A Coordinated Public Health Laboratory Response to COVID-19 in Mali

Bassirou Diarra,Daouda Keita,Aaron Neal,Mariame Sow,Lassina Doumbia,Oumar Dolo,Sidy Bane,Seydou Doumbia,Boureima Degoga,Amadou Somboro,Fanta Sanogo,Kadidia Kone,Dramane Diallo,Chuen-Yen Lau,Moumine Sanogo,Idrissa Sow,Ibréhima Guindo ,A Koné ,Mohamed K Abdou ,Y Coulibaly ,Hawa Mbaye Drame ,Yeya Sadio Sarro ,Fah Gaoussou Traoré ,Larissa Denou ,Anou M Somboro ,Akory Ag Iknane ,Josué Togo ,Mariam Goumane ,Ibrahima B Diallo ,Tenin Aminatou Coulibaly ,Kathryn Shaw-Saliba ,Oumou Ousmane Maiga ,Mariam Coulibaly ,Mahamane Talphi Diakite ,A Togo ,Mahamadou Koné ,Ousmane Koïta ,Mahamadou Diakité ,Lassana G Timbiné ,F Diallo ,G Coulibaly ,Bouréma Kouriba ,Hawa Diarra ,Fatoumata Camara

doi:10.3389/fitd.2021.788616

Abstract

Ability to rapidly and accurate diagnose pathogens during disease outbreaks is essential for public health. Diagnosis depends largely on laboratory capacity, which can be challenging in resource limited settings. We report Mali’s experience involving four research laboratories in response to the COVID-19 pandemic. This coordinated effort leveraged the emerging infectious pathogens diagnostic capacity and partnerships built from the 2014/2015 Ebola outbreak. Since Mali’s first two COVID-19 cases in March 2020, 349,292 suspected cases were tested in the four Bamako laboratories as of July 31, 2021. Laboratory operation, safety considerations, diagnostic assays, and challenges are described herein from the perspective of a participating laboratory, the Mali University Clinical Research Center (UCRC). We also highlight additional roles of the UCRC laboratory in the COVID-19 response, including roll out of vaccination and research efforts. Mali’s readiness to detect the index cases early in the epidemic and continued response to the COVID-19 pandemic highlight the need for strengthening the critical role and capacity of clinical research laboratories for response to emerging infectious disease epidemics in Africa.

Highlights

COVID-19 was first recognized in December 2019, though studies suggest it was circulating earlier
We have identified key components of developing laboratory capacity in resource limited settings (Box 1)
In-country laboratory diagnostic capacity is critical for responding to outbreaks of emerging and re-emerging infectious diseases such as the COVID-19

Summary

Introduction

COVID-19 was first recognized in December 2019, though studies suggest it was circulating earlier. There is considerable concern that low vaccination rates in Africa and circulating variants of concern will impair COVID-19 control. Rapid confirmation of COVID19 cases is important for patient management, and for limiting human-to-human transmission through immediate case isolation and contact tracing. In West Africa, suspected viral infectious disease specimens have generally been sent to the WHO Reference Laboratory at Pasteur Institute in Dakar, Senegal. COVID-19 has challenged this already suboptimal laboratory mechanism with high suspected case numbers, extended delays related to import and export regulations, complicated shipping logistics, air travel restrictions, and border closures, making use of a central referral laboratory for decision making impractical [1, 2]

Results

Discussion

Conclusion