RESUMO
Background: Public healthcare systems in sub-Saharan Africa are challenged by healthcare worker shortages, loss of trained staff and attrition to the private sector. Studies have historically focused on medical doctors, nurses and pharmacists, with limited focus on medical laboratory scientists. Objectives: This study addresses the professional perspectives and expectations of the first two classes of biomedical science students, who graduated from the Polytechnic of Namibia in 2012 and 2013. Methods: A questionnaire was developed to capture qualitative and quantitative data from fourth-year students completing their final semester. Data collected included: demographic information; students' experience; professional expectations; and perceptions about the future of biomedical science education in Namibia. Results: Amongst the 42 of 45 enrolled students who completed the questionnaire, nearly two-thirds anticipated working in government hospitals (29%) or industry (35%), with fewer planning careers in private hospitals (12%) or academia (14%). Most expressed an interest in working abroad (64%) and/or in the capital (64%), with fewer interested in small urban areas (48%). Only 7% expressed interest in working in a rural area. Regarding their view of the future of biomedical science in Namibia, 38% responded that it was encouraging, whereas the rest responded that it was uncertain (52%), negative (2%) or unknown (7%). Conclusion: Members of the first graduating classes of Namibia's nascent Biomedical Science degree programme reported a perceived lack of opportunity for professional advancement in the field if they remained in Namibia. Continued thought needs to be given to develop sustainable strategies and opportunities to retain Namibian biomedical laboratory scientists in Namibia.
RESUMO
INTRODUCTION: The opportunistic fungus Pneumocystis jirovecii causes Pneumocystis pneumonia (PcP), which is a life-threatening infection in HIV/AIDS patients. The seemingly low prevalence of P. jirovecii pneumonia in sub-Saharan Africa has been a matter of great debate because many HIV/AIDS patients reside in this region. The lack of suitable diagnostic practices in this resource limited-region has been added to the uncertainty of PcP prevalence. Only a few studies have evaluated the utility of easily obtainable samples such as expectorated sputum for diagnosis of PcP. Thus, the aim of the current study was to evaluate the effectiveness of expectorated sputum for the routine diagnosis of PcP in a resource-limited sub-Saharan African setting. METHODOLOGY: Randomly collected sputum samples were analysed by microscopy after Grocott's methenamine silver (GMS) stain staining and by qPCR to determine the minimum frequency of detectable P. jirovecii. RESULTS: A total of 475 samples were analysed. Twenty five (5.3%) samples were positive for P. jirovecii, i.e., 17 (3.6%) using both qPCR and GMS staining and eight (1.7%) using qPCR only. P. jirovecii was present in 8/150 (5.3%) HIV-positive and tuberculosis (TB) smear-negative patients, and in 12/227 (5.3%) TB smear-negative patients with an unknown HIV status. The minimum frequency of PcP was 3.6% in Namibian HIV and TB patients, while the actual frequency is likely to be 5.3%. CONCLUSION: This study demonstrated that expectorated sputum can be used routinely for the diagnosis of PcP by GMS, although qPCR is more sensitive, and it requires less time and skill.
