and T.b. gambiense in West Africa, whereas AAT is caused by a number of trypanosome species, including T. brucei brucei, T. evansi, T. vivax, T. congolense, T. godfreyi and T. simiae. The aim of this study was to establish if tsetse flies at Liwonde Wild Life Reserve (LWLR) are infected with these trypanosomes and thus pose a risk to both humans and animals within and surrounding the LWLR. Methods: A total of 150 tsetse flies were caught. Of these, 82 remained alive after capture and were dissected such that the mid-gut could be examined microscopically for trypanosomes. DNA extractions were performed from both mid-guts and the 68 dead flies using a Qiagen Kit. Amplification techniques involved the Internal Transcriber Spacer 1 (ITS 1) conventional polymerase chain reaction (PCR) with primers designed to identify trypanosome species, and Repetitive Insertion Mobile Element - Loop Mediated Isothermal Amplification (RIME LAMP), a sequence specific to T. brucei. Results: Analysis showed that 79/82 (96.3%) of the mid-guts examined microscopically were positive for trypanosomes and that 75/150 (50%) of the DNA extracts (from the mid-gut, and tsetse fly carcasses) were positive for T. brucei, as determined by the RIME LAMP method. ITS1 PCR further showed that 87/150 (58.0%) flies were positive for trypanosomes, of which 56/87 (64.4%) were T. brucei, 9/87 (10.3%) were T. vivax; 7/87 (8.1%) were T. simiae; 6/87 (6.9%) were T. congolense, and 6/87 (6.9%) were T. godfreyi. Ten samples had a mixture of infections. Conclusion: Our analysis demonstrated a mixture of infections from trypanosome species in tsetse flies at LWLR, and that T. brucei, the species that causes HAT, was the most common. Our study successfully used molecular techniques to demonstrate the presence of T. b. rhodesiense at LWLR, a species that causes HAT in both East and Central Africa.
