Wrong diagnosis killing many patients in Nigerian hospitals

…A journey from hysterectomy to stage 4 cervical cancer – pathetic case of 61-year-old woman

Caroline Idemba, 61-year-old woman, is a classic case of a diagnosis gone awry. Her life took a sudden and devastating turn due to a series of medical missteps.

It all began a year ago when she underwent a procedure hysterectomy, a surgery to completely or partially remove the womb.

The procedure was meant to be a solution to the chronic pain and heavy menstrual bleeding she had endured for years. The initial results seemed promising, and Caroline felt a significant relief from her symptoms. For a while, life returned to normal.

“About a year after the procedure, I began experiencing unusual symptoms. I noticed persistent fatigue, pelvic pain, and abnormal bleeding. I became worried and visited the clinic where the doctor recommended a series of tests. Blood tests, ultrasounds, and even a CT scan were conducted, but the results were inconclusive.

“The doctors initially suspected an infection and prescribed antibiotics, but symptoms persisted. Months passed, and the condition only worsened,” she said.

According to Caroline, “I began losing weight rapidly and felt a constant pain that radiated through my lower abdomen. I was desperate for answers; I visited several hospitals and underwent more tests, but each time, the results pointed to nothing more than an elusive infection. The medical professionals I consulted seemed confused, unable to pinpoint the root cause of my deteriorating health.

“I felt like I was going crazy,” Caroline recalls. “No one could tell me what was wrong, and I was just getting sicker and sicker.”

It wasn’t until three tough months later, after many consultations and increasing medical bills, that I finally received a diagnosis. A gynecologist in Lagos suggested a biopsy to rule out any serious conditions. The results came back, revealing the devastating truth: I had stage 4 cervical cancer, which explains the pain, weight loss and bleeding.

“If they had caught it earlier, maybe things would be different; maybe I wouldn’t be fighting for my life right now. This happened because of the misdiagnosis and delay,” Caroline said with a sad voice.

In the broader context, reports have said that “Cervical cancer is one of the most preventable types of cancer if detected early. However, in Nigeria, we face significant barriers in terms of early detection and proper diagnosis. Limited access to screening programs and follow-up care are major issues.”

Also, 45-year-old Chioma Okafor, a mother of three, visited a reputable private hospital in Lagos complaining of persistent headaches and blurred vision. After a series of tests, she was diagnosed with migraines and given medication. Months later, her symptoms worsened, and further consultation at a different hospital revealed that she had a brain tumor. By then, it was too late; the tumor had progressed to an inoperable stage.

Adamu Musa, a 52-year-old farmer from Kano, narrated the ordeal of his wife, Aisha. “My wife had severe stomach pains, and the doctors said it was ulcers. They gave her drugs, but the pain didn’t stop. After months of suffering, we found out it was appendicitis, and it had ruptured. She didn’t survive the surgery.”

Several Nigerians have harrowed experiences with wrong diagnoses. For some, the consequences were fatal; for others, they resulted in long-term health complications. Despite the advancements in medical technology and the presence of skilled professionals, systemic issues continue to hinder proper diagnosis and treatment. Overburdened hospitals, inadequate diagnostic tools, and a lack of continuity in patient care are just some of the challenges that contribute to such tragic outcomes.

Speaking with Casmir Ifeanyi, a scientist and National President Association of Medical Laboratory Scientist of Nigeria (AMLSN), on how to address the issues of wrong diagnosis and misdiagnosis, he said: “It is my agenda for the next three years as president to eliminate quackery; to bring down the issue of wrong diagnosis and misdiagnosis,” he said.

Ifeanyi said that there are both anthropological reasons and human factors that contribute to these diagnostic errors.

Ifeanyi pointed out that resource-related factors and inadequate infrastructure also play significant roles in the prevalence of wrong diagnoses.

“In Nigeria today, we have well over 500,000 medical laboratories, but not up to 8,000 of these are registered with the Medical Laboratory Science Council of Nigeria. So, you can see that the differential is quite huge for illicit operations of medical laboratories that provide all forms of testing in Nigeria,” he said.

Weak governance structures, a fragile regulatory framework, and lack of political will from regulators and the government have led to a proliferation of these unregistered laboratories, often staffed by unqualified personnel.

“Because of weak governance structures, weak regulatory framework, and lack of political will on the part of the regulators, including government, we have a preponderance of these outlets largely manned by quacks and charlatans,” Ifeanyi explained.

Read also: Obi calls for reform of Nigeria’s healthcare, says life expectancy among lowest

Ifeanyi categorised quacks into two groups: obligate quacks and facultative quacks. “Obligate quacks are people who studied microbiology, biochemistry, science laboratory technology, and other related biological courses who now think they can provide laboratory testing. Facultative quacks are doctors, nurses, physiotherapists, and any healthcare practitioner by default who is not a laboratory scientist,” he said.

He stressed the importance of accuracy, precision, and reproducibility in medical laboratory results, which are often compromised by quacks. “Every medical laboratory’s result must be reproducible, accurate, and precise, and these are factors you cannot compromise in test results,” Ifeanyi asserted.

One of the major concerns is the recruitment of unqualified personnel by government officials. “Another worry for wrong diagnosis, misdiagnosis, and fake results everywhere is because we have a situation where government officials recruit quacks and make sure they are employed. These people are not the right human resources for medical laboratory testing because we need to protect the lives of Nigerians,” Ifeanyi warned.

He revealed that unqualified individuals, such as an industrial chemist in Abuja, are often employed to perform the duties of laboratory scientists.

“In Abuja, an industrial chemist was employed to do the job of a lab scientist. These are the human elements and various causes of wrong diagnosis and misdiagnosis,” he said.

Additionally, Nigeria faces a lack of proper regulation and standards for diagnostics, making it a dumping ground for substandard kits, equipment, chemicals, and diagnostics. “These are dumped here, even when practitioners are genuine and have good intentions, they do not have a way of discriminating, and they buy these things and use them, which later results in wrong results, misdiagnosis, or fake results in the long run,” Ifeanyi said.

Also, Bayo Sekumade, a medical doctor in Lagos, said, this growing distrust in laboratory findings has serious implications for patient care and the overall healthcare system.

Describing the situation: “We frequently encounter lab results that just don’t add up with clinical observations. This discrepancy forces us to question their validity, often delaying crucial treatments.”

One of the main reasons for the increase in rejected lab results is the quality of medical laboratories themselves. Many labs in Nigeria lack modern equipment and sufficient staff training, leading to errors in test results.

As Sekumade explains, “Many laboratories are not adequately equipped. They often use outdated machines and lack the resources to maintain them properly. This inevitably leads to inaccuracies.”

Indeed, the working conditions in many Nigerian hospitals are far from ideal. Overcrowded wards, outdated equipment, and a shortage of essential drugs are commonplace. Health workers are often forced to work long hours without adequate rest, leading to burnout and errors in diagnosis.

Sekumade said, “Sometimes, it’s not even about incompetence. It’s about the system failing us. We don’t have the right tools to make accurate diagnoses. Imagine trying to diagnose complex conditions without proper imaging machines or lab tests. It’s a nightmare.”

The impact of wrong diagnoses extends beyond the loss of lives. Families are left devastated, and communities are plunged into grief. The economic burden is also significant, as families often spend their life savings on treatments that ultimately fail.

Ngozi Nkem, a market trader in Lagos, recalls the financial strain her family faced. “My brother had a wrong diagnosis for his heart condition. We spent everything we had on treatments and surgeries, only to lose him in the end. Now, we’re not just mourning him; we’re struggling to survive financially.”

The rising cases of misdiagnoses have led to a growing mistrust in the healthcare system. Many Nigerians are now resorting to alternative medicine, traditional healers, or self-medication, further complicating their health issues. The cycle of mistrust and poor healthcare outcomes continues, deepening the crisis.

However, addressing these, many experts have recommended the need to invest in healthcare infrastructure, particularly in modernising diagnostic equipment and facilities. Also, the government and private sector must collaborate to ensure that all medical laboratories meet standardised quality benchmarks.

Additionally, a robust regulatory framework is essential. Establishing national accreditation standards for laboratories can help ensure consistency and reliability in test results. Regular audits and assessments of lab practices would enforce these standards and identify areas needing improvement.