Laboratory Medicine in Kijabe

I didn't know what to expect in the way of medical labs at Kijabe Hospital and tried not to form many preconceptions. I am actually really impressed not only by how extensive the lab here is, but also by how the challenges in lab med are quite similar between here and the US. Even the accreditation, lab and individual proficiency testing schemes are similar to our CAP-accredited labs! The biggest difference is that the records are on paper.

I hope to post a series of entries on lab medicine in Kenya. Given my interests, there will be a strong bias towards Microbiology/Parasitology, plus I'll post on the blood bank & transfusion medicine here. I will also discuss some of the general practices, required training, and interesting cases. The lab staff has welcomed me graciously ("karibu sana") and is happy to share their interesting cases with me as well as their basic processes. In return, I hope to share some of our experiences with their newest piece of equipment in the Micro lab - the Vitek2 - which is currently being validated in the lab. I will also give a Continuing Medical Education (CME) talk to the technologists at the end of the month.

Partial test list:
CBC and PT/PTT/INR, Chem 7, LFTs, TSH/T3/T4, beta-hCG, progesterone, PSA
Microbiology culture & sensitivities, MTB & rifampin resistance (geneXpert), Ova & Parasites, Salmonella enterica serotype typhi & Helicobacter pylori by stool antigen lateral flow assay
HIV testing, CD4 count (in house), viral load (send out)
UA and urine micro exam
Small blood bank with immunohematology services 

Medical Laboratory Benches at 0750, just before the day shift shows up and things get busy!

Specimen processing/receiving is up front (at right, not shown in the picture).  Virology is the first bench - the black-covered machine is a flow cytometer for CD4 counts. Progressing to the back of the lab we see the immunohematology bench for blood typing. Next bench is hematology for CBC and coag testing. The next several benches are clinical biochemistry and include metabolic studies as well as other useful tests, such as beta-hCG, thyroid hormone/function testing, etc. The back section of the lab is all microbiology and parasitology.

I'll try to cover each bench in at least one post while I'm here. It's really amazing to see how other countries, particularly resource-limited and rural areas, provide these critical lab services.

As a last note, I was delighted to discover that my alma matter - the University of Maryland, School of Medicine - has an active collaboration with the labs here!

The collaboration is through the US President's Emergency Plan For Aids Relief (PEPFAR).

Additional information about the UM SOM's PEPFAR-funded activities can be found in this Baltimore Sun article from 11/2016.