TABLE 4.

Scenarios in which clinicians in Malawi did not use laboratory test results, October-November 2012.

Type of test	When lab tests results were not used
CD4 count	Reagents are often not available; hence, patients managed without laboratory test results History taking is more important than laboratory test results If clinical presentation is strongly suggestive of advanced disease despite laboratory results
Malaria	In cases of severe malaria If clinical symptoms suggest malaria regardless of negative malaria parasites Results came too late, after patients had been discharged Reagents are often not available; hence, patients managed without laboratory test results History taking is more important than laboratory results
Hb/FBC	Laboratory results are inconsistent with clinical presentation Reagents are often not available; hence, patients managed without laboratory test results History taking is more important than laboratory results Results came too late, after patients had been discharged Doubt laboratory expertise
Glucose	Reagents are often not available; hence, patients managed without laboratory test results History taking is more important than laboratory results Use of clinical symptoms only
Tuberculosis microscopy	Reagents are often not available; hence, patients managed without laboratory test results History taking is more important than laboratory results Results came too late, after patients had been discharged Use of experience with clinical symptoms
Bacteriology microscopy culture and sensitivity	Reagents are often not available; hence, patients managed without laboratory test results History taking is more important than laboratory results Laboratory results are not consistent with clinical presentation In cases of urinary tract infection, clinical symptomatic management is used regardless of laboratory results

Hb, Haemoglobin; FBC, Full blood count.