Patients Satisfaction on Clinical Laboratory Services at Nekemte Referral Hospital, Oromia, Ethiopia

Background: Satisfaction is the extent to which the clients feel their needs are fulfilled and their expectations are being met by the service provider. Furthermore, understanding the level of client satisfaction and identifying the factors hindering client satisfaction are the most important base lines to improve the quality of service being delivered. Objective: to assess the extent to which patients were satisfied on clinical laboratory services provided at  Nekemte Referral Hospital   (NRH) . Method: A Hospital based cross sectional study was conducted on randomly selected 422 Patients requested for clinical laboratory service at NRH from March to April 2014. Data were collected using structured, pretested, interviewer-administered questionnaire. Data analysis was performed using SPSS for windows version 20. Result: Among the 422 patients, 255 (60.4%) were satisfied, 75 (17.8%) were neutral and 92(21.8%) were dissatisfied with the laboratory services given in Nekemte Referral Hospital. There was no significant association between socio-demographic characteristics and level of satisfaction of patients (P- value > 0.05).In Likert Scale, the overall mean rate of satisfaction of patients with laboratory services in Nekemte referral hospital was 3.65 out of the 5 points. The lowest mean rating of satisfaction were given for Cleanness of latrine and location of the laboratory in the hospital with mean rating of 2.15 and 2.17 respectively. Conclusion: The overall degree of patient  customers’ satisfaction with the laboratory services at Nekemte Referral Hospital was 60.4% .patients were dissatisfied in cleanness and location of latrines in the hospital. Therefore; hospital administration and the laboratory department of  Nekemte referral Hospital should strive more to enhance patients’ satisfaction, particularly in sanitation and location of the latrine in the hospital. Key Words: patients’ Satisfaction, Clinical Laboratory Services, Nekemte Referral Hospita

External quality assessment of malaria microscopy diagnosis in selected health facilities in Western Oromia, Ethiopia

Abstract Background Accurate early diagnosis and prompt treatment are one of the key strategies to control and prevent malaria disease. External quality assessment is the most effective method for evaluation of the quality of malaria microscopy diagnosis. The aim of this study was to assess the quality of malaria microscopy diagnosis and its associated factors in selected public health facility laboratories in East Wollega Zone, Western Ethiopia. Methods Facility-based cross-sectional study design was conducted in 30 randomly selected public health facility laboratories from November 2014 to January 2015 in East Wollega Zone, Western Ethiopia. Ten validated stained malaria panel slides with known Plasmodium species, developmental stage and parasite density were distributed. Data were captured; cleaned and analyzed using SPSS version 20 statistical software-multivariate logistic regressions and the agreement in reading between the peripheral diagnostic centers and the reference laboratory were done using kappa statistics. Results A total of 30 health facility laboratories were involved in the study and the overall quality of malaria microscopy diagnosis was poor (62.3%). The associated predictors of quality in this diagnosis were in-service training [(AOR = 16, 95% CI (1.3, 1.96)], smearing quality [(AOR = 24, 95% CI (1.8, 3.13)], staining quality [(AOR = 15, 95% CI (2.35, 8.61), parasite detection [(AOR = 9, 95% CI (1.1, 8.52)] and identification skills [(AOR = 8.6, 95% CI (1.21, 1.63)]. Eighteen (60%) of health facility laboratories had in-service trained laboratory professionals on malaria microscopy diagnosis. Conclusion Overall quality of malaria microscopy diagnosis was poor and a significant gap in this service was observed that could impact on its diagnostic services

Clinical isolates of uncomplicated falciparum malaria from high and low malaria transmission areas show distinct pfcrt and pfmdr1 polymorphisms in western Ethiopia

Abstract Background Pfcrt gene has been associated with chloroquine resistance and the pfmdr1 gene can alter malaria parasite susceptibility to lumefantrine, mefloquine, and chloroquine. In the absence of chloroquine (CQ) and extensive use of artemether–lumefantrine (AL) from 2004 to 2020 to treat uncomplicated falciparum malaria, pfcrt haplotype, and pfmdr1 single nucleotide polymorphisms (SNPs) were determined in two sites of West Ethiopia with a gradient of malaria transmission. Methods 230 microscopically confirmed P. falciparum isolates were collected from Assosa (high transmission area) and Gida Ayana (low transmission area) sites, of which 225 of them tested positive by PCR. High-Resolution Melting Assay (HRM) was used to determine the prevalence of pfcrt haplotypes and pfmdr1 SNPs. Furthermore, the pfmdr1 gene copy number (CNV) was determined using real-time PCR. A P-value of less or equal to 0.05 was considered significant. Results Of the 225 samples, 95.5%, 94.4%, 86.7%, 91.1%, and 94.2% were successfully genotyped with HRM for pfcrt haplotype, pfmdr1-86, pfmdr1-184, pfmdr1-1042 and pfmdr1-1246, respectively. The mutant pfcrt haplotypes were detected among 33.5% (52/155) and 80% (48/60) of isolates collected from the Assosa and Gida Ayana sites, respectively. Plasmodium falciparum with chloroquine-resistant haplotypes was more prevalent in the Gida Ayana area compared with the Assosa area (COR = 8.4, P = 0.00). Pfmdr1-N86Y wild type and 184F mutations were found in 79.8% (166/208) and 73.4% (146/199) samples, respectively. No single mutation was observed at the pfmdr1-1042 locus; however, 89.6% (190/212) of parasites in West Ethiopia carry the wild-type D1246Y variants. Eight pfmdr1 haplotypes at codons N86Y–Y184F–D1246Y were identified with the dominant NFD 61% (122/200). There was no difference in the distribution of pfmdr1 SNPs, haplotypes, and CNV between the two study sites (P > 0.05). Conclusion Plasmodium falciparum with the pfcrt wild-type haplotype was prevalent in high malaria transmission site than in low transmission area. The NFD haplotype was the predominant haplotype of the N86Y–Y184F–D1246Y. A continuous investigation is needed to closely monitor the changes in the pfmdr1 SNPs, which are associated with the selection of parasite populations by ACT