A Minimum-Requirement Model to Start Up a Histology Laboratory in a Developing Country
Jose Gabriel Mantilla, Ernestine Middleton, Rouzan G. Karabakhtsian · Archives of Pathology & Laboratory Medicine · 2016
Despite the rapid advancement of technology used in pathology laboratories in developed countries, which often includes cutting-edge diagnostic techniques for precision medicine, a large gap in the availability and quality of health care services worldwide still exists, where large subsets of the population remain underserved, including large geographic areas in Africa, Central and South America, Asia, the Middle East, and even Eastern Europe.Many of these countries still have limited or no access to basic diagnostic methodologies, which restricts the possibility to screen and diagnose common preventable conditions, with cervical squamous and glandular lesions being one of the most common and striking examples. These limitations arise largely owing to the lack of basic histology laboratories, equipped with minimal necessary armamentarium of technical resources, along with other barriers. With this letter, we aim to offer a model of an optimally equipped and functional histology laboratory for developing countries at a minimal cost.The components of a basic histology laboratory should include the following: equipment, reagents, and supplies/consumables; these are necessary for the performance of at least routine hematoxylin-eosin staining, as well as limited special staining. For a low-volume, minimum-cost, basic laboratory in underserved communities, we have constructed a general list of resources for start-up, excluding indirect costs and labor (see Table). The equipment required for this undertaking handles a much lower volume and entails a significantly smaller cost than a fully equipped histology laboratory. It is also important to take into consideration that the use of preowned and refurbished equipment is a viable possibility when funding is limited.We believe and hope that the funding for such a cost-efficient histology laboratory can be possibly obtained through grants for developing countries supported by nongovernmental organizations and donors with a passion for pioneering medical initiatives.We would like to thank Ms. Rita Balian, BA, the founder and co-president of the Armenian American Wellness Center in Yerevan, Armenia, for her initiative and inspiration