Assessment of Supply Chain Management of Laboratory Equipment, Reagents, Supplies and its Potential Impacts the Quality of Laboratory Diagnostic Services of Public Hospitals in Addis Abeba, Ethiopia.
No Thumbnail Available
Date
2019-10
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
Addis Abeba University
Abstract
Background: Tuberculosis (TB) is an infectious disease caused by strains belonging to theMycobacterium tuberculosis complex. Mycobacterium tuberculosis (M. tuberculosis) remains oneof the most significant causes of death from an infectious agent and a major public health problemin the community. Drug development of drug resistance and its association with Humanimmunodeficiency virus (HIV) by far the major cause of the current increase in tuberculosisinfection. Sub-Saharan Africa is endemic for both TB and HIV infection, and pulmonarytuberculosis (PTB) in the HIV-affected countries of eastern and southern Africa, such as Ethiopia,has increased rapidly in the past decades.
Objective:-To assess the magnitude of Mycobacterium tuberculosis, drug-resistance pattern ,and associated factors among patients referred to St. Paul‘s Hospital Millennium Medical College,Addis Ababa, Ethiopia.
Methods: A cross-sectional study was conducted at SPHMMC, Addis Ababa, Ethiopia from Jan toJuly 2019. Socio-demographic data were collected by using structured questionnaire in face to faceinterview with patients. Sputum and non-sputum samples were also collected from 436 presumptiveTB cases. All sputum specimens collected underwent digestion and decontamination using the NaOH-NALC method, whereas and extra pulmonary clinical samples were used directly without decontamination.After centrifugation sputum samples, the sediments were examined using Ziehl-Neelsen technique,analyzed with Gene X-pert MTB/RIF assay, and culture using Lowenstein-Jensen (LJ) and positive culture results were tested for drug resistance pattern using Line probe Assay (LPA). The collecteddata was entered to EPI info 2002 version 3.32 after data editing and cleaning, exported to SPSSversion 23 for analysis.
Results: The total of 436 respondents were included in the study, of this 223 (51%) were male. Themean ±SD age the participants was 38±17years. Regarding marital status, 238 (54.6%) participantswere Julyried, and majority of the respondents 240(55%) urban resident, 214 (49 %) had monthlyincome 100-1000 Ethiopian Birr, 278 (63.8%) used carbohydrate as a usually monthly food item.Of the total, 374(85.8%) were diagnosed for pulmonary tuberculosis and 62(14.2%) were for extrapulmonarytuberculosis, and from all 130 (30-%) were HIV positive individuals. Out of the totalparticipants, the overall LJ culture confirmed Mycobacterium tuberculosis was, 27 (6.2%), andthree isolates were resistant for either INH or RIF drug, while two of them were MDR-TB based on line probe assays method. In a bivariate logistic regression analysis, having a previous TB-contacthistory (COR=3.1; 95 % CI: 1.1, 8.7; P=0.03), patient weight loss (COR=3.6; 95 % CI: 1.5-8.8;P=0.004), having pneumonia with chest X-ray diagnosis (COR=3; 95%CI:3, 33; P=0.02), andhaving CD4+ T-cells count 200-350/mm3 of blood (COR=8.9; 95%CI:0.5, 0.9; p=0.049) weresignificantly associated.
Conclusion: The magnitude of M. tuberculosis and MDR TB in this study highlights the need forfurther extended early case detection and managing MDR TB cases to minimize transmission andthe suffering of patients.
Description
Keywords
Supply chain management, Laboratory, Quality, Service.