Patients' satisfaction with clinical Laboratory Services in Public Hospitals in Ethiopia.

BACKGROUND: Knowing customers' level of satisfaction is relevant to improve and provide quality health care services. In the clinical laboratory, monitoring customers' satisfaction is an important indicator of the quality management system and required by international laboratory standards. However, in Ethiopia, there has not been baseline data about the satisfaction level of patients' with laboratory services at the national level. The aim of this national level survey was to assess patients' satisfaction level with laboratory services at public hospitals in Ethiopia. METHODS: A national survey was conducted using an institutional based cross-sectional study design was employed from 01 to 30 November 2017. A total of 2399 patients were selected randomly from 60 public hospitals. Data was collected using structured questionnaire, entered in Epi Info and analyzed with SPSS software. Multiple logistic regression model was fitted to identify predictors of patients' satisfaction with laboratory services. A p-value of less than 0.05 was taken as statistically significant. RESULT: Overall, 78.6% of the patients were satisfied with the clinical laboratory services. Patients were dissatisfied with cleanness of latrine (47%), long waiting time (30%), clear and understandable advisory service during specimen collection (26%), adequacy of waiting area (25%), easy accessibility of laboratory (19%) and latrine location (20%), availability of requested service (18%), unfair payment of service (17%) and missing of result (12%). The educational status (P = 0.032), and distance (P = 0.000) were significantly associated with client overall satisfaction level. CONCLUSION: Most laboratory patients' were satisfied with the service provided by public hospital laboratories in public hospitals in Ethiopia. However, patients' were dissatisfied with the accessibility of sites, adequacy of waiting area, cleanness of latrine, long TAT, communication, missing of results, availability of requested service and cost of service. Therefore, responsible bodies in each level should act on the identified gaps and improve the need of patients in each hospital laboratory. In addition, all hospital laboratories should conduct a satisfaction survey and meet the needs of laboratory patients.

Trichomonas vaginalis infection in Ethiopia: A systematic review and meta-analysis.

BACKGROUND: An estimated 30 million new cases of Trichomonas vaginalis are recorded annually in sub-Saharan Africa. In Ethiopia, there is no study that systematically compiled the burden of T. vaginalis. Therefore, this study aimed to estimate the pooled prevalence of T. vaginalis in Ethiopia. METHODS: Electronic databases such as PubMed/Medline, EMBASE, Science Direct, Scopus, HINARI, Google Scholar, and Cochrane Library were systematically searched, and studies with high-quality Newcastle Ottawa Scale scores were included. Analyses were performed using STATA version 14 software, and heterogeneity of studies was assessed using the Cochrane's Q test statistics and I2 test statistics. Sub-group, sensitivity analysis, and publication bias were performed. RESULTS: Ten eligible studies consisting of 2979 study participants were included. The overall pooled prevalence of T. vaginalis infections in Ethiopia was 9.62%. Sub-group analysis showed that the overall pooled prevalence of T. vaginalis infections in pregnant women and other study groups was 6.68% and 12.86%, respectively. Publication bias was detected by funnel plots and Egger's tests. CONCLUSIONS: This study showed that the overall pooled prevalence of T. vaginalis infections was relatively high. This study should trigger policy makers, governmental and non-governmental organizations, and healthcare providers to give attention for prevention and control of T. vaginalis infection.

Intestinal parasitic infections and associated factors among street dwellers and prison inmates: A systematic review and meta-analysis.

BACKGROUND: Intestinal parasitic infections are closely associated with low household income, poor personal and environmental sanitation, and overcrowding, limited access to clean water, tropical climate and low altitude. Street dwellers and prisoners are forced to live in deprived situations characterized by inadequate facilities. Therefore, this study aimed to estimate the pooled prevalence and associated factors of intestinal parasitic infections among street dwellers and prison inmates. METHOD: Study searches were carried out in Electronic data bases such as PubMed/Medline, HINARI, EMBASE, Science Direct, Scopus, Google Scholar and Cochrane Library. Studies published only in English and have high quality Newcastle Ottawa Scale (NOS) scores were included for analysis using Stata version 14 software. Random-effects meta-analysis model was used for analysis. Heterogeneity was assessed using the Cochrane's Q test and I2 test statistics with its corresponding p-values. Moreover, subgroup, sensitivity analyses and publication bias were computed. RESULT: Seventeen eligible studies consist of 4,544 study participants were included. Majority of the study participants were males (83.5%) and the mean age of the study participants was 25.7 years old. The pooled prevalence of intestinal parasitic infections among street dwellers and prison inmates was 43.68% (95% CI 30.56, 56.79). Sub-group analysis showed that the overall pooled prevalence of intestinal parasitic infections among prison inmates and street dwellers was 30.12% (95%CI: 19.61, 40.62) and 68.39% (95%CI: 57.30, 79.49), respectively. There was statistically significant association between untrimmed fingernail and intestinal parasitic infections (AOR: 1.09 (95%CI: 0.53, 2.23). CONCLUSION: In this study, the pooled prevalence of intestinal parasitic infections among street dwellers and prison inmates was relatively high. Fingernail status had statistically significant association with intestinal parasitic infection. The prevention and control strategy of intestinal parasitic infection should also target socially deprived segment of the population such as street dwellers and prison inmates.

Physicians' satisfaction with clinical laboratory services at public hospitals in Ethiopia: A national survey.

INTRODUCTION: Physician is a central figure in the client list of clinical laboratory. Monitoring physicians' satisfaction with laboratory service is an important indicator of the quality management system and required by international laboratory standards. However, there is no national data on physician satisfaction with laboratory services in Ethiopia. Therefore, the aim of this national survey was to assess satisfaction level of physicians with laboratory services at public hospitals in Ethiopia. METHODS: Institutional based cross-sectional study design was employed from November 1-30/2017. A total of 327 physicians were randomly selected from 60 public hospitals from all regions of Ethiopia. Data was collected using pre-tested self-administered questionnaire and analyzed with SPSS version 23 software. Logistic regression model was fitted to identify predictors of physician satisfaction with laboratory services. A p-value of less than 0.05 was taken as statistically significant. RESULTS: Overall, 55% of physicians were satisfied with the clinical laboratory services. More than half of the physicians were satisfied with the existing laboratory request form (69%), legibility and completeness of laboratory report (61%), notification of new test (78%) and test interruption (70%). On the other hand, many physicians were dissatisfied with the absence of laboratory hand book (87.5%), the existing test menu (68%), lab-physician interface (62%), availability of referral and/or back up service (62%), notification of Turn Around Time (TAT) (54%), timely notification of panic result (55%), long TAT (33.1%), provision of urgent service (67%), and timely advisory service (57%). Most of the physicians perceived that consistent quality of service was not delivered at all working shifts (71%). At 5% level of significance, we did not find enough evidence to conclude that sex, age, marital status, education level, and experience were statistically associated with physician satisfaction (p-values > 0.05). CONCLUSION: This national survey revealed nearly half of the physicians were unsatisfied with laboratory service at public hospitals in Ethiopia, which mainly related to lack of adequate test menu, laboratory hand book, on time notification of panic result, provision of urgent service, timely advisory service, delivery of quality services in all working shifts and weak lab-physician interface. Therefore, hospital management should address the gaps and improve the needs of physicians for better patient health care. In addition, laboratories should evaluate and monitor physician satisfaction level at regular interval.

Medical laboratory accreditation in a resource-limited district health centre laboratory, Addis Ababa, Ethiopia.

BACKGROUND: Improving the quality of medical laboratory services is a high priority in many countries. However, quality management systems for laboratories in resource-limited settings are often inadequate. OBJECTIVES: This article shares the experiences, benefits and challenges of the laboratory journey towards accreditation in a primary healthcare laboratory in Addis Ababa, Ethiopia. METHODS: A retrospective review of laboratory records in Addis Ketema Health Center was conducted from 2012 to 2015. The study was supplemented by observations from some of the authors of this article who worked in the laboratory. RESULTS: The laboratory journey towards accreditation began with a baseline assessment in 2012 using the World Health Organization African Region Stepwise Laboratory Quality Improvement Process Towards Accreditation; the baseline score was 78 points (0 stars). After mentorship support, the laboratory improved to 198 points (3 stars) in 2013 and 249 points (5 stars) in 2014. The laboratory scaled up to International Organization for Standardization 15189 requirements and received limited-scope accreditation for tuberculosis sputum microscopy and hematology tests in 2015. After adopting and implementing the standards, steady improvement was observed in the reliability of the laboratory services. Lack of resources was the major challenge the laboratory encountered. CONCLUSION: Even though a remarkable quality performance improvement was observed over the entire process, inadequate skilled personnel was the major challenge identified in the road towards accreditation. Therefore, an appropriate, workload-based staffing structure should be developed to improve and sustain medical laboratory quality standards in resource-limited settings.