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Laboratory Diagnostics Market in East Africa: A Survey of Test Types, Test Availability, and Test Prices in Kampala, Uganda

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  • Lee F Schroeder
  • Ali Elbireer
  • J Brooks Jackson
  • Timothy K Amukele

Abstract

Background: Diagnostic laboratory tests are routinely defined in terms of their sensitivity, specificity, and ease of use. But the actual clinical impact of a diagnostic test also depends on its availability and price. This is especially true in resource-limited settings such as sub-Saharan Africa. We present a first-of-its-kind report of diagnostic test types, availability, and prices in Kampala, Uganda. Methods: Test types (identity) and availability were based on menus and volumes obtained from clinical laboratories in late 2011 in Kampala using a standard questionnaire. As a measure of test availability, we used the Availability Index (AI). AI is the combined daily testing volumes of laboratories offering a given test, divided by the combined daily testing volumes of all laboratories in Kampala. Test prices were based on a sampling of prices collected in person and via telephone surveys in 2015. Findings: Test volumes and menus were obtained for 95% (907/954) of laboratories in Kampala city. These 907 laboratories offered 100 different test types. The ten most commonly offered tests in decreasing order were Malaria, HCG, HIV serology, Syphilis, Typhoid, Urinalysis, Brucellosis, Stool Analysis, Glucose, and ABO/Rh. In terms of AI, the 100 tests clustered into three groups: high (12 tests), moderate (33 tests), and minimal (55 tests) availability. 50% and 36% of overall availability was provided through private and public laboratories, respectively. Point-of-care laboratories contributed 35% to the AI of high availability tests, but only 6% to the AI of the other tests. The mean price of the most commonly offered test types was $2.62 (range $1.83–$3.46). Interpretation: One hundred different laboratory test types were in use in Kampala in late 2011. Both public and private laboratories were critical to test availability. The tests offered in point-of-care laboratories tended to be the most available tests. Prices of the most common tests ranged from $1.83-$3.46.

Suggested Citation

  • Lee F Schroeder & Ali Elbireer & J Brooks Jackson & Timothy K Amukele, 2015. "Laboratory Diagnostics Market in East Africa: A Survey of Test Types, Test Availability, and Test Prices in Kampala, Uganda," PLOS ONE, Public Library of Science, vol. 10(7), pages 1-14, July.
    • Handle: RePEc:plo:pone00:0134578
    DOI: 10.1371/journal.pone.0134578
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    References listed on IDEAS

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    1. David W Dowdy & Karen R Steingart & Madhukar Pai, 2011. "Serological Testing Versus Other Strategies for Diagnosis of Active Tuberculosis in India: A Cost-Effectiveness Analysis," PLOS Medicine, Public Library of Science, vol. 8(8), pages 1-10, August.
    2. Karen R Steingart & Laura L Flores & Nandini Dendukuri & Ian Schiller & Suman Laal & Andrew Ramsay & Philip C Hopewell & Madhukar Pai, 2011. "Commercial Serological Tests for the Diagnosis of Active Pulmonary and Extrapulmonary Tuberculosis: An Updated Systematic Review and Meta-Analysis," PLOS Medicine, Public Library of Science, vol. 8(8), pages 1-19, August.
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    4. Mickey Urdea & Laura A. Penny & Stuart S. Olmsted & Maria Y. Giovanni & Peter Kaspar & Andrew Shepherd & Penny Wilson & Carol A. Dahl & Steven Buchsbaum & Gerry Moeller & Deborah C. Hay Burgess, 2006. "Requirements for high impact diagnostics in the developing world," Nature, Nature, vol. 444(1), pages 73-79, November.
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