The deployment of mobile diagnostic laboratories for Ebola virus disease diagnostics in Sierra Leone and Guinea.
Ebola
Ebola virus
Guinea
Sierra Leone
West Africa
diagnostics
epidemic
laboratory capacity
mobile diagnostic laboratories
outbreak
outbreak response
service expansion
Journal
African journal of laboratory medicine
ISSN: 2225-2002
Titre abrégé: Afr J Lab Med
Pays: South Africa
ID NLM: 101603205
Informations de publication
Date de publication:
2021
2021
Historique:
received:
29
09
2020
accepted:
18
03
2021
entrez:
3
12
2021
pubmed:
4
12
2021
medline:
4
12
2021
Statut:
epublish
Résumé
Ebola virus emerged in West Africa in December 2013. The ease of mobility, porous borders, and lack of public health infrastructure led to the largest Ebola virus disease (EVD) outbreak to date. The 2013 EVD outbreak signalled the need for laboratory diagnostic capabilities in areas without strong public health systems. As part of the United States' Department of Defense response, MRIGlobal was contracted to design, fabricate, equip, deploy, and operate two mobile diagnostic laboratories (MDLs). The first laboratory analysed blood samples from patients in an adjacent Ebola Treatment Centre (ETC) and buccal swabs from the deceased in the community in Moyamba, Sierra Leone. The second laboratory was deployed to support an ETC in Conakry, Guinea. The Department of Defense provided real-time quantitative reverse transcription polymerase chain reaction assays that were deployed and validated on-site. Prompt and accurate molecular diagnostics reduced sample turn-around times from over 24 h to under 4 h. Experienced laboratory staff tested up to 110 samples per day and on-site engineering proved necessary for MDL setup and operation. As the Ebola response slowed, the sustainment of the MDLs' operations was prioritised, including staff training and the transition of the MDLs to local governments. Training programmes for local staff were prepared in Sierra Leone and Guinea. The MRIGlobal MDL team significantly contributed to establishing increased laboratory capacity during the EVD outbreak in West Africa. Using the MDLs for molecular diagnosis is highly recommended until more sustainable solutions can be provided.
Sections du résumé
BACKGROUND
BACKGROUND
Ebola virus emerged in West Africa in December 2013. The ease of mobility, porous borders, and lack of public health infrastructure led to the largest Ebola virus disease (EVD) outbreak to date.
INTERVENTION
METHODS
The 2013 EVD outbreak signalled the need for laboratory diagnostic capabilities in areas without strong public health systems. As part of the United States' Department of Defense response, MRIGlobal was contracted to design, fabricate, equip, deploy, and operate two mobile diagnostic laboratories (MDLs). The first laboratory analysed blood samples from patients in an adjacent Ebola Treatment Centre (ETC) and buccal swabs from the deceased in the community in Moyamba, Sierra Leone. The second laboratory was deployed to support an ETC in Conakry, Guinea. The Department of Defense provided real-time quantitative reverse transcription polymerase chain reaction assays that were deployed and validated on-site.
LESSONS LEARNT
CONCLUSIONS
Prompt and accurate molecular diagnostics reduced sample turn-around times from over 24 h to under 4 h. Experienced laboratory staff tested up to 110 samples per day and on-site engineering proved necessary for MDL setup and operation. As the Ebola response slowed, the sustainment of the MDLs' operations was prioritised, including staff training and the transition of the MDLs to local governments. Training programmes for local staff were prepared in Sierra Leone and Guinea.
RECOMMENDATIONS
CONCLUSIONS
The MRIGlobal MDL team significantly contributed to establishing increased laboratory capacity during the EVD outbreak in West Africa. Using the MDLs for molecular diagnosis is highly recommended until more sustainable solutions can be provided.
Identifiants
pubmed: 34858796
doi: 10.4102/ajlm.v10i1.1414
pii: AJLM-10-1414
pmc: PMC8603149
doi:
Types de publication
Journal Article
Langues
eng
Pagination
1414Informations de copyright
© 2021. The Authors.
Déclaration de conflit d'intérêts
The authors declare that they have no financial or personal relationships that may have inappropriately influenced them in writing this article.
Références
N Engl J Med. 2014 Oct 9;371(15):1418-25
pubmed: 24738640
MMWR Suppl. 2016 Jul 08;65(3):44-9
pubmed: 27389781
PLoS Negl Trop Dis. 2017 May 15;11(5):e0005622
pubmed: 28505171