title: Laboratory Diagnostics Market in East Africa: A Survey of Test Types, Test Availability, and Test Prices in Kampala, Uganda.
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.
  
  
  RESULTS
  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).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Pathology, University of Michigan School of Medicine, Ann Arbor, Michigan, United States of America.
authors.forename: Lee F
authors.initials: LF
authors.lastname: Schroeder
authors.affiliation: Makerere University-Johns Hopkins University Clinical Core Laboratory at Infectious Diseases Institute, Kampala, Uganda; Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America.
authors.forename: Ali
authors.initials: A
authors.lastname: Elbireer
authors.affiliation: Department of Laboratory Medicine and Pathology, University of Minnesota Medical School, Minneapolis, Minnesota, United States of America.
authors.forename: J Brooks
authors.initials: JB
authors.lastname: Jackson
authors.affiliation: Makerere University-Johns Hopkins University Clinical Core Laboratory at Infectious Diseases Institute, Kampala, Uganda; Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America.
authors.forename: Timothy K
authors.initials: TK
authors.lastname: Amukele
mesh_terms: D019411:Clinical Laboratory Techniques / Q000191:economics / Q000706:statistics & numerical data*; D003132:Commerce / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D017048:Health Care Costs / Q000706:statistics & numerical data; D006801:Humans; D019095:Point-of-Care Systems / Q000191:economics / Q000706:statistics & numerical data; D014454:Uganda