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. 2019 May 29;33(Suppl 2):8.
doi: 10.11604/pamj.supp.2019.33.2.17366. eCollection 2019.

Enhancing laboratory capacity during Ebola virus disease (EVD) heightened surveillance in Liberia: lessons learned and recommendations

Victoria Katawera  1 , Henry Kohar  2 , Nuha Mahmoud  1 , Philomena Raftery  1 , Christine Wasunna  3 , Ben Humrighouse  4 , Patrick Hardy  2 , John Saindon  4 , Randal Schoepp  5 , Monear Makvandi  6 , Lisa Hensley  7 , Orla Condell  1 , Kara Durski  8 , Shalini Singaravelu  8 , Laetitia Gahimbare  1 , Gene Olinger  7 , Francis Kateh  2 , Dhamari Naidoo  8 , Peter Nsubuga  9 , Pierre Formenty  8 , Tolbert Nyenswah  2 , Sheick Oumar Coulibaly  10 , Joseph Chukwudi Okeibunor  10 , Ambrose Talisuna  10 , Ali Ahmed Yahaya  10 , Soatiana Rajatonirina  10 , Desmond Williams  4 , Bernice Dahn  2 , Alex Gasasira  1   2   3   4   5   6   7   8   9   10 , Ibrahima Socé Fall  10
Affiliations

Enhancing laboratory capacity during Ebola virus disease (EVD) heightened surveillance in Liberia: lessons learned and recommendations

Victoria Katawera et al. Pan Afr Med J. .

Abstract

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.

Keywords: Ebola Virus Disease; Laboratory capacity; enhanced surveillance.

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Conflict of interest statement

The authors declare no competing interest.

Figures

Figure 1
Figure 1
Distribution of Ebola Virus Disease testing laboratories per county and administrative region during heightened surveillance in Liberia, 2015
Figure 2
Figure 2
Laboratory capacity indicating specific intervention points during enhanced surveillance in Liberia, 2015
See this image and copyright information in PMC

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