Regional Laboratory Research Articles

Comparison of MIC Test Strip and reference broth microdilution method for amphotericin B and azoles susceptibility testing on wild type and non-wild type Aspergillus species.

This study was performed to evaluate whether the MIC Test Strip (MTS) quantitative assay for determining the minimum inhibitory concentration (MIC) correlated with the CLSI reference broth microdilution method (BMD) for antifungal susceptibility testing of wild-type and non-wild-type Aspergillus species isolated from cystic fibrosis patients against antifungal agents known to be usually effective against Aspergillus spp. This study was performed to assist in the decision-making process for possible deployment of the MTS assay for antimicrobial susceptibility testing of Aspergillus species into regional public health laboratories of Mycology due to difficulties in equipping the reference BMD methods in a laboratory routine. For this purpose, a set of 40 phenotypically diverse isolates (27 wild-type, 9 non-wild-type, and 4 species with reduced susceptibility to azoles and amphotericin B (AMB)) collected from clinical samples were tested. MICs were performed by both MTS and reference BMD for AMB, and azoles. MTS results for posaconazole correlated well with reference BMD rendering an almost perfect agreement (kappa value=1.000) by category interpretation (CI)/category distribution of MICs (CDM) (100%) while voriconazole MTS results yielded a substantial correlation with BMD (kappa value=0.788) by CI/CDM (97.5%). In contrast, itraconazole and AMB yielded the poorest correlation with BMD, rendering a moderate agreement (kappa values of 0.554 and 0.437, respectively) by CI/CDM (87.5% and 85%, respectively). In conclusion, the MTS method represents a valid option for antimicrobial susceptibility testing of Aspergillus species against posaconazole and voriconazole. Itraconazole and AMB MTS results showed some concerning lack of correlation with the corresponding reference BMD results.

Estimation and Characterization of Dengue Serotypes in Patients Presenting with Dengue Fever at Makkah Hospitals.

Dengue fever is caused by four common serotypes of the dengue virus (DENV-1, DENV-2, DENV-3, and DENV-4). Patients infected with one serotype may develop lifelong serotype-specific protective immunity. However, they remain susceptible to reinfection with the other serotypes, often increasing the risk of severe forms of dengue. This cross-sectional study investigates the prevalence of the four dengue serotypes in patients who presented with dengue fever at Makkah hospitals between April 2023 and May 2024. Data were collected from the medical records of the Regional Laboratory in Makkah, Saudi Arabia. The 238 positive dengue samples included 185 samples (77.73%) from male patients. The average age of the patients was 37.65 years (SD = 15.05). Dengue type 2 was the most common serotype, followed by type 1, type 3, and type 4. Most of the dengue patients were Saudi nationals, followed by Egyptians. There were 11 dengue-positive samples that were not diagnosed with any of the four dengue serotypes. Since Makkah receives numerous international travelers, these samples might contain novel dengue serotypes circulating in different parts of the world. This study underscores the need for the continuous monitoring of dengue serotypes to predict potential outbreaks and mitigate the risk of severe dengue in susceptible populations.

Analysis of glycemic control in diabetic patients by monitoring HbA1c levels before, during and after Covid-19 confinement in Auvergne, France.

To describe glycemic control in diabetic patients monitored by glycated hemoglobin (HbA1c) before, during and after COVID-19 confinement. To identify factors, measured before confinement, associated with HbA1c testing during confinement and those associated with a 1 % increase in HbA1c after confinement. Retrospective, descriptive study of diabetic patients over 18 years old who underwent at least one HbA1c test before and after confinement. The data were collected from medical analysis laboratories in the Auvergne region (France) and included HbA1c measurements between March 17, 2019, and May 11, 2021, age, sex, residential area, and medical specialty of the prescribing physician. 70,286 patients were included (54.1 % men, mean age 71.7 ± 13.1 years). The average preconfinement HbA1c level (6.80 % ± 1.16) was similar to the average post-confinement HbA1c level (6.80 % ± 1.14). A larger median reduction of 0.90 % points in HbA1c level in the year following confinement was observed in patients whose preconfinement HbA1c level was ≥ 9 %. Only 24.5 % of the patients had an HbA1c test performed during confinement, the majority of whom were over 80 years of age and had an average HbA1c level between 7 and 9 % before confinement. For 5.1 % of the patients, the average HbA1c level increased by one percentage point or more after confinement. Patients ≤ 64, those with an insufficient number of blood tests before confinement and those with an imbalance in HbA1c before confinement were at risk of glycemic imbalance after confinement. Confinement had no impact on HbA1c levels in diabetic patients.

Significance of NAT in the Identification of HBV Infections and HCV Infections Among Serologically Negative Blood Donors in Hail, Saudi Arabia.

Hepatitis C virus (HCV) and hepatitis B virus (HBV) infections pose significant global health concerns, contributing to chronic liver diseases. Blood transfusion is identified as a potential route for the transmission of these viruses, necessitating effective screening strategies for blood donors. The aim of this study was to assess the significance of nucleic acid testing (NAT) in detecting HBV and HCV infections among blood donors who initially tested negative in serological tests. Additionally, the study aimed to determine the seroprevalence of HBV and HCV infections among blood donors in Hail. A total of 23,954 records were retrieved from voluntary blood donors at Hail Regional Laboratory and Blood Bank from January 2020 to April 2023. ‎Chi-squared tests were used to assess the association between the serological and NAT results, while t-tests were employed to compare the means of continuous variables. Numbers of the reactive ELISA serological methods or screening were 36 (0.15%) for HBs Ag, 931 (3.6%) for HBcAb, 57 (0.23%) for HBsAb, and finally, 57 (0.23%) for HCV Ab. Seroprevalence was low, with a prevalence rate of 0.15% for HBV and 0.23% for HCV. The study compared serological and nucleic acid testing results for hepatitis B and C infections; a small percentage (0.01%) showed reactive NAT results, indicating early acute infections that may have been missed by serological testing alone. The study concludes that incorporating NAT into blood screening protocols is crucial for enhancing early infection detection and reducing risk of transfusion-transmitted infections. Low seroprevalence rate suggests effectiveness of existing preventive measures.

Prevalence of Vitamin D Deficiency With Biochemical Abnormalities in Children Undergoing Vitamin D Testing.

Vitamin D deficiency (VDD) in children can cause hypocalcaemia and rickets, but the prevalence of these complications and the 25-hydroxyvitamin D (25OHD) concentrations below which they arise is uncertain. We investigated this in children (< 18 years) with 25OHD measurements. We obtained 25OHD results from the regional laboratory database, alongside albumin-adjusted serum calcium (aCa), parathyroid hormone (PTH) and alkaline phosphatase (ALP) within 6 months of the index 25OHD. We defined confirmed VDD with biochemical abnormalities (VDDba) as all of low aCa, elevated PTH and elevated ALP. Possible/potential VDDba were defined as 2/3 VDDba criteria with the third test missing (possible), or in the normal range (potential). Clinical records of identified cases were reviewed, and a consensus diagnosis was reached. A total of 30,663 25OHD measurements were identified over 11.5 years (1 January 2009 to 15 June 2020); mean age 8 y, 47% female. After excluding ineligible results, 12,858 25OHD measurements from 9516 individuals with ≥ 2 aCa, PTH and ALP were analysed. Median 25OHD was 61 nmol/L; 36% < 50 nmol/L, 10% < 25 nmol/L. In total, 152 index 25OHD measurements were categorised as VDDba (30 confirmed, 23 possible and 99 potential). Following record review, 118 individuals (111 < 3 years) had 120 clinically confirmed VDDba episodes (62 clinical rickets, 15 biochemical rickets, 16 hypocalcaemia, 23 secondary hyperparathyroidism and 4 partially treated rickets). Fifty-six had undetectable 25OHD, and 104 < 25 nmol/L. The proportion of clinically confirmed VDDba was 0.9% for all eligible 25OHD measurements, and 8% for 25OHD < 25 nmol/L. VDDba is uncommon in children undergoing 25OHD testing, and occurs almost entirely in children < 3 years.

Microbiological water quality assessment of swimming pools and jacuzzis in Northern Greece: a retrospective study.

Swimming pools and jacuzzis can pose significant public health risks as potential sources of infections. The present study aimed to evaluate the prevalence and concentration of microbiological indicators in recreational water facilities in Thessaloniki, Northern Greece, focusing on their hygiene status before and after the COVID-19 pandemic. Between January 2018 and December 2022, 1114 water samples were analyzed by the regional Water Hygiene Laboratory at Aristotle University of Thessaloniki, using standardized ISO methods. Jacuzzis exhibited the highest microbial contamination, particularly for Pseudomonas aeruginosa (19.7%), while indoor adult pools showed the lowest. Overall, P. aeruginosa was found in 12.4% of samples, with the highest concentrations in jacuzzis (median: 30 CFU/100 ml). Significant seasonal variations were identified in the prevalence of total microbial flora (p < 0.001) and total coliforms (p = 0.03), as well as in the concentration of residual chlorine (p = 0.023). During the COVID-19 pandemic, microbial prevalence decreased across facilities. We concluded a strong compliance with Greek and international microbiological standards. The decline in microbial prevalence overtime likely reflects the impact of the strict hygiene measures implemented during the pandemic. These findings highlight the importance of maintaining rigorous hygiene practices to protect public health.

Healthcare waste management knowledge, attitudes and practices of laboratory workers at a regional hospital, Lesotho.

Safe management of healthcare waste (HW) safeguards laboratory biosafety and biosecurity. Knowledge and attitudes influence HW practices, presenting a need for evidence of the current status. This study assessed the knowledge, attitudes and practice of laboratory workers towards waste management at a regional hospital laboratory in Lesotho. The study was conducted from March 2023 to June 2023 using a mixed-methods descriptive case study design. The entire population (n = 30) of technical and non-technical laboratory workers and generated waste were sampled. A structured questionnaire and an observational checklist were used to collect data. Waste generation was assessed by weighing and measuring waste volumes. Data were analysed using descriptive statistics. All respondents (26/26; 100%) can define HW and (3/3) laboratory assistants (100%) gave correct responses for three questions, namely: risk associated with HW, waste container colour-coding, and disposal requirements. Knowledge on waste management responsibilities ranged between 0% (0/4) for cleaners and 54.5% (6/11) among laboratory technicians. Attitudes were mainly positive, and practices conformed in part to standard operating procedures. Infectious solid waste comprised 77% of solid HW, while 63% of chemical liquid waste emanated from the full blood count area. Knowledge exists among workers and attitudes are predominantly positive; however, some unsafe practices continue, thus knowledge is not fully translated to safe practices. Regular training and measuring and recording of HW were recommended. The study contributes understanding of the status of HW knowledge, attitudes and management practices, highlighting the need for compliance monitoring.

Understanding the professional factors that impact the retention of pathology workers in regional, rural and remote Australia.

The objective of this study was to determine what professional factors impact the retention of pathology workers in regional, rural and remote Australia. A cross-sectional survey was used to collect data regarding the professional factors that impact the retention of regional, rural and remote pathology workers in Australia (n = 95). The survey focused on pathology workers' satisfaction with specific professional factors and how long they intended to stay in their current position. Regional, rural and remote (MM2-7) pathology laboratories in Australia. There were a total of 95 participants, including 24 phlebotomists/laboratory assistants, 34 medical laboratory scientists and 29 supervisors/managers, with the majority of participants being from New South Wales, Queensland and Western Australia. Significant positive associations were found between satisfaction with career advancement opportunities, workplace culture and maintaining professional skills with the retention of regional, rural and remote pathology workers. Open-ended responses indicated that personal factors also played an important role in pathology worker retention in regional, rural and remote communities. This study provides important insights into the professional factors that impact the retention of pathology workers in regional, rural and remote Australia. Personal factors were also found to play an important role in retention. These findings have highlighted the need for further research to be conducted to explore the relationship between professional and personal factors and how this impacts the retention of pathology workers in regional, rural and remote Australia.

Introduction of wastewater surveillance of SARS-CoV-2 in Ukraine

Abstract Since the Russian invasion, Ukraine has faced humanitarian crises and challenges in diseases surveillance. The primary healthcare (PHC) system struggled with growing numbers of internally displaced and wounded people. In October 2022, the PATH-led, USAID-funded Support TB Control Efforts in Ukraine (STBCEU) project, supported implementation of wastewater surveillance (WWS) for SARS-CoV-2 in four oblasts on request of the Ministry of Health (MoH), expanding to 18 oblasts by October 2023. Samples were collected from 64 sites twice per week and tested for SARS-CoV-2 and influenza A/B using BioExtract® Premium Mag test kits in regional laboratories. From October 2022 to April 2024, 4,784 samples were collected at municipal aqueducts, with SARS-CoV-2 delta and omicron variants detected across all regions. WWS sample results were compared with routine surveillance to assess trends in concentrations and reported cases among population. Gradual decrease in SARS-CoV-2 concentration to zero by May 29, 2023, coincided with a decrease in morbidity. In the last week of August 2023, the concentration of the SARS-CoV-2 in wastewater began its gradual increase with the beginning of new cases registration among the population within 2 weeks, by mid-September. From October 2023, SARS-CoV-2 dominated in 96.6% of positive WWS testing results; in other specimens, influenza and respiratory viruses have been identified. The implementation of WWS in Ukraine highlighted its effectiveness as a public health tool in settings where traditional surveillance methods are disrupted, providing timely data on the viral pathogens for outbreaks prediction and responses, underscoring its role in preventive health measures. The MOH of Ukraine recommended extending the method nationwide for routine surveillance of SARS-CoV-2 and other pathogens, enhancing Ukraine’s capacity to manage public health threats and strengthen the resilience of its health system against future crises. Key messages • WWS in Ukraine underscores its effectiveness as a public health tool, providing timely data on viral pathogens for outbreak prediction and response in disrupted settings. • Notable decline in SARS-CoV-2 concentration in wastewater correlates with reduced morbidity, highlighting WWS’s predictive value.

The association of NT-proBNP levels in atrial fibrillation patients and 3-year risk of heart hospitalization and death

Abstract Background NT-proBNP-levels are often elevated in patients with atrial fibrillation (AF), but their clinical use and interpretation for predicting subsequent cardiovascular events has not been explored in an all-comers setting. Aim To determine whether NT-proBNP levels are associated with the risk of subsequent heart failure (CHF) and/or death in patients with AF and its relation to prior CHF diagnosis Method All patients with new-onset AF (defined by ICD-code I48) who had an NT-proBNP-level within +/- 14 days of the date of the AF date measured in a regional laboratory repository between 2000-2021 were included in the analysis cohort. Patients were categorized into NT-proBNP level (pg/mL) &amp;lt;1000, 1000-1999, ≥2000. If several NT-proBNP-levels were measured, the maximal value was used. The association between NT-proBNP level and the outcome CHF hospitalization and/or death within 3 years of diagnosis was assessed in Cox regression analyses adjusted for baseline characteristic and medications. Since there was an interaction (p&amp;lt;0.001) between Nt-proBNP-level and prior/new-onset CHF at time of AF diagnosis and no known CHF, two separate analyses were performed in patients with or new-onset CHF and those without prior CHF. Results There were 10559 patients with AF and no CHF, and 11 257 with AF and CHF. There were 14% of patients with new-onset CHF at time of new-onset AF diagnosis. These were grouped together with patients with known CHF. Patients with no prior CHF were younger (76 years (95% CI 68-83) vs 80 (72-87), p&amp;lt;0.001), and healthier with less often diabetes (18.4% vs 24.5%, p&amp;lt;0.001), prior myocardial infarction (12.0% vs 24.3%), a lower CHA2DS2-VASc score (3.0 vs 5.0, p&amp;lt;0.001) and a lower median NT-proBNP level (1650 pg/mL (95% CI 702-3549) vs 4240 pg/mL (2160-8860), p&amp;lt;0.001). Among patients with AF and no prior CHF, the incidence rate in the lowest NT-proBNP level was low, but increased with higher levels (Table). Adjusting for covariates and medications, the risk of both CHF hospitalization and CHF/death compared to the reference category NTproBNP&amp;lt; 1000 pg/mL was nearly 2 and 3 times higher among those who with initial NT-proBNP level 1000-1999 and ≥ 2000. Among patients with AF and known CHF, the incidence rate of CHF hospitalization or CHF hospitalization/death at the same NT-proBNP-strata was several times higher compared to patients without known CHF. Adjusting for covariates, the risk increased for CHF hospitalization or CHF/hospitalization similarly for each strata as for patients without known CHF. AF patients without known HF but with the highest elevation of NTproBNP-level had a risk of subsequent hospitalization of heart failure which was higher than those with known heart failure and lowest NTproBNP-level. Conclusion A higher NTproBNP-level in patients with AF identifies patients at higher risk of CHF hospitalization and/or death in both patients with no and prior CHF.Table

B-206 Tick-borne disease molecular testing positivity and coinfection incidence in the northeastern united states: 2021-2023

Abstract Background The CDC estimates that Lyme disease affects hundreds of thousands of people each year in the United States. Tick-borne diseases caused by pathogens such as Anaplasma phagocytophilum, Babesia microti, Ehrlichia chaffeensis, and species of Borrelia follow a seasonal pattern due to the life cycle of disease-carrying ticks. In endemic areas, like the northeastern United States, the risk of coinfection by multiple tick-borne disease pathogens is higher and can complicate patient treatment. For example, while Anaplasma and Borrelia can be treated with doxycycline a Babesia coinfection would not be resolved with this medication. In this study, we performed a retrospective analysis of tick-borne disease molecular testing results to monitor positivity rates and incidence of coinfection. Methods This retrospective analysis included whole blood specimens submitted to a regional clinical laboratory in the northeastern United States for tick-borne disease molecular testing. Test results from 2021-2023 were analyzed for positivity rate trends and coinfection incidence. DNA was isolated from patient specimens and tested using laboratory developed real-time Taq polymerase PCR assays. Results Positivity rates for all tick-borne disease pathogens studied followed typical seasonal patterns (Table). Beginning in the early spring, as nymphs ended their dormancy and began to feed, infection rates of tick-borne disease climbed. Infections peaked in mid-summer and remained elevated through late autumn. For Anaplasma, a biphasic pattern was observed, with a smaller peak in late autumn when adult ticks are most active. Coinfections with Anaplasma and Babesia were observed in 136 specimens, while coinfections with Borrelia and Babesia were observed in 145 specimens. Conclusions Positivity rates for tick-borne disease pathogens followed expected seasonal patterns in the northeastern US. The incidence of coinfections involving Babesia microti highlights the importance of properly identifying tick-borne infections given the different treatment regimens indicated.

Assessment of the impact of gold panning on bacteriological parameters, heavy metals and cyanide in the waters of the Niger river in Guinea

Artisanal mining, or traditional gold panning, plays a key role in Guinea's socio-economic activities. Today, this ancestral activity has undergone changes with the introduction of new extraction techniques that affect the population's living environment. The aim of this study is to assess the impact of artisanal mining on bacteriological parameters, heavy metals and cyanide in the waters of the Niger River in Guinea. To carry out this work, we chose five (05) sites (sampling points), taking into account the intensity of the mining activity taking place around them and on the Niger. We took fifteen samples to determine bacteriological parameters (fecal coliforms, total coliforms and Escherichia coli), free cyanide and certain heavy metals at the regional water quality laboratory. This study enabled us to determine the impact of gold panning on bacteriological parameters, cyanide and certain heavy metals in the waters of the Niger River in Guinea, and to identify possible solutions. Conclusion and outlook: Analysis of the results shows that, overall, the water sampled is of good quality. However, some parameters at certain measurement sites showed signs of pollution.

Sausage meat product enriched by jida

The development strategy aimed at creating the independence of the use of our raw materials by domestic meat producers is currently achieving the following goals: building modern production facilities and introducing new primary and processing technologies; expanding the assortment of meat products. The scientific research works carried out during the development of technology for the production of meat products by replacing a certain amount of beef or chicken with vegetable raw materials are important. Production of meat products based on these raw materials allows effective use of local raw materials, production of functional products and expansion of the range of meat products. The purpose of the study is to consider the features of the production technology of sausage meat product enriched with jida. The article presents the processing of the meat product production technology by enriching its composition with raw materials of vegetable origin - jida powder and the analysis of the mineral content of the finished product. The research work was carried out at the "Food Engineering" department of the M. Auezov South Kazakhstan University and at the "Construction and Biochemical Materials" regional test laboratory of engineering profile. Raster electron microscope (REM) and inductively coupled plasma mass spectrometry (ICP-MS) methods were used to determine the amount of mineral substances in meat products - sausage. The specialty of this work is the technology of product production using vegetable raw materials to enrich the content of meat products - sausages with minerals. Vegetable raw material - jida powder, by using it in the production of functional meat products, enriches the mineral content of meat products, and also by replacing a small part of meat raw materials, contributes to increasing the yield of the product. Jida powder is a vegetable raw material that is soluble in cold water and rich in dietary fiber, vitamin C, flavonoids and organic acids and does not cause losses in the production of food product. Jida powder production technology consists of: cleaning berries from dust and impuri[1]ties (passing them through a sorting fan); crushing (optimal duration of berry crushing in the IV-1 crusher τ= 52-65 sec, rotation speed of the working body 12000 rpm); drying (dry in the sun for fruits with a high sugar content).

Profile of Laboratories With the Seal of the Clinical Laboratory Accreditation Program (PALC)

Objective: The objective of this study is to analyze clinical analysis laboratories accredited by the quality seal of the Clinical Laboratory Accreditation Program (PALC) in Brazil. Theoretical Framework: It presents the fundamentals of the research, covering the importance of hospital accreditation, PALC regulations, historical evolution of hospital quality, economic impact on health, quality management in clinical laboratories and the usefulness of quality indicators. Method: A documentary study was carried out, with descriptive and quantitative analysis. During the study period, 163 clinical laboratories were detected in the country accredited by the PALC seal. Results and Discussion: In the study, 163 accredited clinical laboratories were identified in Brazil, with only 32 laboratories in the entire northeast region. Where 92% of accredited laboratories are private and 82% are part of large national diagnostic networks. Highlighting the need for greater investment in quality seals, which better certify the quality of the laboratory service provided. Research Implications: The importance of policies and strategies to promote the accreditation of clinical laboratories stands out, especially in the northeast region of Brazil, aiming to improve the quality and reliability of health services provided to the population, in addition to promoting greater security in medical diagnoses. Originality/Value: This study contributes to the literature by highlighting the originality by examining the grographic distribution and the public and private nature of accredited clinical laboratories in Brazil. The relevance and value of this research are evidenced by its crucial role of accreditation in ensuring quality laboratory services, encouraging continuous improvement and patient confidence.

Promoting molecular diagnostic equity: assessing in-house real-time PCR for Neisseria gonorrhoeae in anal samples from MSM recruited in an outpatient setting in Morocco.

Gonorrhea is a prevalent sexually transmitted infection among men who have sex with men (MSM). In Morocco, the basic laboratory diagnosis of Neisseria gonorrhoeae (NG) is based on microscopy and, in some settings, on culture. However, no nucleic acid amplification test (NAAT) has been implemented for routine diagnosis of gonorrhoeae.The aim of this study is to assess the effectiveness of an in-house real-time PCR test for detecting N. gonorrhoeae DNA in anal swabs samples collected during an Integrated Behavioral and Biological survey. Samples from 245 MSM, recruited using a Respondent Driven Sampling, were collected and tested for NG infection using GeneXpert CT/NG assay (Cepheid, USA). An In-House real-time PCR technique targeting the pseudo gene porA was developed and used for a parallel investigation of the same infection. The reliability of the in-house RT-PCR was validated through tests of reproducibility, repeatability, limit of detection, and cross-reactivity with other bacteria. The intrinsic performance characteristics of the qRT-PCR were assessed, namely, the sensitivity, the specificity, the positive predictive value (PPV), and the negative predictive value (NPV). The GeneXpert CT/NG assay was adopted as a reference method. For N. gonorrhoeae detection, the in-house real-time PCR assay showed a sensitivity and specificity of 80% and 100%, respectively. The PPV of the assay was 100% and the NPV was 97.3%. The in-house real-time PCR assay has high specificity and sensitivity, and it emerges as a promising approach for detecting N. gonorrhoeae in clinical specimens, particularly in decentralized settings such as regional laboratories.

Economical Experimental Device for Evaluating Thermal Conductivity in Construction Materials under Limited Research Funding

African scientific research faces formidable challenges, particularly with limited access to state-of-the-art measurement instruments. The high cost associated with these devices presents a significant barrier for regional research laboratories, impeding their ability to conduct sophisticated experiments and gather precise data. This predicament not only hampers the individual laboratories but also has broader implications for the African scientific community and the advancement of knowledge in developing nations—the financial cost barrier considerably impacts the research quality of these laboratories. Reflection on technical and economical solutions needs to be quickly found to help these countries advance their research. In civil engineering, the thermal conductivity property is the most important measurement for characterizing heat transfer in construction materials. Existing devices (i.e., conductometers) in a laboratory are expensive (approximately EUR 30,000) and unavailable for some African laboratories. This study proposes a new and affordable device to evaluate thermal conductivity in construction materials. The method involves establishing a thermal flux between a heat source (from the Joule effect provided by steel wool where a current is circulating) and a cold source (generated by ice cubes) under steady-state conditions. The development of the cylindrical prototype is based on the comparative flux-meter method outlined in the measuring protocol of the ASTM E1225 standard document. Experiments were conducted on four distinct materials (polystyrene, wood, agglomerated wood, and rigid foam). The results indicate a correct correlation between the experimental values obtained from the newly developed prototype and the reference values found in the literature. For example, concerning the experimental polystyrene study, the detailed case analysis reveals a good correlation, with a deviation of only 4.88%. The percent error found falls within the acceptable range indicated by the standard recommendations of the ASTM E1225 standard, i.e., within 5% acceptable error.

Rapid regional mobile laboratory response and genomic monkeypox virus (MPXV) surveillance in seven East African Community partner states, August 2024: preparedness activities for the ongoing outbreak.

The East African Community (EAC) is experiencing an unprecedented, emerging mpox outbreak since July 2024 in five of eight partner states. We highlight rapid regional response measures, initiated August 2024 coordinated by EAC: field deployment of six mobile laboratories in Burundi, Rwanda, Uganda, Tanzania, Kenya, South Sudan to high-risk areas, donation of one mobile laboratory to Democratic Republic of the Congo and genomic monkeypox virus (MPXV) surveillance support. These interventions aim to limit local mpox spread and support international containment.

RE: 'Laboratory capacity expansion: lessons from establishing molecular testing in regional referral laboratories in Ethiopia'.

RE: 'Laboratory capacity expansion: lessons from establishing molecular testing in regional referral laboratories in Ethiopia'.

The Global Measles and Rubella Laboratory Network Supports High-Quality Surveillance.

With 762 laboratories, the Global Measles and Rubella Laboratory Network (GMRLN) is the largest laboratory network coordinated by the World Health Organization (WHO). Like the Global Polio Laboratory Network, the GMRLN has multiple tiers, including global specialized laboratories, regional reference laboratories, national laboratories, and, in some countries, subnational laboratories. Regional networks are supervised by regional laboratory coordinators reporting to a global coordinator at WHO headquarters. Laboratories in the GMRLN have strong links to national disease control and vaccination programs. The GMRLN's goal is to support member states in obtaining timely, complete, and reliable laboratory-based surveillance data for measles and rubella as part of the strategy for achieving measles and rubella elimination. Surveillance data are reported to the national program and are included in annual reports on the status of measles and rubella elimination to national verification committees for review by regional verification commissions. Quality within the GMRLN is ensured by monitoring performance through external quality assurance programs, confirmatory and quality control testing, accreditation, and coordination of corrective action and training where needed. The overall performance of the laboratories has remained high over the years despite many challenges, particularly the COVID-19 pandemic. The GMRLN is well-positioned to support high-quality laboratory-based surveillance for measles and rubella and to transition to supporting laboratory testing for other pathogens, including vaccine-preventable diseases.

Respiratory diphtheria in the time of Omicron.

Diphtheria is a potentially fatal bacterial infection caused by toxin-producing strains of corynebacteria, most often Corynebacterium diphtheriae and less commonly Corynebacterium ulcerans. Incidence of the disease has fallen significantly since the introduction of vaccination programs; it is now rare in countries with high vaccination coverage such as Australia. This article presents the most recent respiratory cases of diphtheria in two children in New South Wales-the first locally acquired childhood cases in Australia in 30 years-and discusses potential contributing factors. These encompass the lack of clinical awareness and the delays in laboratory diagnosis in regional laboratories. The cases also highlight the problem of vaccine hesitancy and the role that primary carers play in addressing these anxieties. While clinical management of the cases progressed well, factors in the public health responses were complicated by access to appropriate care and by delays in antibiotic sensitivity profiles. The public health response to these cases raises important considerations for clinicians and public health practitioners, including preparedness for rare and re-emerging diseases, the need for culturally safe environments and the importance of addressing vaccine hesitancy. Preparedness requires consideration of the capacity of regional health systems with fewer resources and of how public health departments can support response to multiple crises. Preparedness also relies on access to necessary diagnostic laboratory resources, on up-to-date guidelines, and on maintaining awareness among clinicians for these rare infections.