Strengthening Biorisk Management Capacities in Burkina Faso: Contribution of the Global Health Security Agenda

Abstract

The Global Health Security Agenda and the International Health Regulations (2005) recommend that countries strengthen the capacity of their national laboratory systems to comply with the International Health Regulations. To efficiently and effectively direct these efforts, the US Centers for Disease Control and Prevention-in collaboration with the Ministry of Health Directorate of Laboratories, the African Society for Laboratory Medicine, and Integrated Quality Laboratory Service-assessed Burkina Faso's national laboratory system using the World Health Organization Laboratory Assessment Tool. Based on gaps observed in biorisk management, the Biosafety and Biosecurity Laboratory Assessment Tool (BSS LAT) was developed to assess 10 public laboratories handling dangerous pathogens. This tool uses a specific scoring matrix with quantitative output. Composite assessment scores for the 9 primary modules (capacity areas) were reported, with the highest scores reported in cleaning, disinfection, sterilization, waste management (42%), and good laboratory practices (40%), and the lowest scores in biosecurity/biosafety (33%), documents/regulations (18%), emergency management (16%), and risk management (5%). To address challenges identified in the assessments, a set of activities was planned with a focus on biorisk management. Results from an evaluation conducted 1 year later, using the BSS LAT, showed an increase in the average score of all indicators from 25% to 45% and an increase in the biorisk management module score from 5% to 35%. This evaluation process was a decisive step toward strengthening the capacity of the laboratory system in Burkina Faso. Global Health Security Agenda investments and activities have made a lasting impact on improving biosafety and biosecurity in public health laboratories. To ensure sustainability, a strong laboratory quality management program based on a mentorship system is greatly needed.

Keywords: Biorisk management; Burkina Faso; Global Health Security Agenda; Laboratory assessment; Laboratory safety.

Figure 1.

Timeframe of the implementation of activities. Abbreviations: BSS LAT, Biosafety and Biosecurity Laboratory Assessment Tool; BSC, biosafety cabinet.

Figure 2.

The evolution of the general indicator score between the initial assessment (conducted in 2017) and 1 year later (2018) using the Biosafety and Biosecurity Laboratory Assessment Tool. This score represents the average score of the mean score of the 9 modules.

Figure 3.

Summary of the results from the initial assessment (conducted in 2017) of biosafety and biosecurity compared with the results 1 year later (conducted in 2018) using the Biosafety and Biosecurity Laboratory Assessment Tool. Indicator abbreviations by category: (A) DM/PA, data management/preanalytical; FSA, facilities and safety assessment; PA, preanalytical; PC, premises control; WO, workflow organization. (B) BCT, biosafety continuous training; BO, biosafety officer; CA, competency assessment; IGK, introduction/general knowledge; IP, induction program; OH, occupational health; OR, organization and responsibilities; PF, personnel file; STBTO, safety training/biosafety before taking office. (C) AICM, analysis and implementation of corrective measures; ASM, audits, surveillance, monitoring: RAP, risk assessment performance; RAT, risk assessment training. (D) AM, aerosol management; APPE, availability of personal protective equipment; BCM, biosafety cabinet management; CDA, clean and dirty areas; DPM, dangerous pathogen management; E, equipment; GBGLP, general behavior/good laboratory practices; HW, handwashing; RSUC, reuse of single-use consumables; SP, sample preparation; SRS, specimen referral system; specimen transportation (ST). UPPE, use of personal protective equipment. (E) A, antiseptics; CD, cleaning and disinfecting; CS, cleaning staff; SG, sterilization in general; SMC, sterilization management and control; WE, waste elimination; WM, waste management. (F) AFC, availability of forms/checklist; AP-E, availability of procedures (emergency); AP-H, availability of procedures (hygiene, cleaning, disinfection); BM, biosafety manual; NR, national regulations; PA, procedure availability (good laboratory practices); PISS, product insert and safety sheets; PSSSG, presampling and sampling SOP/guideline; RLI, relationships of the laboratory with International Health Regulations. (G) BEE, biosafety emergency equipment; BSK, biological spill kit; CS, chemical safety; CSK, chemical spill kit; EM, emergency management; FAK, first aid kit; FP, fire prevention; GEE, general emergency equipment. (H) ITSPB, IT security protection and back up; LAE, laboratory access and evacuation; PM, pathogen management; SW, signage and warnings; TP, theft protection. (I) CR, chemical risks; ER, electrical risks; PR, physical risks.