Development of Mobile Laboratory for Viral Hemorrhagic Fever Detection in Africa

Abstract

We developed a mobile laboratory for molecular detection of viral hemorrhagic fever viruses for an African team that tested its function during several outbreaks. This was the first team deployed onsite during the Ebola outbreak in West Africa 2014–2016.

Rapid Extraction Method of Mycobacterium ulcerans DNA from Clinical Samples of Suspected Buruli Ulcer Patients

“…We combined this DNA extraction technique with our already developed RPA assay for the effective diagnosis of suspected BU cases. The whole procedure was optimized for easy application in a mobile laboratory suitcase [19,20]. The clinical sensitivity and specificity of this procedure was 87% and 100% respectively, when compared to the routinely used Puregene DNA extraction qPCR protocol for M. ulcerans confirmation [16][17][18].…”

“…We have evaluated a simple, rapid and sensitive protocol for the extraction of M. ulcerans DNA from clinical samples of suspected BU patients. The unsophisticated extraction procedure coupled with the minimal technical demand of the Mu RPA assay facilitates application in a mobile suitcase laboratory [19,20]. This setup will enable the early detection of Buruli ulcer-suspected lesions directly at the point of need, allowing the prompt treatment of confirmed cases.…”

“…Four samples (two for RPA and two for PCR assay) were taken for each patient following the WHO recommended guideline for sample collection. DNA extraction with Mu DNA GenoLyse protocol and amplification with Mu RPA assay were performed in a mobile laboratory suitcase [19,20]. The results of the Mu DNA GenoLyse RPA assay were compared with the results of the Puregene DNA extraction (Qiagen, Hilden, Germany) with IS2404 real-time PCR.…”

Challenges and perspectives on the use of mobile laboratories during outbreaks and their use for vaccine evaluation

“…The challenges associated with the use of molecular diagnostic techniques in remote locations that lack significant infrastructure has led some researchers to develop alternative tests that do not require sophisticated operational and analysis equipment, nor access to refrigeration equipment to keep reagents cold. Commercialized kits or in-house developed assays with lyophilized reagents eliminate the need for reagent freezing, while the development of rapid lateral flow assays that can be performed directly at the bedside eliminates the need for specialized equipment, highly trained technical staff and reduces the turnaround time for results from hours (approximately three hours with real-time RT-PCR) 9,12 to minutes (approximately 30 minutes). 13,14 The ability to obtain a reliable result directly at the patient's bedside also removes the need for the diagnostic laboratory to communicate test results with the doctors and support staff actually caring for the patients.…”

“…Our ability as researchers and outbreak responders to improve the molecular assays available for use during an outbreak is exemplified by a field team from IPD in Senegal and their collaborators. 12 Over the course of as little as five years, they went from using the standard infrastructure reliant real-time RT-PCR assay to a real-time recombinase polymerase amplification (RT-RPA) assay that has many of the same benefits as the lateral flow assays mentioned above. This team was able to respond to outbreaks of Dengue virus in Cape Verde Islands, Rift Valley Fever virus in Mauritania, Yellow Fever virus in Uganda and Ebola virus in Guinea using a similar mobile laboratory setup and evolving diagnostic assay platform.…”