Test Cost and Test Accuracy in Clinical Laboratories in Kampala, Uganda

Research output: Contribution to journalArticle

Abstract

Objectives: To assess the accuracy and costs of laboratory tests in Kampala, Uganda. Methods: A random selection of 78 laboratories tested external quality assurance samples at market rates. There were 40 moderate- to high-complexity and 38 low-complexity laboratories. Four percent (3/78) of these laboratories were accredited and 94% (73/78) were private. The 40 moderate- to high-complexity laboratories performed malaria blood smear, urine human chorionic gonadotropin (hCG), human immunodeficiency virus (HIV), syphilis, glucose, and three-panel tests: CBC, liver function tests, and kidney function tests. The 38 low-complexity laboratories performed malaria blood smear, urine hCG, and syphilis testing only. Hematology, HIV, syphilis, and malarial proficiency testing samples were prepared by accredited laboratories in Kampala. All other samples were provided by the Royal College of Pathologists of Australia. Results: 77.1% of all results were accurate (met target values). It varied widely by laboratory (50%-100%), test identity (malaria blood smear, 96%; serum urea nitrogen, 38%), and test type (quantitative: 66% [31%-89%], qualitative: 91% [68%-97%]). Test prices varied by up to 3,600%, and there was no correlation between test cost and accuracy (r2 = 0.02). Conclusions: There were large differences in accuracy and price across laboratories in Kampala. Price was not associated with quality.

Original languageEnglish (US)
Pages (from-to)522-529
Number of pages8
JournalAmerican Journal of Clinical Pathology
Volume149
Issue number6
DOIs
StatePublished - Apr 25 2018

Fingerprint

Uganda
Costs and Cost Analysis
Syphilis
Malaria
Chorionic Gonadotropin
Kidney Function Tests
HIV
Urine
Liver Function Tests
Hematology
Urea
Nitrogen
Glucose

Keywords

  • Accuracy
  • Africa
  • Cost
  • Laboratory
  • Quality

ASJC Scopus subject areas

  • Pathology and Forensic Medicine

Cite this

Test Cost and Test Accuracy in Clinical Laboratories in Kampala, Uganda. / Amukele, Timothy Kien; Jones, Robert; Elbireer, Ali M.

In: American Journal of Clinical Pathology, Vol. 149, No. 6, 25.04.2018, p. 522-529.

Research output: Contribution to journalArticle

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