Background
Health systems in low- and middle-income countries (LMICs) struggle with gross inadequacy and poor quality of laboratory services as well as other aspects of health care provision. Thus, the sole histopathology laboratory in Sierra Leone has weathered not a few operational challenges with fluctuations in availability of service. In the latest stretch of unbroken operations, specimens have been received from various parts of the country. This report is an analysis of the operations of the laboratory seeking to determine the demographic profile of patients, trends in service uptake and pattern of diagnostic entities.
Methods
The study was conducted at the histopathology laboratory of the Connaught Hospital unit of the University of Sierra Leone Teaching Hospital Complex, Freetown. Data was extracted from archived histopathology reports and the specimen reception register for cases seen from 1st January 2021 to 31st December 2024. Statistical analysis was done using R statistical software.
Results
There was a 99% increase in demand for histopathology services between 2021 and 2024. The female-to-male ratio of laboratory users increased significantly from 1.4:1 in 2021 to 3:1 in 2024. The specimen originated from 47 hospitals in 9 out of the country’s 16 districts. Thirty-eight per cent of all examined cases were malignant, while 62% were benign. Breast cancer represented 41.8% of all malignancies in females, while prostate cancer constituted 42% of cancers in males.
Conclusion
Demand for histopathology services is increasing in Sierra Leone. There is a sex difference in the utilisation of histopathology services, with twice as many females as males. About thirty-eight (38%) percent of all specimens are histologically malignant. The most common malignancy in females is breast cancer, while prostate cancer is the leading malignancy in males.