No abstract

No abstract

BackgroundLaunched in 2009, the Strengthening Laboratory Management Toward Accreditation (SLMTA) programme has emerged as an innovative approach for the improvement of laboratory quality. In order to ensure sustainability, Mozambique embedded the SLMTA programme within the existing Ministry of Health (MOH) laboratory structure.ObjectiveThis article outlines the steps followed to establish a national framework for quality improvement and embedding the SLMTA programme within existing MOH laboratory systems.MethodsThe MOH adopted SLMTA as the national laboratory quality improvement strategy, hired a dedicated coordinator and established a national laboratory quality technical working group comprising mostly personnel from key MOH departments. The working group developed an implementation framework for advocacy, training, mentorship, supervision and audits. Emphasis was placed on building local capacity for programme activities. After receiving training, a team of 25 implementers (18 from the MOH and seven from partner organisations) conducted baseline audits (using the Stepwise Laboratory Quality Improvement Process Towards Accreditation [SLIPTA] checklist), workshops and site visits in six reference and two central hospital laboratories. Exit audits were conducted in six of the eight laboratories and their results are presented.ResultsThe six laboratories demonstrated substantial improvement in audit scores; median scores increased from 35% at baseline to 57% at exit. It has been recommended that the National Tuberculosis Reference Laboratory apply for international accreditation.ConclusionSuccessful implementation of SLMTA requires partnership between programme implementers, whilst effectiveness and long-term viability depend on country leadership, ownership and commitment. Integration of SLMTA into the existing MOH laboratory system will ensure durability beyond initial investments. The Mozambican model holds great promise that country leadership, ownership and institutionalisation can set the stage for programme success and sustainability.

In Venezuela, the restricted manner of works on scorpion envenoming has contributed little to the real magnitude and knowledge of this subject in our country. The lack of basic scorpiofauna knowledge, distribution, clinical manifestations, and especially of specific treatments justify multidisciplinary studies. The purpose of these studies is to obtain information that allows the elaboration of a preventive plan. This paper demonstrates the magnitude of scorpion envenomings in Venezuela

In recent years, in addition to American cutaneous leishmaniasis (ACL), a significant number of cases of American visceral leishmaniasis (AVL) have been reported in periurban areas of Barcelona city (Anzoátegui State, Venezuela). We studied the bionomics of Lutzomyia (Lutzomyia) evansi and Lutzomyia (Psychodopygus) panamensis, possible vectors of AVL and ACL, respectively, in El Rincón, a periurban village of that city. To evaluate the seasonal domiciliary landing/biting activity of sandflies on human bait, a house was chosen in El Rincón. Landing catches were carried out between 18:00 and 06:00, once a month for a year. The results show the presence of 2 species, Lu. (Lu.) evansi (89.9%) and Lu. (Psy.) panamensis (10.1%). Lu. evansi was most abundant in the months of October and July, associated with the bimodal cycle of annual rainfall in the area. Maximum landing/biting activity of Lu. evansi was observed at 24:00 and 03:00. These findings suggest that at this time of the year and at these hours there is heightened risk of the transmission of AVL. Lu. panamensis monthly abundance also shows a direct association with rainfall and maximum landing/biting activity was observed between 02:00 and 03:00. The lower domiciliary abundance of Lu. panamensis suggests its greater importance in the extradomiciliary transmission of ACL.