Abstract
BackgroundPast and recent outbreaks have highlighted the vulnerability of humans to infectious diseases, which represent serious economic and health security threats. A paradigm shift in the management of sanitary crises is urgently needed. Based on lessons from the 2014 Ebola outbreak, the Praesens Foundation has developed an all-terrain mobile biosafety laboratory (MBS-Lab) for effective field diagnostics capabilities.ObjectiveThe aim of the study was to train African teams and run a field evaluation of the MBS-Lab, including robustness, technical and operational sustainability, biosafety, connectivity, turn-around times for testing and result delivery.MethodsThe MBS-Lab was deployed in Senegal in October 2017 for a six-month field assessment under various ecological conditions and was mobilised during the dengue outbreaks in 2017 and 2018.ResultsThe MBS-Lab can be considered an off-grid solution that addresses field challenges with regard to working conditions, mobility, deployment, environment and personnel safety. Blood (n = 398) and nasal swab (n = 113) samples were collected from 460 study participants for molecular screening for acute febrile illnesses and respiratory infections. The results showed that malaria (particularly in Kédougou) and upper respiratory tract infections remain problematic. Suspected dengue samples were tested on board during the dengue outbreaks in 2017 (882 tests; 128 confirmed cases) and 2018 (1736 tests; 202 confirmed cases).ConclusionThe MBS-Lab is an innovative solution for outbreak response, even in remote areas. The study demonstrated successful local ownership and community engagement. The MBS-Lab can also be considered an open mobile healthcare platform that offers various opportunities for field-deployable, point-of-care technologies for surveillance programmes.
Highlights
Past and recent disease outbreaks have shown that infectious diseases continue to affect the lives of people, while representing social, economic and national security threats that can quickly evolve into global health crises.[1]
A total of 398 blood samples and 113 nasal swabs were screened using the commercial LightMix kits (TIB Molbiol, Berlin, Germany) based on a syndromic approach for the diagnosis of febrile infections, including malaria, those caused by Salmonella or arboviruses and respiratory diseases associated with influenza, parainfluenza, human metapneumovirus, adenovirus and respiratory syncytial viruses
The results showed that malaria remains problematic in Senegal, in the southern areas, where 60% (98/162) of the blood samples collected in Kédougou were positive (Table 1)
Summary
Past and recent disease outbreaks (e.g. severe acute respiratory syndrome, Middle East respiratory syndrome-related coronavirus, severe acute respiratory syndrome coronavirus, Ebola, Zika, dengue) have shown that infectious diseases continue to affect the lives of people, while representing social, economic and national security threats that can quickly evolve into global health crises.[1] For example, the 2014–2016 Ebola outbreak in West Africa cost $32.6 billion and resulted in the loss of 11 000 lives.[2] dengue fever has become endemic in Africa with recurrent outbreaks in different countries.[3,4,5] A parallel threat is the rise of antimicrobial resistance with an estimated 4.1 million deaths per year, expected to lead to a $42 trillion loss to the African economy by 2050.2 It is urgent to further strengthen infectious disease surveillance and outbreak preparedness. Based on lessons from the 2014 Ebola outbreak, the Praesens Foundation has developed an all-terrain mobile biosafety laboratory (MBS-Lab) for effective field diagnostics capabilities
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