Lessons from the Field

Pre-Ebola virus disease laboratory system and related challenges in Liberia

Stephen B. Kennedy, John B. Dogba, Christine L. Wasunna, Philip Sahr, Candace B. Eastman, Fatorma K. Bolay, Gloria T. Mason, Mark W.S. Kieh
African Journal of Laboratory Medicine | Vol 5, No 3 | a508 | DOI: https://doi.org/10.4102/ajlm.v5i3.508 | © 2016 Stephen B. Kennedy, John B. Dogba, Christine L. Wasunna, Philip Sahr, Candace B. Eastman, Fatorma K. Bolay, Gloria T. Mason, Mark W.S. Kieh | This work is licensed under CC Attribution 4.0
Submitted: 20 June 2016 | Published: 31 October 2016

About the author(s)

Stephen B. Kennedy, Incident Management System, Emergency Operations Center, Ministry of Health, Monrovia, Liberia and Partnership for Research on Ebola Virus in Liberia, Liberia-US Clinical Research Partnership Program, First Floor, John F. Kennedy Medical Center, Monrovia, Liberia
John B. Dogba, National Reference Laboratory, Ministry of Health, Charlesville, Margibi County, Liberia
Christine L. Wasunna, Partnership for Research on Ebola Virus in Liberia, Liberia-US Clinical Research Partnership Program, First Floor, John F. Kennedy Medical Center, Monrovi, Liberia
Philip Sahr, Partnership for Research on Ebola Virus in Liberia, Liberia-US Clinical Research Partnership Program, First Floor, John F. Kennedy Medical Center, Monrovia, Liberia and National Reference Laboratory, Ministry of Health, Charlesville, Margibi County, Liberia
Candace B. Eastman, Africabio Enterprises, Inc., Payne Avenue, Sinkor, Monrovia, Liberia
Fatorma K. Bolay, Partnership for Research on Ebola Virus in Liberia, Liberia-US Clinical Research Partnership Program, First Floor, John F. Kennedy Medical Center, Monrovia, Liberia; Liberia Institute for Biomedical Research, Ministry of Health, Charlesville, Margibi County, Liberia and National Research Ethics Board, Partnership for Research on Ebola Virus in Liberia, First Floor, John F. Kennedy Medical Center, Monrovia, Liberia
Gloria T. Mason, National Research Ethics Board, Partnership for Research on Ebola Virus in Liberia, First Floor, John F. Kennedy Medical Center, Monrovia, Liberia
Mark W.S. Kieh, Partnership for Research on Ebola Virus in Liberia, Liberia-US Clinical Research Partnership Program, First Floor, John F. Kennedy Medical Center, Monrovia, Liberia


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Abstract

Prior to the Ebola virus disease outbreak in Liberia, the laboratory system was duplicativefragmented and minimally coordinated. The National Reference Laboratory was conceptualisedto address the existing challenges by promoting the implementation of effective and sustainablelaboratory services in Liberia. However, in a resource-limited environment such as Liberiaprogress regarding the rebuilding of the health system can be relatively slow, while efforts tosustain the transient gains remain a key challenge for the Ministry of Health. In this paper, wedescribe the pre-Ebola virus disease laboratory system in Liberia and its prevailing efforts toaddress future emerging infectious diseases, as well as current Infectious diseases, all of whichare exacerbated by poverty. We conclude that laboratory and diagnostic services in Liberiahave encountered numerous challenges regarding its efforts to strengthen the healthcaredelivery system. These challenges include limited trained human resource capacity, inadequateinfrastructure, and a lack of coordination. As with most countries in sub-Saharan Africa, whencomparing urban and rural settings, diagnostic and clinical services are generally skewedtoward urban health facilities and private, faith-based health facilities. We recommend thatstructured policy be directed at these challenges for national institutions to develop guidelinesto improve, strengthen and sustain diagnostic and curative laboratory services to effectivelyaddress current infectious diseases and prepare for future emerging and re-emerging infectiousdiseases.


Keywords

Liberia; Laboratory System; Ministry of Health (MoH); Emerging Infectious Diseases (EIDs); Ebola Virus Diseases (EVD); Human Resource Capacity; Laboratory Diagnostic Services

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