Status Of Point Of Care Testing Practices in Africa, Insights From AFCC POCT-Committee Survey.

Background

Point-of-care testing (POCT) refers to all forms of medical laboratory testing conducted in a wide variety of locations that are outside of the physical boundaries of a conventional or central laboratory. POCT offers rapid actionable test results for better patient outcome; however, its widespread adoption has raised concerns in the quality of results and overall management POCT in healthcare institutions contributed by multiple sites, operators, and devices used at a given time. In Africa, the practice is not standardized / harmonized and most of the data, policies and protocols are country or institutional based. Being a regional federation in 2022, the African federation of clinical chemists (AFCC) on its goal of providing international leadership for developing the clinical practice of POCT in Laboratory Medicine in Africa constituted point of care committee to provide a roadmap towards harmonization of POCT in Africa.
 

Methods

This was a cross section online survey conducted in the month of August to October 2024. The survey tool was developed and approved for online (google forms) distribution by the AFCC POCT committee. Committee members distributed the tool electronically and the AFCC national representatives, for the non-AFCC member countries the committee members shared the tool with their close contacts in those countries. Data analyzed using SPSS and presented in frequencies and percentages.

Results

176 responses received from eleven African countries, Medical laboratory technologist/scientists made the highest number of the respondents (54%) with nurses being the lowest (1.1%).The national tertiary referral hospital had the highest respondents (38.1%) type of facility for the respondents. Sixty five percent of the respondents reported to performing point of care testing daily and 75.6% of the facilities perform multiple tests on point of care.  The survey indicates that 60.2% of data generated being manually entered into patient records with 31.3 % reporting POCT connectivity to hospital information systems. Thirty-four respondents affirmed Training and certification with 18.8% respondents indicating performing quality control every time before testing. 44% and 55.7% of the respondents reported that laboratory/pathology department bears the responsibility for training and guiding user concerns respectively.  Documented procedures and policies that guide POCT were available in 58.0% of the facilities surveyed with 56.8% of the surveyed group reported to lacking multidisciplinary POCT committee. Most facilities have implemented a quality management system with 38% of the facilities indicating accredited to ISO 15189 standard.

Conclusion

Point of care testing is popular in the respondents African countries. There is variability in POCT training, clinical governance and quality practices in the participating countries. Data management is still mostly manual, with very few facilities reporting connectivity capability of their POCT. This survey revealed the need for intensified efforts to train health care professionals of appropriate implementation and utility of POCT.