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. 2023 Feb 7;12(1):1956.
doi: 10.4102/ajlm.v12i1.1956. eCollection 2023.

Building clinical pharmacology laboratory capacity in low- and middle-income countries: Experience from Uganda

Denis Omali  1 , Allan Buzibye  1 , Richard Kwizera  1 , Pauline Byakika-Kibwika  1   2 , Rhoda Namakula  1 , Joshua Matovu  1 , Olive Mbabazi  1 , Emmanuel Mande  1 , Christine Sekaggya-Wiltshire  1 , Damalie Nakanjako  1   2 , Ursula Gutteck  3 , Keith McAdam  4 , Philippa Easterbrook  5 , Andrew Kambugu  1 , Jan Fehr  3 , Barbara Castelnuovo  1 , Yukari C Manabe  1   6 , Mohammed Lamorde  1 , Daniel Mueller  3 , Concepta Merry  7
Affiliations

Building clinical pharmacology laboratory capacity in low- and middle-income countries: Experience from Uganda

Denis Omali et al. Afr J Lab Med. .

Abstract

Background: Research and clinical use of clinical pharmacology laboratories are limited in low- and middle-income countries. We describe our experience in building and sustaining laboratory capacity for clinical pharmacology at the Infectious Diseases Institute, Kampala, Uganda.

Intervention: Existing laboratory infrastructure was repurposed, and new equipment was acquired. Laboratory personnel were hired and trained to optimise, validate, and develop in-house methods for testing antiretroviral, anti-tuberculosis and other drugs, including 10 high-performance liquid chromatography methods and four mass spectrometry methods. We reviewed all research collaborations and projects for which samples were assayed in the laboratory from January 2006 to November 2020. We assessed laboratory staff mentorship from collaborative relationships and the contribution of research projects towards human resource development, assay development, and equipment and maintenance costs. We further assessed the quality of testing and use of the laboratory for research and clinical care.

Lessons learnt: Fourteen years post inception, the clinical pharmacology laboratory had contributed significantly to the overall research output at the institute by supporting 26 pharmacokinetic studies. The laboratory has actively participated in an international external quality assurance programme for the last four years. For clinical care, a therapeutic drug monitoring service is accessible to patients living with HIV at the Adult Infectious Diseases clinic in Kampala, Uganda.

Recommendations: Driven primarily by research projects, clinical pharmacology laboratory capacity was successfully established in Uganda, resulting in sustained research output and clinical support. Strategies implemented in building capacity for this laboratory may guide similar processes in other low- and middle-income countries.

Keywords: HIV; Uganda; building laboratory capacity; resource-limited setting; therapeutic drug monitoring.

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Conflict of interest statement

The authors declare that they have no financial or personal relationships that may have inappropriately influenced them in writing this article.

Figures

FIGURE 1
FIGURE 1
High-performance liquid chromatography-ultraviolet detection machines installed in the clinical pharmacology laboratory at the Infectious Diseases Institute, Makerere University College of Health Sciences, Kampala, Uganda between 2007 and 2013.
FIGURE 2
FIGURE 2
A liquid chromatography-mass spectrometry instrument installed in the clinical pharmacology laboratory at the Infectious Diseases Institute, Makerere University College of Health Sciences, Kampala, Uganda in 2018.
FIGURE 3
FIGURE 3
A nitrogen generator installed to support continuous nitrogen gas supply to the mass spectrometer in the clinical pharmacology laboratory at the Infectious Diseases Institute, Makerere University College of Health Sciences, Kampala, Uganda in 2019.
See this image and copyright information in PMC

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