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Improving Clinical Laboratory Quality through reduction of Tests’ Turnaround Time in Democratic republic of the Congo: Key Strategies

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journal of Biosciences and Medicines 2021年第10期9卷 96-116页

作者： Chabo Byaene Alain Mabela Makengo Matendo rostin Konde Nkiama Numbi joël Muhindo Mavoko Hypolite Kayembe Nzongola-Nkasu Donatien Tanon Aristophane Koffi muwonga masidi jérémie Situakibanza Nani-Tuma Hippolyte Department of Medical Biology University Hospital of Kinshasa Faculty of Medicine University of Kinshasa Kinshasa Democratic Republic of the Congo (DRC) Department of Mathematics and Informatics Faculty of Sciences University of Kinshasa Kinshasa Democratic Republic of the Congo (DRC) Department of Health and Environment Faculty of Medicine University of Kinshasa Kinshasa Democratic Republic of the Congo (DRC) Department of Tropical Medicine University Hospital of Kinshasa Faculty of Medicine University of Kinshasa Kinshasa Democratic Republic of the Congo (DRC) Department of Dermatology and Infectiology Faculty of Medical Sciences Félix Houphou&euml t Boigny University Abidjan-Cocody C&ocirc te d’Ivoire Department of Internal Medicine University Hospital of Kinshasa Faculty of Medicine University of Kinshasa Kinshasa Democratic Republic of the Congo (DRC)

In Democratic republic of the Congo (DrC), the laboratory TAT is significantly very long and do not comply with either international standards or the suggestions of customers. However, there is neither a national nor a local strategy to improve the laboratory TAT. The aim of the present study is to develop practical management strategies to shorten clinical laboratory tests’ TAT. This was a qualitative study conducted in Kinshasa. Focus groups and Lean tools were used respectively to generate a wide range of views from a variety of laboratory staff and to eliminate several form of waste in the laboratory flow process. Based on the identified root causes of delay, focus groups participants reported that there is a lot of scope for the improvement of TAT in DrC. Consistent attendance and punctuality are essential. The hospital management should implement the Laboratory Information Systems (LIS) and install Middleware. Total laboratory automation, inventory system for all reagents and supplies used in the laboratory, expansion of the sampling area, sufficient number of high-power machine and a clear job description are indispensable. LIS, 3.5 mL BD vacutainer BarricorTM tube and point-of-care testing (POCT) are necessary for workflow improvement. A reduction of 312 minutes was achieved by eliminating or decreasing non-value-added activities. Applying the suggested key strategies, and particularly the new workflow process, is a basis for improving the laboratory tests’ TAT. The algorithm presented can be easily implemented in other laboratories that face this type of problem.

关键词： Turnaround Time Quality Indicator Quality Improvement Clinical Laboratory Focus Groups Lean Management Quality Assurance Democratic republic of the Congo

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Evaluation of Clinical Laboratory Tests’ Turnaround Time in a Tertiary Hospital in Democratic republic of the Congo

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journal of Biosciences and Medicines 2021年第7期9卷 96-111页

The delay in the delivery of laboratory results can be fatal and can even lead to the death of patients. This study was conducted at the clinical laboratory of the University Hospital of Kinshasa (UHK) from October 2020 to April 2021, aimed to evaluate the laboratory tests’ turnaround time (TAT) and to identify reasons for delay. TAT was quantified using a time and motion analysis approach. The evaluation of TAT consisted of comparing the overall intra-lab TAT with the suggested TAT using student t-test at 95% confidence intervals. Brainstorming was the root cause analysis tool used for identifying reasons for delay. In this study, the laboratory tests’ TATs were significantly higher (p ring to international guidelines (60 minutes) and customers’ suggested TAT (120 minutes). Only 0.98% of the samples were reported within 60 minutes of patient reception and 1.47% within 120 minutes, i.e. an outlier rate of 98.5%. root causes of delay related to Machinery, Management, Manpower, Materials, Method and Milieu. Because of many reasons, the laboratory is not meeting the established TAT. Preventive and curative measures must be undertaken to reduce the delay and improve the TAT.

关键词： Time-Motion Analysis Turnaround Time Clinical Laboratory Quality Assurance Value Stream Mapping Democratic republic of the Congo

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Importance of the Glycated Hemoglobin Assay in Congolese Women with Polycystic Ovary Syndrome: A Case-Control Study in Kinshasa, Dr Congo

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Open journal of Obstetrics and Gynecology 2019年第11期9卷 1492-1509页

作者： Daddy Kabamba Numbi Dophie Tshibuela Beya Guelord Mukiapini Luzolo Passy Kimena Nyota Placide Cyanga Ngandu Mamy Ngole Zita Gustave Ilunga Ntita Donatien Kayembe Nzongola-Nkasu jérémie muwonga masidi Mireille Nganga Nkanga justin Mboloko Esimo Arsène Mputu Lobota jean Bosco Kasiam Onkin Baudouin Buassa-bu-Tsumbu Cathy Ali risasi Fons Verdonck Bernard Spitz jean Pierre Elongi Moyene Département de Biologie Médicale Service de Biologie Clinique Cliniques Universitaires de Kinshasa Kinshasa DR Congo Département de Gynécologie-Obstétrique Cliniques Universitaires de Kinshasa Kinshasa DR Congo Département de Médecine Interne Service d’Endocrinologie et Diabétologie Cliniques Universitaires de Kinshasa Kinshasa DR Congo Département de Biologie Clinique Hopital Général de Référence de Kinshasa Kinshasa DR Congo Department of Physiology KU Leuven Leuven Belgium Department of Gynecology-Obstetrics KU Leuven Leuven Belgium Département de Gynécologie-Obstétrique Hopital Général de Référence de Kinshasa Kinshasa DR Congo

Context: Polycystic ovary syndrome (PCOS) is considered a syndrome related to the metabolic syndrome with a high risk for developing diabetes mellitus. The evaluation of the glycated hemoglobin (HbA1c) seems to be an interesting tool to detect states of hyperglycemia that may be associated with this syndrome and to understand her pathophysiology. Aims: The purposes of this study are to determine the profile of HbA1c in Congolese women with PCOS, to determine the frequency of states of hyperglycemia and to assess the impact of this marker on clinical signs on this syndrome. Material and methods: This is a case-control study of 130 Congolese subfertile women;65 with a diagnosis of PCOS and 65 others without PCOS. This is conducted from june 2016 to june 2019 among Congolese women of childbearing age. All these women were recruited at the subfertility outpatient clinic of the University Hospital of UNIKIN as well of the YANGA medical centers in Kinshasa, Democratic republic of Congo. Sickle cell disease was excluded as also the cases of anemia. HbA1c was assayed via the immunoturbidimetric method and the results interpreted according to the ADA recommendations with a pathological cut-off point ≥ 6.5%. results: Mean hemoglobin was 11.6 ± 1.2 g/dl (11.5 ± 1.1 g/dl vs. 11.8 ± 1.4 g/dl, P = 0.568). The proportion of diabetics was 1.6% (1.6% vs. 1.5%, P = 0.74). Higher HbA1c values were noted in the PCOS group compared to the control group (7.3% ± 2.1% vs. 5.6% ± 0.6%, P 0.001). The multivariate analysis showed a strong correlation between elevated HbA1c levels and PCOS (Or 14.79 (CI 5.43 - 40.32), P 0.001). In the PCOS group, higher HbA1c values were significantly correlated with a higher socio-economic status (Or 3.38 (1.67 - 8.47), P = 0.018) and with obesity (Or 3.48 IC (1.31 - 7.13) P = 0.029). A perfect, positive and significant linear correlation was found between HbA1c and fasting blood glucose (r = 0.807). 60% of women in the PCOS group had pathological values of H

关键词： PCOS HbA1c Subfertility Congolese Women

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The Profile of Glycated Hemoglobin in Non-Diabetic Pregnant Women with Preeclampsia: A Case-Control Study in Kinshasa, the Democratic republic of Congo

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Open journal of Obstetrics and Gynecology 2020年第3期10卷 365-389页

作者： Guelord Mukiapini Luzolo Dophie Tshibuela Beya Daddy Kabamba Numbi Passy Kimena Nyota Placide Cyanga Ngandu Blaise Sumbu Matondo Manzambi Aliocha Nkodila Natuhoyila Mamy Ngole Zita Gustave Ilunga Ntita Mireille Nganga Nkanga jérémie muwonga masidi Donatien Kayembe Nzongola-Nkasu Dieudonné Sengeyi Mushengezi Arsene Mputu Lobota Baudouin Buassa-Bu-Tsumbu Cathy Ali risasi Fons Verdonck Bernard Spitz jean Pierre Elongi Moyene Département de Biologie Médicale Service de Biologie Clinique Cliniques Universitaires de Kinshasa Kinshasa Congo Département de Médecine interne Cliniques Universitaires de Kinshasa Kinshasa Congo Département de Gynécologie-Obstétrique Cliniques Universitaires de Kinshasa Kinshasa Congo Département de Biologie Clinique Hopital Général de Référence de Kinshasa Kinshasa Congo Department of Physiology KU Leuven Belgium Department of Gynecology-Obstetrics KU Leuven Belgium Département de Gynécologie-Obstétrique Hopital Général de Référence de Kinshasa Kinshasa Congo

Background: A disturbed glucose metabolism is quite common during pregnancy. It is due to the diabetogenic potential of pregnancy and responsible for many obstetric complications. The glycated hemoglobin is one of the markers used to depict these disorders. Higher concentrations of this marker would be associated with unfavorable results of pregnancy. Objective: To describe the profile of HbA1c in non-diabetic preeclamptic pregnant women and to establish the association between the values of this marker and the maternal and fetal complications. Materials and Method: This is a case-control study of 142 pregnant women in their second and third trimester. They were followed in the maternity hospitals of University Clinics and the General reference Hospital in Kinshasa, Democratic republic of Congo between May and October 2019. The sampling of preeclamptic pregnant women was exhaustive. Controls were healthy pregnant women carrying pregnancies of the same type and of the same gestational age as the cases. Ultimately, 71 were preeclamptic and 71 healthy (controls). HbA1c was determined by immunoturbidimetry. results: A total of 142 pregnant women took part in this study consisting of 71 preeclamptic women (cases) and 71 healthy pregnant women (controls). The average age of these pregnant women was 28.8 ± 6.8 (28.2 ± 6.8 years vs 29.5 ± 6.8 years p = 0.559), with an average parity of 2.3 ± 1.5 (2.2 ± 1.7 vs 2.4 ± 1.2, p = 0.005). The majority were carriers of monofoetal pregnancy. Higher HbA1c values were observed in the preeclamptic pregnant women compared to the controls (5.7 ± 1.3% vs 4.8 ± 0.7%, p 0.001). The proportion of pregnant women with pathological HbA1c values (>5.6%) was also higher in the group of preeclamptic pregnant women (46.5% vs 9.9%, p Conclusion: This study established that 46.5% of non-diabetic pregnant women with preeclampsia have high HbA1c values, which moreover are associated with preeclampsia and its complications. Systematic screening is essen

关键词： HbA1c Preeclampsia Prognosis Congo

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