Lessons from the Field

The laboratory health system and its response to the Ebola virus disease outbreak in Liberia

Stephen B. Kennedy, Christine L. Wasunna, John B. Dogba, Philip Sahr, Candace B. Eastman, Fatorma K. Bolay, Gloria T. Mason, Mark W.S. Kieh
African Journal of Laboratory Medicine | Vol 5, No 3 | a509 | DOI: https://doi.org/10.4102/ajlm.v5i3.509 | © 2016 Stephen B. Kennedy, Christine L. Wasunna, John B. Dogba, 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
Christine L. Wasunna, 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
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 3 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

The laboratory system in Liberia has generally been fragmented and uncoordinatedAccordingly, the country’s Ministry of Health established the National Reference Laboratoryto strengthen and sustain laboratory services. However, diagnostic testing services were oftenlimited to clinical tests performed in health facilities, with the functionality of the NationaReference Laboratory restricted to performing testing services for a limited number ofepidemic-prone diseases. The lack of testing capacity in-country for Lassa fever and otherhaemorrhagic fevers affected the response of the country’s health system during the onset ofthe Ebola virus disease (EVD) outbreak. Based on the experiences of the EVD outbreak, effortswere initiated to strengthen the laboratory system and infrastructure, enhance human resourcecapacity, and invest in diagnostic services and public health surveillance to inform admittancetreatment, and discharge decisions. In this article, we briefly describe the pre-EVD laboratorycapability in Liberia, and extensively explore the post-EVD strengthening initiatives to enhancecapacity, mobilise resources and coordinate disaster response with international partners torebuild the laboratory infrastructure in the country. Now that the EVD outbreak has endedadditional initiatives are needed to revise the laboratory strategic and operational plan forpost-EVD relevance, promote continual human resource capacity, institute accreditation andvalidation programmes, and coordinate the investment strategy to strengthen and sustain thepreparedness of the laboratory sector to mitigate future emerging and re-emerging infectiousdiseases.


Keywords

Liberia; Laboratory System; Capacity Building; Diagnostic Services; Public Health Surveillance

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