Survey of anatomic and clinical pathology services and infrastructure in Nigeria

Jonathan Tucci; Jeremy W Jacobs; Zainab U Ibrahim; Aminu A Yusuf; Ali Bala Umar; Danny A Milner Jr; Quentin Eichbaum

doi:10.1093/ajcp/aqae156

Survey of anatomic and clinical pathology services and infrastructure in Nigeria

Am J Clin Pathol. 2024 Dec 7:aqae156. doi: 10.1093/ajcp/aqae156. Online ahead of print.

Authors

Jonathan Tucci¹, Jeremy W Jacobs¹, Zainab U Ibrahim^{2

3}, Aminu A Yusuf^{4

5}, Ali Bala Umar^{6

7}, Danny A Milner Jr^{8

9}, Quentin Eichbaum¹

Affiliations

¹ Department of Pathology, Microbiology, and Immunology, Vanderbilt University Medical Center, Nashville, TN, US.
² Department of Chemical Pathology, Faculty of Clinical Sciences, College of Health Sciences, Bayero University, Kano, Nigeria.
³ Department of Chemical Pathology and Immunology, Aminu Kano Teaching Hospital, Kano, Nigeria.
⁴ Department of Hematology, Faculty of Clinical Sciences, College of Health Science, Bayero University, Kano, Nigeria.
⁵ Department of Hematology and Blood Transfusion, Aminu Kano Teaching Hospital, Kano, Nigeria.
⁶ Department of Pathology, Faculty of Clinical Sciences, College of Health Science, Bayero University, Kano, Nigeria.
⁷ Department of Pathology, Aminu Kano Teaching Hospital, Kano, Nigeria.
⁸ Access to Oncology Medicines, Union of International Cancer Control, Geneva, Switzerland.
⁹ Harvard T. H. Chan School of Public Health, Boston, MA, US.

PMID: 39657620
DOI: 10.1093/ajcp/aqae156

Abstract

Objectives: The paucity of data regarding the availability and extent of diagnostic medical services across sub-Saharan Africa hinders appropriate allocation of resources to improve health care in these regions. We assessed anatomic pathology (AP) and clinical pathology (CP) services in Nigeria, one of the most populous and fastest-growing countries in the world.

Methods: Two individual surveys (AP focused and CP focused) were developed by subject matter experts and administered to individuals involved in pathology and laboratory medicine diagnostic services at hospitals and laboratories across Nigeria between June and August 2022 using the American Society for Clinical Pathology email listserv.

Results: A total of 75 responses (29 AP and 46 CP) were received from 48 unique laboratories. Twenty-four sites provided AP services and 35 provided CP services. Eleven respondents performed both AP and CP services. Among AP services, basic surgical and cytopathology capabilities were available at most sites; however, the availability of automated technologies (eg, automated sample processing and staining) was more variable. Advanced diagnostic techniques, (eg, immunohistochemistry, human papillomavirus testing, molecular diagnostics) were rarely performed. The most frequently available CP services included hematology, microbiology, and chemistry. Microbiology services appeared to be among the most robust laboratory medicine services, particularly parasitology and bacteriology testing. Similar to AP services, more advanced diagnostic assays, such as flow cytometry, cytogenetics, and molecular testing, were largely unavailable.

Conclusions: These findings augment earlier studies and identify gaps that should be prioritized from a policy perspective to improve medical services and the overall health care infrastructure in Nigeria.

Keywords: Africa; Nigeria; anatomic pathology; blood bank; clinical pathology; coagulation; diagnostic medicine; flow cytometry; global health; health care; hematology; hematopathology; histology; immunohistochemistry; infrastructure; laboratory medicine; microbiology; molecular diagnostics; pathology; resources; transfusion medicine.