Lessons from the Field

The deployment of mobile diagnostic laboratories for Ebola virus disease diagnostics in Sierra Leone and Guinea

Lance D. Presser, Jeanette Coffin, Lamine Koivogui, Allan Campbell, Julian Campbell, Fatmata Barrie, Jone Ngobeh, Zein Souma, Samuel Sorie, Doris Harding, Alimou Camara, Pepe Tohonamou, Basala Traore, Frank A. Hamill, Joe Bogan, Sharon Altmann, Casey Ross, Jay Mansheim, Robert Hegerty, Scott Poynter, Scott Shearrer, Carmen Asbun, Brendan Karlstrand, Phil Davis, Jane Alam, David Roberts, Paul D. Stamper, Jean Ndjomou, Nadia Wauquier, Mohamed Koroma, Alhaji Munu, Jason McClintock, Mar Mar, True Burns, Stephen Krcha
African Journal of Laboratory Medicine | Vol 10, No 1 | a1414 | DOI: https://doi.org/10.4102/ajlm.v10i1.1414 | © 2021 Lance D. Presser, Jeanette Coffin, Lamine Koivogui, Allan Campbell, Julian Campbell, Fatmata Barrie, Jone Ngobeh, Zein Souma, Samuel Sorie, Doris Harding, Alimou Camara, Pepe Tohonamou, Basala Traore, Frank A. Hamill, Joe Bogan, Sharon Altmann, Casey Ross | This work is licensed under CC Attribution 4.0
Submitted: 29 September 2020 | Published: 22 October 2021

About the author(s)

Lance D. Presser, Global Engagement Program, MRIGlobal, Gaithersburg, Maryland, United States
Jeanette Coffin, Global Engagement Program, MRIGlobal, Gaithersburg, Maryland, United States
Lamine Koivogui, Centre de Recherche et de Formation en Infectiologie de Guinée, Université Gamal Abdel Nasser de Conakry, Conakry, Guinea
Allan Campbell, Central Public Health Reference Laboratory, Freetown, Sierra Leone
Julian Campbell, Central Public Health Reference Laboratory, Freetown, Sierra Leone
Fatmata Barrie, Central Public Health Reference Laboratory, Freetown, Sierra Leone
Jone Ngobeh, Central Public Health Reference Laboratory, Freetown, Sierra Leone
Zein Souma, Central Public Health Reference Laboratory, Freetown, Sierra Leone
Samuel Sorie, Central Public Health Reference Laboratory, Freetown, Sierra Leone
Doris Harding, Central Public Health Reference Laboratory, Freetown, Sierra Leone
Alimou Camara, Institut National de Santé Publique, Conakry, Guinea
Pepe Tohonamou, Institut National de Santé Publique, Conakry, Guinea
Basala Traore, Institut National de Santé Publique, Conakry, Guinea
Frank A. Hamill, Global Engagement Program, MRIGlobal, Gaithersburg, Maryland, United States
Joe Bogan, Global Engagement Program, MRIGlobal, Gaithersburg, Maryland, United States
Sharon Altmann, Global Engagement Program, MRIGlobal, Gaithersburg, Maryland, United States
Casey Ross, Global Engagement Program, MRIGlobal, Gaithersburg, Maryland, United States
Jay Mansheim, Global Engagement Program, MRIGlobal, Gaithersburg, Maryland, United States
Robert Hegerty, Global Engagement Program, MRIGlobal, Gaithersburg, Maryland, United States
Scott Poynter, Global Engagement Program, MRIGlobal, Gaithersburg, Maryland, United States
Scott Shearrer, Global Engagement Program, MRIGlobal, Gaithersburg, Maryland, United States
Carmen Asbun, Global Engagement Program, MRIGlobal, Gaithersburg, Maryland, United States
Brendan Karlstrand, Global Engagement Program, MRIGlobal, Gaithersburg, Maryland, United States
Phil Davis, Global Engagement Program, MRIGlobal, Gaithersburg, Maryland, United States
Jane Alam, Global Engagement Program, MRIGlobal, Gaithersburg, Maryland, United States
David Roberts, Global Engagement Program, MRIGlobal, Gaithersburg, Maryland, United States
Paul D. Stamper, Global Engagement Program, MRIGlobal, Gaithersburg, Maryland, United States
Jean Ndjomou, Global Engagement Program, MRIGlobal, Gaithersburg, Maryland, United States
Nadia Wauquier, Global Engagement Program, MRIGlobal, Gaithersburg, Maryland, United States
Mohamed Koroma, Global Engagement Program, MRIGlobal, Gaithersburg, Maryland, United States
Alhaji Munu, Global Engagement Program, MRIGlobal, Gaithersburg, Maryland, United States
Jason McClintock, Global Engagement Program, MRIGlobal, Gaithersburg, Maryland, United States
Mar Mar, Global Engagement Program, MRIGlobal, Gaithersburg, Maryland, United States
True Burns, Global Engagement Program, MRIGlobal, Gaithersburg, Maryland, United States
Stephen Krcha, Global Engagement Program, MRIGlobal, Gaithersburg, Maryland, United States


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Abstract

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: 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: 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: 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.


Keywords

Ebola; Ebola virus; Sierra Leone; Guinea; diagnostics; laboratory capacity; service expansion; epidemic; outbreak; outbreak response; West Africa; mobile diagnostic laboratories

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