Establishing Ebola Virus Disease (EVD) diagnostics using GeneXpert technology at a mobile laboratory in Liberia: Impact on outbreak response, case management and laboratory systems strengthening
| العنوان: | Establishing Ebola Virus Disease (EVD) diagnostics using GeneXpert technology at a mobile laboratory in Liberia: Impact on outbreak response, case management and laboratory systems strengthening |
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| المؤلفون: | Esther L Hamblion, Alex Gasasira, Ruth Zwizwai, Jonathan Kpaka, Evelyn Castle, Tolbert Nyenswah, Mark Miller, April Baller, John Saindon, Victoria Harris, Philip Bemah, Mahmood Nuha, Christine Wasunna, Philomena Raftery, Maxwell Freeman, Orla Condell, Victoria Katawera, Moses Massaquoi, Mosoka Fallah, Desmond E. Williams |
| المصدر: | PLoS Neglected Tropical Diseases PLoS Neglected Tropical Diseases, Vol 12, Iss 1, p e0006135 (2018) |
| سنة النشر: | 2017 |
| مصطلحات موضوعية: | 0301 basic medicine, RNA viruses, Viral Diseases, Research Facilities, Epidemiology, Physiology, Artificial Gene Amplification and Extension, medicine.disease_cause, Pathology and Laboratory Medicine, Polymerase Chain Reaction, Disease Outbreaks, Geographical Locations, 0302 clinical medicine, Medicine and Health Sciences, Medicine, 030212 general & internal medicine, Data Management, Disease surveillance, GeneXpert MTB/RIF, Emergency management, lcsh:Public aspects of medicine, Ebolavirus, Body Fluids, Infectious Diseases, Blood, Medical Microbiology, Preparedness, Filoviruses, Viral Pathogens, Epidemiological Monitoring, Viruses, Medical emergency, Pathogens, Anatomy, Research Laboratories, Ebola Virus, Research Article, Neglected Tropical Diseases, Computer and Information Sciences, lcsh:Arctic medicine. Tropical medicine, lcsh:RC955-962, Disease Surveillance, Research and Analysis Methods, Microbiology, Ebola Hemorrhagic Fever, 03 medical and health sciences, Humans, Molecular Biology Techniques, Microbial Pathogens, Molecular Biology, Viral Hemorrhagic Fevers, Ebola virus, Biology and life sciences, business.industry, Hemorrhagic Fever Viruses, Public Health, Environmental and Occupational Health, Organisms, Outbreak, lcsh:RA1-1270, Reverse Transcriptase-Polymerase Chain Reaction, Hemorrhagic Fever, Ebola, medicine.disease, Liberia, Tropical Diseases, 030104 developmental biology, People and Places, Africa, business, Case Management, Mobile Health Units, Government Laboratories |
| الوصف: | The 2014–16 Ebola Virus Disease (EVD) outbreak in West Africa highlighted the necessity for readily available, accurate and rapid diagnostics. The magnitude of the outbreak and the re-emergence of clusters of EVD cases following the declaration of interrupted transmission in Liberia, reinforced the need for sustained diagnostics to support surveillance and emergency preparedness. We describe implementation of the Xpert Ebola Assay, a rapid molecular diagnostic test run on the GeneXpert platform, at a mobile laboratory in Liberia and the subsequent impact on EVD outbreak response, case management and laboratory system strengthening. During the period of operation, site coordination, management and operational capacity was supported through a successful collaboration between Ministry of Health (MoH), World Health Organization (WHO) and international partners. A team of Liberian laboratory technicians were trained to conduct EVD diagnostics and the laboratory had capacity to test 64–100 blood specimens per day. Establishment of the laboratory significantly increased the daily testing capacity for EVD in Liberia, from 180 to 250 specimens at a time when the effectiveness of the surveillance system was threatened by insufficient diagnostic capacity. During the 18 months of operation, the laboratory tested a total of 9,063 blood specimens, including 21 EVD positives from six confirmed cases during two outbreaks. Following clearance of the significant backlog of untested EVD specimens in November 2015, a new cluster of EVD cases was detected at the laboratory. Collaboration between surveillance and laboratory coordination teams during this and a later outbreak in March 2016, facilitated timely and targeted response interventions. Specimens taken from cases during both outbreaks were analysed at the laboratory with results informing clinical management of patients and discharge decisions. The GeneXpert platform is easy to use, has relatively low running costs and can be integrated into other national diagnostic algorithms. The technology has on average a 2-hour sample-to-result time and allows for single specimen testing to overcome potential delays of batching. This model of a mobile laboratory equipped with Xpert Ebola test, staffed by local laboratory technicians, could serve to strengthen outbreak preparedness and response for future outbreaks of EVD in Liberia and the region. Author summary We describe a model of a mobile laboratory co-located at an Ebola treatment unit (ETU) equipped with GeneXpert molecular diagnostic platform and automated qRT-PCR test for Ebola virus disease (EVD). The laboratory contributed significantly to the EVD response in Liberia, including supporting surveillance, outbreak detection, contact tracing and management of confirmed cases. The laboratory was run by local laboratory technicians as opposed to international experts on short missions, making it a more sustainable option in prolonged outbreaks and early recovery phases. The redeployment and strategic placement of these GeneXpert instruments to complement EVD isolation facilities throughout the country has strengthened preparedness and response capabilities for future EVD outbreaks in Liberia. |
| وصف الملف: | application/pdf |
| تدمد: | 1935-2735 1935-2727 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::e98efd7ba80b15286a29ae1177a4eb10 https://pubmed.ncbi.nlm.nih.gov/29304039 |
| حقوق: | OPEN |
| رقم الأكسشن: | edsair.doi.dedup.....e98efd7ba80b15286a29ae1177a4eb10 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 19352735 19352727 |
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