Abstract
BackgroundIn August 2014, the National Institute for Communicable Diseases (NICD) in South Africa established a modular high-biosafety field Ebola diagnostic laboratory (SA FEDL) near Freetown, Sierra Leone in response to the rapidly increasing number of Ebola virus disease (EVD) cases.Methods and findingsThe SA FEDL operated in the Western Area of Sierra Leone, which remained a “hotspot” of the EVD epidemic for months. The FEDL was the only diagnostic capacity available to respond to the overwhelming demand for rapid EVD laboratory diagnosis for several weeks in the initial stages of the EVD crisis in the capital of Sierra Leone. Furthermore, the NICD set out to establish local capacity amongst Sierra Leonean nationals in all aspects of the FEDL functions from the outset. This led to the successful hand-over of the FEDL to the Sierra Leone Ministry of Health and Sanitation in March 2015. Between 25 August 2014 and 22 June 2016, the laboratory tested 11,250 specimens mostly from the Western Urban and Western Rural regions of Sierra Leone, of which 2,379 (21.14%) tested positive for Ebola virus RNA.ConclusionsThe bio-safety standards and the portability of the SA FEDL, offered a cost-effective and practical alternative for the rapid deployment of a field-operated high biocontainment facility. The SA FEDL teams demonstrated that it is highly beneficial to train the national staff in the course of formidable disease outbreak and accomplished their full integration into all operational and diagnostic aspects of the laboratory. This initiative contributed to the international efforts in bringing the EVD outbreak under control in Sierra Leone, as well as capacitating local African scientists and technologists to respond to diagnostic needs that might be required in future outbreaks of highly contagious pathogens.
Highlights
Ebola virus (EBOV) was previously only identified to cause outbreaks of Ebola virus disease (EVD) in central equatorial Africa [1], but emerged in West Africa in late 2013 in Guinea [2], and spread into Liberia in March, Sierra Leone in May, and Nigeria in late July 2014 [3]
South African (SA) Ebola modular high biosafety field laboratory in Sierra Leone course of formidable disease outbreak and accomplished their full integration into all operational and diagnostic aspects of the laboratory. This initiative contributed to the international efforts in bringing the EVD outbreak under control in Sierra Leone, as well as capacitating local African scientists and technologists to respond to diagnostic needs that might be required in future outbreaks of highly contagious pathogens
This paper describes the deployment, organisation, diagnostic and biosafety procedures utilised by the South African (SA) field Ebola diagnostic laboratory (FEDL) in Sierra Leone, the training of Sierra Leonean national staff during the EVD outbreak, laboratory results, and the hand-over of the SA FEDL to the Ministry of Health and Sanitation (SL MoHS) as a part of the SA EVD diagnostic capacity building initiative in West Africa
Summary
Ebola virus (EBOV) was previously only identified to cause outbreaks of Ebola virus disease (EVD) in central equatorial Africa [1], but emerged in West Africa in late 2013 in Guinea [2], and spread into Liberia in March, Sierra Leone in May, and Nigeria in late July 2014 [3]. The United Nations (UN) Security Council recognised the outbreak as a threat to peace and security on 19th September 2014 [5], and the UN Mission for Ebola Emergency Response (UNMEER) was deployed to combat the Ebola crisis in West Africa [6]. In August 2014, the National Institute for Communicable Diseases (NICD) in South Africa established a modular high-biosafety field Ebola diagnostic laboratory (SA FEDL) near Freetown, Sierra Leone in response to the rapidly increasing number of Ebola virus disease (EVD) cases
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