Abstract
BackgroundResource-limited tropical countries are home to numerous infectious pathogens of both human and zoonotic origin. A capability for early detection to allow rapid outbreak containment and prevent spread to non-endemic regions is severely impaired by inadequate diagnostic laboratory capacity, the absence of a “cold chain” and the lack of highly trained personnel. Building up detection capacity in these countries by direct replication of the systems existing in developed countries is not a feasible approach and instead requires “leapfrogging” to the deployment of the newest diagnostic systems that do not have the infrastructure requirements of systems used in developed countries.MethodsA laboratory for molecular diagnostics of infectious agents was established in Bo, Sierra Leone with a hybrid solar/diesel/battery system to ensure stable power supply and a satellite modem to enable efficient communication. An array of room temperature stabilization and refrigeration technologies for reliable transport and storage of reagents and biological samples were also tested to ensure sustainable laboratory supplies for diagnostic assays.ResultsThe laboratory demonstrated its operational proficiency by conducting an investigation of a suspected avian influenza outbreak at a commercial poultry farm at Bo using broad range resequencing microarrays and real time RT-PCR. The results of the investigation excluded influenza viruses as a possible cause of the outbreak and indicated a link between the outbreak and the presence of Klebsiella pneumoniae.ConclusionsThis study demonstrated that by application of a carefully selected set of technologies and sufficient personnel training, it is feasible to deploy and effectively use a broad-range infectious pathogen detection technology in a severely resource-limited setting.
Highlights
Resource-limited tropical countries are home to numerous infectious pathogens of both human and zoonotic origin
Developing countries in tropical regions of the world are the home for numerous important infectious pathogens [1,2,3]
While outbreaks caused by highly lethal pathogens such as Ebola, Nipah or H5N1 influenza viruses are usually followed by high profile epidemiologic investigations, the everyday infectious disease diagnostics and epidemiological surveillance systems in many of these regions are only rudimentary, sub-Saharan Africa being one of the prime examples [16,17]. This situation is compounded by serious shortages of resources and trained personnel capable of performing diagnostic procedures
Summary
Resource-limited tropical countries are home to numerous infectious pathogens of both human and zoonotic origin. Many of these infectious agents may have their reservoirs in domesticated or wild animals [4,5,6,7,8] Since inhabitants of these countries live in relatively closer contact with animals, than populations of highly regions are only rudimentary, sub-Saharan Africa being one of the prime examples [16,17]. This situation is compounded by serious shortages of resources and trained personnel capable of performing diagnostic procedures. By the time of confirmation, there were approximately 200 confirmed cases and nearly 50 deaths were recorded [18,19]
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