Credit: MamaYe!/Sierra Leone

Strengthening laboratories for Ebola testing and diagnosis, Sierra Leone

The Ebola outbreak in 2014–2015 is the most significant and widespread ever recorded, with over 8,500 confirmed cases in Sierra Leone as of April 2015. Options works with the Ministry of Health and Sanitation (MoHS) to strengthen laboratory performance. In close collaboration with the Laboratory Technical Working Group (LTWG), we are supporting improvements in data management, information flows and laboratory system coordination to ensure prompt turnaround of Ebola test results.

Laboratories are an essential and fundamental part of all health systems. Despite this, many countries have seen little attention afforded to the strengthening of nationally coordinated laboratory services. The significant challenges facing the laboratory system and network in Sierra Leone have become particularly apparent during the current Ebola outbreak. Inadequate disease surveillance failed to identify Ebola and halt transmission. The laboratory system needed support to cope with the demands for rapid and reliable testing, and to ensure the safety of laboratory staff.

To improve the management of Ebola patients and break the chain of transmission it is essential to reduce the time taken from specimen collection to communication of test results to less than 24 hours. At the height of the Ebola epidemic, we were contracted by DFID to support to the government’s LTWG to improve laboratory performance.

In close collaboration with the MoHS, LTWG and WHO, we are improving the use of data to inform accurate and timely decision-making in support of an effective response to Ebola. Our work focuses on:

  • Ensuring that necessary data on the sampling and specimen management process are gathered, packaged, and used for problem solving, and receive an immediate response
  • Ensuring optimal use of available resources for transport, through effective use of information and coordination between all partners involved
  • Supporting the LTWG to track laboratory performance and coordinate across the laboratory system so that issues that affect laboratory performance are swiftly identified and tackled
  • Influencing the long-term development of a strong laboratory system that is fit for purpose – while in the short term prioritising reducing Ebola transmission to zero.

Project achievements:

  • In Western Area (an area significantly affected by the epidemic) the average turnaround time of Ebola testing has been reduced from above 24 hours in December 2014, to below 12 hours mid 2015. Our interventions include the placement of Laboratory Liaison Officers, who immediately call out laboratory results to clinicians, to ensure swift and appropriate treatment of patients. Specimen Courier Supervisors have been appointed to oversee safe and swift transport of specimens from the moment of collection to delivery to the laboratory.
  • We completed a National Assessment of Laboratory Capacity and Systems for the MoHS, identifying priority needs in Sierra Leone’s laboratory system. This assessment informed the development of a long-term and evidence-informed strategic plan for strengthening medical diagnostic laboratories.
  • We are strengthening standardisation, and therefore quality of laboratory services, by developing standard operating procedures, manuals and regulatory documents.

Results:

Reduced average turnaround time of Ebola testing from above 24 hours in 2014 to below 12 hours in 2015

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