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Research and the development of microbiological services: an example from Nigeria.


 A research study funded by the UK Overseas Development Administration provided impetus to the development of laboratory services in Port Harcourt, Rivers State, Nigeria. The Microbiological Laboratory of the University of Port Hartcourt serves a hospital with 500-600 beds and an outpatient department. However, inadequate space, little quality control, lack of interest in medical microbiology by clinicians, and low priority for call on hospital resources limited the efficiency of the laboratory. In 1992 a community-based research study focused on reproductive tract infections (RTIs) and sexually transmitted diseases (STDs) in order to determine baseline data on RTIs and induced abortion among women. A number of activities were undertaken to improve laboratory facilities: the bacteriology section was upgraded, a microbiologist attended a preparatory course on laboratory management of RTIs/STDs at the University of Liverpool, the organization of the laboratory was streamlined and equipment was supplied to deal with microscopic examination of endocervical smears, culture of gonococcal specimens in selective media, and serological tests for syphilis, chlamydia, and HIV. Key factors in developing a central laboratory meant that technical staff maintained routine hospital services; the laboratory developed an ability to deal with routine problems, such as fluctuating power supplies; and regular meetings with clinicians were extended to routine hospital services to ensure that samples were taken correctly. As a consequence of the research studies the Department of Microbiology now acts a coordinating center for the development of peripheral diagnostic services for RTI/STDs. Activities underway include the upgrading of an STD clinic within the hospital; select health centers are to be equipped to provide simple diagnostic services; and a field laboratory is being set up in a rural health center lacking electricity and piped water. The study provided for the first time information on RTIs, antimicrobial resistance, and populations at risk.
