Advancing Medical Laboratory Science and Diagnostic Services in Nigeria: A Systematic Review of Progress, Challenges, and Future Prospects with Sub-Saharan African Context
Elemuwa Ononiwu Christopher *
Department of Medical Microbiology, Immunology & Parasitology, Faculty of Medical Laboratory Science, Federal University Otuoke, Bayelsa State, Nigeria.
*Author to whom correspondence should be addressed.
Abstract
Medical laboratory science and diagnostic services are essential to evidence-based healthcare, disease surveillance, antimicrobial resistance monitoring, outbreak response, and health-system resilience. This review examines the development, current status, persistent challenges and future prospects of diagnostic services in Nigeria, with contextual comparison across selected Sub-Saharan African settings. The manuscript synthesises evidence on laboratory infrastructure, molecular and genomic diagnostics, point-of-care testing, digital pathology, artificial intelligence applications, laboratory accreditation, workforce development, antimicrobial resistance surveillance, One Health approaches and policy frameworks. It also considers lessons from the COVID-19 pandemic for diagnostic preparedness and emergency response. The review shows that Nigeria and several comparator countries have made important progress through expanded polymerase chain reaction capacity, strengthened public health laboratories, growing quality-management initiatives and wider use of rapid and molecular tests. However, diagnostic systems remain constrained by unreliable infrastructure, limited financing, workforce shortages, supply-chain fragility, uneven quality assurance and substantial urban-rural inequities. Advanced technologies, including whole-genome sequencing, CRISPR-based diagnostics, artificial intelligence-enabled interpretation and digital pathology, offer practical opportunities, but their implementation requires sustainable financing, regulatory oversight, trained personnel and reliable supply systems. The review identifies continuing gaps in integrated surveillance, local manufacturing, non-communicable disease diagnostics, bioinformatics capacity and long-term sustainability after donor-supported programmes. A Diagnostic Systems Readiness Framework is proposed to support structured assessment of infrastructure, workforce, quality systems, technology adoption, financing and governance. Strengthening diagnostic systems in Nigeria and Sub-Saharan Africa requires coordinated policy action, domestic investment, regional collaboration and equitable access strategies. Emphasis is placed on cautious interpretation of evidence because diagnostic capacity varies widely across countries and facility levels.
Keywords: Medical laboratory science, diagnostic services, Nigeria, Sub-Saharan Africa, molecular diagnostics, genomic surveillance, antimicrobial resistance, point-of-care testing, laboratory accreditation, One Health, artificial intelligence, health systems strengthening.