Leveraging gains from African Center for Integrated Laboratory Training to combat HIV epidemic in sub-Saharan Africa.

BACKGROUND: In sub-Saharan Africa, there is dearth of trained laboratorians and strengthened laboratory systems to provide adequate and quality laboratory services for enhanced HIV control. In response to this challenge, in 2007, the African Centre for Integrated Laboratory Training (ACILT) was established in South Africa with a mission to train staffs from countries with high burdens of diseases in skills needed to strengthen sustainable laboratory systems. This study was undertaken to assess the transference of newly gained knowledge and skills to other laboratory staff, and to identify enabling and obstructive factors to their implementation. METHODS: We used Kirkpatrick model to determine training effectiveness by assessing the transference of newly gained knowledge and skills to participant's work environment, along with measuring enabling and obstructive factors. In addition to regular course evaluations at ACILT (pre and post training), in 2015 we sent e-questionnaires to 867 participants in 43 countries for course participation between 2008 and 2014. Diagnostics courses included Viral Load, and systems strengthening included strategic planning and Biosafety and Biosecurity. SAS v9.44 and Excel were used to analyze retrospective de-identified data collected at six months pre and post-training. RESULTS: Of the 867 participants, 203 (23.4%) responded and reported average improvements in accuracy and timeliness in Viral Load programs and to systems strengthening. For Viral Load testing, frequency of corrective action for unsatisfactory proficiency scores improved from 57 to 91%, testing error rates reduced from 12.9% to 4.9%; 88% responders contributed to the first national strategic plan development and 91% developed strategies to mitigate biosafety risks in their institutions. Key enabling factors were team and management support, and key obstructive factors included insufficient resources and staff's resistance to change. CONCLUSIONS: Training at ACILT had a documented positive impact on strengthening the laboratory capacity and laboratory workforce and substantial cost savings. ACILT's investment produced a multiplier effect whereby national laboratory systems, personnel and leadership reaped training benefits. This laboratory training centre with a global clientele contributed to improve existing laboratory services, systems and networks for the HIV epidemic and is now being leveraged for COVID-19 testing that has infected 41,332,899 people globally.

Sistema de Laboratorios Remoto para el estudio de la Microbiología y Parasitología Médica / Remote Laboratory System for the study of Medical Microbiology and Parasitology

Introducción: como parte del proceso de formación de enfermeros, médicos y tecnólogos de la salud son habilitados temas relacionados con la microbiología. Sin embargo, a partir del conjunto de medidas de seguridad y la disponibilidad de recursos físicos, no es posible el estudio de diversos microorganismos. Objetivo: desarrollar un Sistema de Laboratorios Remoto para la práctica de Microbiología y Parasitología Médica. Materiales y métodos: el sistema de Laboratorios Remoto posee un microscopio electrónico controlado mediante una interface de comunicación con un ordenador conectado a la red. Resultados: se obtuvo como resultado un Sistema de Laboratorios Remoto que puede ser accedido mediante Internet o la red institucional. Facilita el estudio y la interpretación de diferentes muestras biológicas. Brinda un conjunto de reportes y estadísticas que permiten realizar análisis históricos de comportamiento. Conclusiones: a partir del desarrollo de las prácticas de laboratorios a distancia, es posible el estudio de diferentes microorganismos sin riesgos biológicos para el estudiante(AU)

Introduction: as part of the training process for nurses, physicians and health technologists, topics related to microbiology are enabled. However, based on the set of security measures and the availability of physical resources, the study of various microorganisms is not possible. Objective: to develop a Remote Laboratory System for the practice of the subject Medical Microbiology and Parasitology. Methods: the Remote Laboratory System has an electronic microscope controlled by a communication interface with a computer connected to the network. Results: a Remote Laboratory System that can be accessed through the Internet or the institutional network. The system facilitates the study and interpretation of different biological samples and also provides a set of reports and statistics that allow for historical behavior analysis. Conclusions: from the development of remote laboratory practices, it is possible to study different microorganisms without biological risks for the student(AU)

A Competency Framework for Developing Global Laboratory Leaders.

Building sustainable national health laboratory systems requires laboratory leaders who can address complex and changing demands for services and build strong collaborative networks. Global consensus on laboratory leadership competencies is critically important to ensure the harmonization of learning approaches for curriculum development across relevant health sectors. The World Health Organization (WHO), the Food and Agriculture Organization of the United Nations (FAO), the World Organisation for Animal Health (OIE), the European Centre for Disease Prevention and Control (ECDC), the U.S. Centers for Disease Control and Prevention (CDC), and the Association of Public Health Laboratories (APHL) have partnered to develop a Laboratory Leadership Competency Framework (CF) that provides a foundation for the Global Laboratory Leadership Programme (GLLP). The CF represents the first global consensus from multiple disciplines on laboratory leadership competencies and provides structure for the development of laboratory leaders with the knowledge, skills and abilities to build bridges, enhance communication, foster collaboration and develop an understanding of existing synergies between the human, animal, environmental, and other relevant health sectors.

Taiwan's Public Health National Laboratory System: Success in Influenza Diagnosis and Surveillance.

Taiwan's National Laboratory System is one of the action packages of the Global Health Security Agenda, which was launched by the World Health Organization (WHO) to promote health security as an international priority and to encourage progress toward full implementation of the WHO International Health Regulations (IHR) 2005. The mission of each national laboratory system is to conduct real-time biosurveillance and effective laboratory-based diagnostics, as measured by a nationwide laboratory system able to reliably conduct diagnoses on specimens transported properly to designated laboratories from at least 80% of the regions in the country. In Taiwan, the national laboratory system for public health is well-established and coordinated by the Taiwan Centers for Disease Control (CDC), which is the government authority in charge of infectious disease prevention and intervention. Through the national laboratory system, Taiwan CDC effectively detects and characterizes pathogens that cause communicable diseases across the entire country, including both known and novel threats, and also conducts epidemiologic analyses of infectious diseases. In this article, we describe the national laboratory system for public health in Taiwan. We provide additional information on the national influenza laboratory surveillance network to demonstrate how our national laboratory systems work in practice, including descriptions of long-term seasonal influenza characterization and successful experiences identifying novel H7N9 and H6N1 influenza viruses.

Emergency clinical laboratory system for civilian and military uses in actual military operations / 医疗卫生装备

Objective To develop an emergency clinical laboratory system for civilian and military uses to enhance medical support of filed medical unit for mass casualties.Methods The missions of field medical unit were analyzed in the actual confrontation,and an emergency clinical laboratory system for civilian and military uses was built to fulfill clinical laboratory support.The factors were explored for clinical laboratory examination,and some measures were taken accordingly.Results The requirements of field medical unit were met by the developed system.Conclusion The system can be applied in largescale military exercises to enhance clinical laboratory support ability of field medical unit.

Color stability of mineral trioxide aggregate and calcium enriched mixture cement.

AIM: To assess the effect of light irradiation and different immersion media on discoloration of white mineral trioxide aggregate (WMTA) and calcium enriched mixture (CEM) cement at different time intervals. METHODS: Enamel sections of 12 teeth were removed and six cavities were prepared in each tooth. The cavities were filled randomly either with WMTA or CEM and covered with transparent sealant. Half the specimens were irradiated for 160 sec (eight exposures of 20 sec each) and the remaining were irradiated for 40 sec (two exposures of 20 sec each); digital images were taken after each exposure. The teeth were stored in phosphate buffer saline, oxygen-rich medium and glycerin (n = 4). Digital images were obtained after 1, 3, 7, 14, and 28 days. Commission Internationale de I'E'clairage (CIE) color space system and Photoshop CS5 software were used to evaluate the discoloration. The color change (ΔE) and lightness (ΔL) values was analyzed using repeated measures anova and Tukey's Tukey's honest significant difference (HSD) test. RESULTS: The materials tested showed significant discoloration over time (WMT > CEM; P < 0.001). ΔE increased significantly while ΔL decreased in three media over time (P < 0.001). Greater duration of light curing caused a significant decrease in ΔL and ΔE values in both materials (WMTA > CEM; P < 0.001). CONCLUSION: Color stability of WMTA was inferior to CEM samples after exposure to different duration of irradiation and media over time.

Results of the assessment of the laboratory system / Эрүүл мэндийн лаборатори

Rationale: Effective healthcare starts with an accurate diagnosis, and laboratory plays an important role in this. All health laboratories, be it clinical, animal health, food safety, or environmental health laboratory, contribute to health care and public health security. Therefore, many public health programs are conducting laboratory assessments. The assessment findings can be used for identification of areas in which efforts should be directed in order to strengthen the national laboratory system and health laboratories. Goal: The goal of the project was to assess the national laboratory system and health laboratories of Mongolia. Methods and materials: Laboratory assessment tool (LAT) developed by WHO was used for the assessment of two areas: 1. strategic organization at the national level, and 2. specific technical capacities at the laboratories level. The national laboratory system was assessed using LAT System questionnaire with the participation of MOH officers, and the assessment of laboratories was conducted using LAT Facility questionnaire with the involvement of laboratories representing public and private sectors, all three levels of urban and rural health care organizations, and clinical and public health areas of laboratory services. Results: The strongest areas of the national laboratory system at the policy and regulatory level were “Coordination and management” and “Laboratory information system”. The weaker (below 75%) areas were “Structure and organizations”, “Regulations”, “Infrastructure” and “Human resources”. The insufficient infrastructure score was due to the lack of financing. The main problems detected in the area of Human resources were insufficient financial and organizational support of continuous education of laboratory workers, shortage of trained personnel and incomplete national registration system of laboratory professionals. The results of the laboratory capacities showed that the assessed laboratories were strong in “Data and information management”, “Specimen collection and handling” and “Consumables and reagents”. The testing performance of most laboratories was excellent but the external quality assurance was not available in some test disciplines. The weaker areas of the laboratories were “Facilities”, “Public health functions” and “Biorisk management”. The module “Organization and management” showed lower score mainly due to insufficient budget. The same was with “Facilities”. Although the general safety management of laboratories was very good, the biosafety component was not incorporated in it. Conclusions and recommendations: 1.A national regulatory body needs to be established for the registration of all laboratories and laboratory professional staff. 2.Each laboratory should formally designate an appropriately trained Quality manager, 3.Set-up a formal professional development/ continuous education system for laboratory professionals. 4.Develop biosafety policy and implementation plan. 5.Establish a comprehensive national laboratory information management system (LIMS).

Results of the assessment of the laboratory system / Эрүүл мэндийн лаборатори

Rationale: Effective healthcare starts with an accurate diagnosis, and laboratory plays an important role in this. All health laboratories, be it clinical, animal health, food safety, or environmental health laboratory, contribute to health care and public health security. Therefore, many public health programs are conducting laboratory assessments. The assessment findings can be used for identification of areas in which efforts should be directed in order to strengthen the national laboratory system and health laboratories.Goal:The goal of the project was to assess the national laboratory system and health laboratories of Mongolia.Methods and materials:Laboratory assessment tool (LAT) developed by WHO was used for the assessment of two areas: 1. strategic organization at the national level, and 2. specific technical capacities at the laboratories level. The national laboratory system was assessed using LAT System questionnaire with the participation of MOH officers, and the assessment of laboratories was conducted using LAT Facility questionnaire with the involvement of laboratories representing public and private sectors, all three levels of urban and rural health care organizations, and clinical and public health areas of laboratory services. Results: The strongest areas of the national laboratory system at the policy and regulatory level were “Coordination and management” and “Laboratory information system”. The weaker (below 75%) areas were “Structure and organizations”, “Regulations”, “Infrastructure” and “Human resources”. The insufficient infrastructure score was due to the lack of financing. The main problems detected in the area of Human resources were insufficient financial and organizational support of continuous education of laboratory workers, shortage of trained personnel and incomplete national registration system of laboratory professionals.The results of the laboratory capacities showed that the assessed laboratories were strong in “Data and information management”, “Specimen collection and handling” and “Consumables and reagents”. The testing performance of most laboratories was excellent but the external quality assurance was not available in some test disciplines. The weaker areas of the laboratories were “Facilities”, “Public health functions” and “Biorisk management”. The module “Organization and management” showed lower score mainly due to insufficient budget. The same was with “Facilities”. Although the general safety management of laboratories was very good, the biosafety component was not incorporated in it.Conclusions and recommendations:1.A national regulatory body needs to be established for the registration of all laboratories and laboratory professional staff.2.Each laboratory should formally designate an appropriately trained Quality manager, 3.Set-up a formal professional development/ continuous education system for laboratory professionals. 4.Develop biosafety policy and implementation plan.5.Establish a comprehensive national laboratory information management system (LIMS).