Browsing by Author "Njue, Lilly Alice Murugi"

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    Quality of selected immunological and immunoheamatological tests in clinical laboratories in Kiambu County, Kenya
    (Kenyatta University, 2025-04) Njue, Lilly Alice Murugi
    Laboratories play an indispensable part in preventing and controlling diseases by ensuring availability of well-timed and accurate results for the treatment and management of patient’s conditions by providing essential diagnostic information that guides treatment decisions and overall patient care; ranging from diagnosis of disease, Monitoring Disease Progression, Guiding Treatment Decisions, Assessing Organ Function, Screening and Preventive Care, Quality Control and Assurance and Patient Education and Counselling. This obligation spread out to giving disease surveillance statistics. Despite the critical role that immunological and hematological play in patient diagnosis and management, there is limited research on the quality of these tests in relation to the skills and competencies of laboratory personnel in Kiambu County, Kenya. Existing literature may focus on general laboratory practices or specific testing methodologies but often overlooks the interplay between personnel competency and test quality. To guarantee the production of high-quality laboratory information medical diagnostic laboratories need to adopt Good Clinical Laboratory Practices (GCLP). However, many diagnostics laboratories in limited resources settings do not receive enough technical and financial support. Participation in quality management undertakings is often costly for many regular clinical diagnostic laboratories; hence, most level two (2) and three (3) laboratories do not participate. This study aimed at evaluation of the quality of diagnostic results generated by clinical laboratories in Kiambu County by the assessment of accuracy, reliability and precision of test results from standard Immunological and haematological control samples from partaking laboratories. Laboratory personnel qualifications, training, and proficiency while conducting the tests was evaluated and healthcare workers' opinions on the quality of the laboratory services were also assessed. This study was a multi-site descriptive cross-sectional study involving a total of 38 laboratories from entirely all levels, and 76 laboratory workers. Five focused group discussions were conducted with the healthcare workers. Data to compare the difference of haematological profiles was analysed using Mann Whitney U test while comparison between the profiles was tested using Kruskal-Wallis test. The reliability of each single cell type was done using Mann Whitney U test. Laboratory personnel competency was analysed using content analysis method of the interviews, documentation and observation if they were following the guidelines. Healthcare workers’ views were analysed using thematic analysis. The analysis of the findings was done at 95% confidence level (P<0.05). The findings showed that the comparison of laboratory results none of the comparisons show a statistically significant difference between the control and the laboratory results, with all (P<0.005) Individual hematological profiles the all the p values were greater than 0.005(P>0.005) therefore the results showed a significant difference with those of the control. The immunological tests the CD4 cell count were precise together with CRP results. The laboratory personnel were competent and skilful. Most healthcare workers had a good perception on the laboratory services quality. Customer satisfaction surveys should be done regularly in each laboratory and ways of reducing the dissatisfaction level designed and implemented promptly.