MEDICAL

LABORATORY
SCIENCES

Amos K.
Zayzay
(Lecturer)
MLT, Medical Lab
INTRODUCTION:
 In the era of modern technology, health care
delivery system involves so many different
personnel and specialties that the caregiver
must have an understanding and working
knowledge of other professional endeavors,
including the role of diagnostic evaluation.
 Basically, laboratory and diagnostic tests
are tools by and of themselves, they are
not therapeutic.
 In conjunction with a pertinent history and
physical examination, these tests can confirm a
diagnosis or provide valuable information
about a patient status and response to therapy.
 In addition to these, laboratory findings
are essential for epidemiological
Contd…
 If the entire network of a laboratory
service is to be effectively utilized and
contribute to health care and disease
 Understandevery
prevention, the role of theoflaboratory
member its work
and
forceits contribution
need to: to the nation’s health
 service;
Appreciate the need to involve all
members in the provision of health
service;
 Follow professional ethics and code of
conduct;
 Experience job satisfaction and have
professional loyalty.
 Medical
laboratory
Medical laboratory science is a complex field
embracing a number of different disciplines
science
such as
 Microbiology,
 Hematology,
 Clinical Chemistry,
 Urinalysis,
 Immunology,
 Serology,
 Histopathology,
 Immunohematology and
Medical
Laboratory
Technology
 Introduction to Medical Laboratory
Technology is a basic course that equips
the student with the most essential
knowledge and skill pertaining to medical
laboratories such as:
 Importance of laboratory services;
 Role of medical laboratory technologist;
 Use of laboratory wares, instruments
and sterilization techniques;
 Prevention and control of laboratory
accidents and;
 Institution of quality control system.
Contd…
 Moreover, this course is extremely
important for the student as it paves the
ways to easily understand various
professional courses such as Hematology,
Bacteriology, Urinalysis, Parasitology, and
others.
 Hence, great emphasis should be given
to this subject matter so as to train
qualified, competent and task oriented
medical laboratory technologists.
History of Medical
Laboratory Science:
 It is difficult to exactly say when and
where medial laboratory science was
started.
 However, some early historical references
have shown that there was examination of
body fluid around the era of Hippocrates.
 The laboratory’s contribution to modern
medicine has only recently been recognized by
historians as something more than the addition
of another resource to medical science and is
now being appreciated as the seat of medicine,
where clinicians account for what they observe
in their patients.
 The first medical diagnoses made by
humans were based on what ancient
Contd…
 The ancient Greeks attributed all
disease to disorders of bodily fluids
called humors, and during the late
medieval period, doctors routinely
performed uroscopy.
 Later, the microscope revealed not only
the cellular structure of human tissue, but
also the organisms that cause disease.
 More sophisticated diagnostic tools and
techniques—such as the thermometer for
measuring temperature and the
stethoscope for measuring heart rate—
were not in widespread use until the end
of the 19th century.
 Contd…
 The most important event that contributes
for the development of the profession was the
discovery of microscope by a German scientist
Antony Van Leeuwenhoek.
 Improvements in the microscope allowed
further exploration of the cellular and
microbial worlds in the 19th century.
 Previously one cannot talk about the field
of medical laboratory science without also
talking about the medical specialty of
pathology.
 Early laboratory practioners were physicians,
pathologists or both.
 But sooner medical laboratory profession
was developed into a separate discipline
Ancient
diagnostic
 In ancient, the earliest physicians made
methods:
diagnoses and recommended treatments
based primarily on observation of clinical
symptoms.
 Other less-than-scientific methods of
diagnosis used in treating the middle
and lower classes included divination
through ritual sacrifice to predict the
outcome of illness.
 Usually a sheep would be killed before
the statue of a god. Its liver was examined
for malformations or peculiarities; the
Contd…
 Ancient physicians also began the
practice of examining patient specimens.
The oldest known test on body fluids was
done on urine in ancient times (before 400
BC). Urine was poured on the ground and
observed to see whether it attracted
insects. If it did, patients were diagnosed
with boils.
 The ancient Greeks also saw the value
in examining body fluids to predict
disease.
 At around 300 BC, Hippocrates
laboratory science in
Health Care:
 The medical laboratory services play a
pivotal role in the promotion, curative and
preventive aspects of a nation’s health
delivery system.
 The service gives a scientific foundation
by providing accurate information to those
with the responsibility for:
 Treating patients and monitoring their
response to treatment,
 Monitoring the development and
spread of infectious and dangerous
pathogens (disease causing organisms),
Contd…
Without reliable laboratory services:
• The source of a disease may not be
identified correctly.
• patients are less likely to receive the
best possible care.
• Resistance to essential drugs may
develop and continue to spread.
• Epidemic diseases may not be
identified on time and with confidence.
WHYTHE
LABORATORY IS
NEEDED IN
The clinical laboratory science has an
HEALTHCARE:
important role in improving the:
• Quality,
• Efficiency,
• Cost-effectiveness,
• planning and management of district
health care.
What diff erence can the
laboratory maketo the quality
of healthcare?
Laboratory investigations increase
the accuracy of disease diagnosis:
Many infectious diseases and serious
illnesses can only be diagnosed
reliably by using the laboratory. For
example, errors in the diagnosis of
malaria have been shown to be
particularly high when diagnosis is
based on clinical symptoms alone.
Contd…
Misdiagnosis or late diagnosis can lead
to:
 Incorrect treatment with misuse and
waste of drugs.
 Increased morbidity and mortality.
 Hospitalization and need for specialist
care.
 patient dissatisfaction leading to negative
responses to future health interventions.
 Underutilization of health facilities
 Lack of confidence and motivation of
health personnel.
Contd…
The laboratory has an essential role in
screening for ill health and assessing
response to treatment:
At district level the laboratory is
needed to:
• Assess a patient’s response to drug
therapy.
• Assist in monitoring the condition of a
patient and help to decide when it may
be necessary to refer for specialist care.
• Screen pregnant women for anaemia,
proteinuria, and infections which if not
Contd…
• Screen the contacts of persons with
infectious diseases such as tuberculosis
and sexually transmitted diseases.
• Detect inherited abnormalities such as
haemoglobin-S as part of district family
planning health services.
• Screen whole blood and blood
products for transfusion transmitted
pathogens.
Contd…
The laboratory is needed to work with
others in reducing infection in the
community and investigating
epidemics
The public rapidly
health functions of a district
service
health include:
laboratory
• Detecting the source(s) of infection,
identifying carriers, and contact tracing.
• participating in epidemiological surveys.
• Assisting in disease surveillance
and in the selection, application,
and evaluation of control methods.
Contd…
• Helping to control hospital acquired
infections.
• participating in health education.
• Examining designated community
water supplies for indicators of
faecal and chemical pollution.
• Responding rapidly when an epidemic
occurs, including appropriate on-site
testing and the collection and despatch of
specimens to the Regional or Central
Microbiology Laboratory for pathogen
identification.
In what ways can the laboratory
contribute to achieving efficiency and
cost effectiveness in health care
System?
The laboratory can help to reduce
expenditure on drugs
• When the laboratory is used to improve
the accuracy of diagnosis, perform
appropriate antimicrobial susceptibility
testing, and monitor a patient’s
response to treatment:
• Drugs can be used more selectively and
only when needed.
• Patterns of emerging drug resistance
Contd…
The laboratory can lower health
care costs by identifying
disease at an early stage
Early successful treatment following
early correct laboratory diagnosis
can help to:
• Reduce the number of times a patient
may need to seek medical care for the
same illness.
• Prevent complications arising from
advanced untreated disease.
• Avoid hospitalization and further
Contd…
Significant savings can be made
when the laboratory participates in
local disease surveillance and
control
This is because:
• The spread of infectious disease can
be contained more rapidly.
• Disease control measures can be
selected and targeted more effectively.
• Sources of infection and disease carriers
can be identified.
Whatinformation can the laboratory
provide to
achieve rational health
planning and good health
management?
Reliable laboratory test results with
relevant patient data, provide
information on the health status of
a community, health patterns, and
disease trends
• This information is needed to establish
health care priorities and plan:
• Health care programmes and location of
health facilities.
• Training of district health personnel and
delivery of health services.
 Contd…
Public health laboratory activities
provide accurate epidemiological
information for health planning
 This information can help to determine:
• Causes of ill health in the
community and risk factors
contributing to the presence and
spread of diseases.
• Prevalence and incidence rates of
important infectious diseases.
• Effectiveness of health care
programmes, drug treatments, and
immunization programmes.
 Role of Medical/Clinical
Laboratory Scientists:
The medical laboratory scientist has the best
of both worlds with the challenges and
rewards of medicine and science.
 The medical laboratory scientist performs a
full range of laboratory tests—from simple
pre-marital blood tests, to more complex
tests to uncover diseases such as AIDS,
diabetes, and cancer. The medical
technologist is also responsible for
confirming the accuracy of test results and
reporting laboratory findings to the
pathologist and other doctors.
 Medical laboratory scientists work quickly
Contd…
• In their search for data on a patient’s
health, medical technologists do much
more than examine specimens
through a microscope. They operate
complex electronic equipment,
computers, and precision instruments.
• Medical laboratory scientists are self-
sufficient, precise and thorough. They
are trouble-shooters who not only report
accurate results, but also know when
results are incorrect and need to be
rechecked.
• Medical laboratory scientists work in five
major areas of the laboratory: Blood
Role of medical laboratory
technologist :
Some of the major roles of medical
laboratory technologist are to:
• Carry out routine and advanced
laboratory tests using standard
laboratory methods;
• Apply problem-solving strategies to
administrative, technical and research
problems;
• Conduct community – based researches in
collaboration with other categories of
health professionals;
• Provide professional consultancy on
matters related to the establishment,
renovation, upgrading and reorganization
Medical Laboratory
Technicians:
• The challenges and rewards of medicine
and science — the medical laboratory
technician has the best of both worlds.
• The medical laboratory technician
performs general tests in all laboratory
areas — Blood banking, Chemistry,
Hematology, Immunology and
Microbiology. Working with the
supervision of a medical technologist, a
medical laboratory technician hunts for
clues to the absence, presence, extent,
and causes of diseases.
• Medical laboratory technicians must be
accurate, dedicated and skilled. They
 Phlebotomy technicians:
• Phlebotomy technicians must like
challenge and responsibility.
• They must also be accurate, work well
under pressure and communicate
effectively.
• Because the phlebotomy technician
works directly with the patient, he or she
must also act as the "eyes and ears" of
the doctors, nurses and laboratory
professionals.
• The phlebotomist must notice and
relay any important information
 Contd…
NOTE: All medical laboratory scientists
have certain common characteristics.
• They are problem-solvers.
• They like challenge and responsibility.
• They are accurate, reliable, work well under
pressure and are able to finish a task once
started.
• They communicate well, both in writing and
speaking.
• They set high standards for themselves and
expect quality in the work they do.
• But, above all, they are deeply committed to
their profession, and are truly fascinated by all
that science has to offer. For someone who
Laboratory organization:
Organization: - is a system, an orderly
structure, putting things together into a
working order, and making arrangements
for undertakings that involve co-
operations.
 The emphasis is on arrangements that
enable peoples working together and
accomplishing common objectives in an
efficient, planned and economic manner.
 In a single medical laboratory at
least there are two interlocking
components of organizations.
S tructure of
medical/Clinical
laboratory services:
A laboratory service network
consists of:
1. Community based primary health
care laboratory:
Duties:
 To support primary health care in
investigating, controlling and preventing
major diseases in the country.
Promoting health care by integrated health
education
Contd…
Main activities are to:
 Investigate by referral or testing on site,
important diseases and health problems
affecting the local community. Such
investigations usually include bacterial
diseases, parasitic diseases and other causes
of illness.
 Assist health care worker in deciding the
severity of a patient’s conditions.
 Collect and refer specimens for testing to
the district laboratory.
 Notify the district hospital at an early
Contd…
 Screen pregnant women for anemia,
proteinuria, malaria, and refer serum for
antibody testing.Promote
 health cares and assists in community
health education
 Keep records, which can be used by
health authorities in health planning
and for epidemiological purposes.
 Keep an inventory of stocks and order
supplies.
 Send an informative monthly report to
2.District hospital
laboratory :
Duties:
 In addition to the works stated above,
these laboratories have an important role
in supervising the work of the peripheral
community based laboratories, testing
referred specimens, and performing a
range of tests compatible with the work of
district hospital
Main activities are to:
 Perform a range of tests relevant to the
medical, surgical, and public health
activities of the district hospital.
Contd…
 Support the work of the community-based
laboratories by testing referred specimens,
providing reagents, controls, standards,
specimen containers, and other essential
laboratory supplies. And also visit each
primary health care laboratory in their
catchments area to inspect and discuss the
investigations being performed and,
comment on their quality assurance
system, record keeping, safety procedures,
as well as the status of equipment
maintenance.
Contd…
• Refer specimens to the regional
laboratory for test (s) that cannot be
performed in district laboratory.
• Notify the regional laboratory of any
result of public health importance and to
send specimens for confirmatory tests.
• Participate in the external quality
assurance programme organized by the
regional laboratory.
• Prepare and send periodical reports to
the regional laboratory.
3.Regional hospital
laboratory:
Duties:
 In addition to the duties done at the two
above lower levels, the regional laboratory
assists and supervises the district
laboratories. It analyses referred
specimens and performs a range of
specialized and other tests as required by
the work of the regional hospital.
Main activities are to:
 Operate a regional blood transfusion
center;
 P r epare reagents, controls, standard
Contd…
• Investigate epidemics and perform
tests of public health importance in
the region;
• Supervise and support the work of
district laboratories;
• Send specimens that require special
investigation to the central and public
health laboratory;
• Prepare periodical reports and send to
the central and public health
laboratory.
4.Central and public health
laboratory:
Duties:
 The central and public health laboratory
is responsible for planning, advising and
overall coordinating of medical
laboratory services in the region.
Main activities are to:
 Formulate a professional code of
conduct to medical laboratory
personnel.
 Perform a range of special tests not
normally undertaken in the regional
laboratories such as viral,
histopathological, cytological,
Contd…
• Carry out appropriate research of
importance in order to mitigate public
health problems.
• Evaluate new technologies and
standardize techniques.
• Purchase supplies and equipments for
the national laboratory service and
organize an efficient system of
requisition, distribution, and
maintenance of equipment.
• Communicate and collaborate
with International Organizations
 Contd…
 Organize laboratory-teaching seminars
and prepare training manuals for the
different laboratory-training programmes.
 Support the work of the regional hospital
laboratories.
 Organize refreshment training and
seminars/ workshops for district and
primary health care laboratory personnel.
 Prepare training manuals for the different
laboratory training programmes.
 Participate in the prompt laboratory