Laboratory use in Ghana: Physician perception and practice

Christopher R Polage, George Bedu-Addo, Alex Owusu-Ofori, Enoch Frimpong, Weston Lloyd, Emily Zurcher, DeVon Hale, Cathy A. Petti

Research output: Contribution to journalArticle

40 Scopus citations

Abstract

Clinical diagnosis of infectious diseases in Africa has been associated with increased misdiagnosis and mortality, but when laboratory testing is available, it remains underused. We retrospectively compared infectious diagnoses, test results, anti-microbial use, and patient cost with laboratory and physician surveys at a teaching hospital in Ghana to evaluate the potential barriers to laboratory use and financial impact for patients. Laboratory capacity was high, but physician survey results and objective data indicated a reliance on clinical judgment and empirical therapy. For the study period, 9-15% of malaria diagnoses, 34-43% of urinary tract infections (UTIs), and 62% of meningitis cases were supported by abnormal laboratory results. For the same period, 0.82-2.09 units of antibiotics were consumed per patient day, and patient cost for antibiotics was 4.8-21.6 times that of laboratory testing. Physician perception regarding the value of diagnostic testing is potentially a major barrier to laboratory use, resulting in empiricism, disproportionate anti-microbial administration, and cost to patients.

Original languageEnglish (US)
Pages (from-to)526-531
Number of pages6
JournalAmerican Journal of Tropical Medicine and Hygiene
Volume75
Issue number3
StatePublished - 2006
Externally publishedYes

ASJC Scopus subject areas

  • Parasitology
  • Infectious Diseases

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    Polage, C. R., Bedu-Addo, G., Owusu-Ofori, A., Frimpong, E., Lloyd, W., Zurcher, E., Hale, D., & Petti, C. A. (2006). Laboratory use in Ghana: Physician perception and practice. American Journal of Tropical Medicine and Hygiene, 75(3), 526-531.