Evaluation of diagnostic microbiology capacity and barriers in testing for HIV and TB at peripheral hospital-based laboratories in Oyo-state, Nigeria

Abstract

Tuberculosis (TB) (caused by Mycobacterium tuberculosis) and human immunodeficiency virus (HIV) (a Lentivirus) are two interrelated infectious diseases that continue to threaten public health in several parts of the world. In Nigeria, a maximum of 52,000 people died from HIV and TB in 2017. The prevalence of HIV and TB co-infection in Nigeria currently stands around 19.1% which suggests that the two diseases are still a burden on the nation’s health. Improved diagnostic testing at peripheral hospitals is therefore required to facilitate case detection which will reduce the incidence of the two diseases. Thus, this study sought to evaluate the diagnostic microbiology capacity and barriers in testing for HIV and TB at peripheral government-owned secondary hospital- based laboratories in Oyo State, Nigeria. For HIV, 14 (82.4%) of the laboratories had ‘low capacity’ and 3 (17.6%) had ‘fair capacity’ to test serum for HIV antigen and blood for viral load. Analysis of type of assay performed at the laboratories indicated that 9 (52.9%) of the laboratories could carry out acid-fast bacilli (AFB) smear using Ziehl-Neelsen stain, 8 (47.1%) Rhodamine/Auramine stain and no laboratory could perform AFB culture and sensitivity. Seven (41.2%) of the laboratories could carry out serological test for HIV and 3 (17.6%) could test blood for viral load. The low capacity of laboratories in this state underscores the need for interventions to improve supply of testing kits, reagents and culture facilities which will enhance prompt detection of HIV and TB cases. It will also improve local healt demands and reduce unnecessary influx of health service seekers to laboratories in tertiary institutions which are already congested.