Enhancing laboratory capacity during Ebola virus disease (EVD) heightened surveillance in Liberia: lessons learned and recommendations
Enhancing laboratory capacity during Ebola virus disease (EVD) heightened surveillance in Liberia: lessons learned and recommendations
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DOI：
10.11604/pamj.supp.2019.33.2.17366
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发表时间：
2019-05-01
影响因子：
1.2
通讯作者：
Fall, Ibrahima Soce
中科院分区：
文献类型：
--
作者：
Katawera, Victoria;Kohar, Henry;Fall, Ibrahima Soce
导言：继世界卫生组织宣布利比里亚于2015年5月9日成功阻断埃博拉病毒传播后，该国进入加强监测期。在宣布之前，病例数量已经大幅减少，导致11个埃博拉检测实验室中的8个关闭。加强监测导致对实验室服务的需求突然增加。我们报告了加强实验室能力的干预措施、成果、经验教训和建议。方法：利用存档数据，报告旨在提高实验室能力的干预前后的情况。实验室能力的定义是具有埃博拉病毒病检测能力的实验室数量、合格工作人员数量、测试样本数量、积压样本、每日和激增检测能力以及周转时间。使用STATA 14(Stata Corporation，College Station，TX，USA)，报告了所有连续变量的中位数和趋势。结果：在2015年5月至12月期间，包括招聘和培训8名工作人员、建立一个埃博拉实验室设施、实施10个埃博拉基因Xpert诊断平台和建立轮班工作在内的干预措施使检测样本数量增加了8倍，样本积压减少到零，周转时间恢复到24小时。这使得能够建立一个更有效的监测系统，便于及时发现和遏制随后观察到的两个埃博拉病毒聚集性。结论：在高峰期有效加强实验室服务需要结合具体情况进行干预。建设和确保地方能力的可持续性是有效监测和应对疾病暴发努力的组成部分。
Introduction: following a declaration by the World Health Organization that Liberia had successfully interrupted Ebola virus transmission on May 9th, 2015; the country entered a period of enhanced surveillance. The number of cases had significantly reduced prior to the declaration, leading to closure of eight out of eleven Ebola testing laboratories. Enhanced surveillance led to an abrupt increase in demand for laboratory services. We report interventions, achievements, lessons learned and recommendations drawn from enhancing laboratory capacity.Methods: using archived data, we reported before and after interventions that aimed at increasing laboratory capacity. Laboratory capacity was defined by number of laboratories with Ebola Virus Disease (EVD) testing capacity, number of competent staff, number of specimens tested, specimen backlog, daily and surge testing capacity, and turnaround time. Using Stata 14 (Stata Corporation, College Station, TX, USA), medians and trends were reported for all continuous variables.Results: between May and December 2015, interventions including recruitment and training of eight staff, establishment of one EVD laboratory facility, implementation of ten Ebola GeneXpert diagnostic platforms, and establishment of working shifts yielded an 8-fold increase in number of specimens tested, a reduction in specimens backlog to zero, and restoration of turn-around time to 24 hours. This enabled a more efficient surveillance system that facilitated timely detection and containment of two EVD clusters observed thereafter.Conclusion: effective enhancement of laboratory services during high demand periods requires a combination of context-specific interventions. Building and ensuring sustainability of local capacity is an integral part of effective surveillance and disease outbreak response efforts.