Establishment of COVID-19 testing laboratory in resource-limited settings: challenges and prospects reported from Ethiopia

Abera, Adugna; Belay, Habtamu Gebrehana; Zewude, Aboma; Gidey, Bokretsion; Nega, Desalegn; Dufera, Boja; Abebe, Abnet; Endriyas, Tujuba; Getachew, Birhanu; Birhanu, Henok; Difabachew, Hailemariam; Mekonnen, Bacha; Legesse, Helina; Bekele, Firdawek; Mekete, Kalkidan; Seifu, Seble; Sime, Heven; Yemanebrhan, Nebiyou; Tefera, Mesfin; Amare, Hiwot; Beyene, Berhane; Tsige, Estifanos; Kebede, Adisu; Tasew, Geremew; Tollera, Getachew; Abate, Ebba; Woyessa, Adugna; Assefa, Ashenafi

doi:10.1080/16549716.2020.1841963

Cited by 16 publications

(22 citation statements)

References 3 publications

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“…Despite the rapid increase in the number of COVID-19 cases reported globally, limited molecular laboratory capacity is evident in resource-constraint settings for case diagnosis and overall disease management. As the Ethiopian Public Health Institute (EPHI) shared the experience of the rapid establishment of one of its COVID-19 research laboratories from locally available resources, the optimal use of existing resources and the repurposing of other sources for human medical treatment could be considered as a preferable approach to the management of restricted facilities ( 118 , 119 ).…”

Section: Integrated Strategic Approaches Against the Covid-19 Pandemic And Lesson Learned In Combating The Crises Mirroring Ways To Safegmentioning

confidence: 99%

“…It has also created an ability to enhance our services and health care systems and learn how to be better positioned for the next emergency ( 116 ). On the other hand, by taking advantage of the opportunity provided by the current pandemic, different settings have benefited from the establishment of an additional standard molecular laboratory, trained staff as well as the attribution of human and material resources that could last beyond the COVID-19 era ( 118 ).…”

Section: Integrated Strategic Approaches Against the Covid-19 Pandemic And Lesson Learned In Combating The Crises Mirroring Ways To Safegmentioning

confidence: 99%

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Expected Impacts of COVID-19: Considering Resource-Limited Countries and Vulnerable Population

Gashaw

Hagos

Sisay

2021

Front. Public Health

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Coronavirus disease in 2019 emerged in Wuhan, Hubei Province, China, in December 2019. After a month, it was declared a global threat to public health. The effects of the pandemic could be socio-economic, undermining the health system and risking livelihoods. Vulnerability to this infection has been associated with underlying comorbidities such as hypertension, diabetes, coronary heart disease, chronic respiratory diseases, cancer, and compromised immune systems. Co-morbidity has been common to the elderly, the disabled, and the homeless. In addition, more severe coronavirus disease outcomes have been reported in older males than females. Nonetheless, multiple variables are related to the concept of cultural gender that should be taken into account as women in more affected sectors are economically disadvantageous and over-represented. Similarly, although children are not the face of this pandemic, calamity has a profound effect on their welfare, especially for those living in poor and inconvenient situations. Moreover, the economic influence could be profound and universal when viewed through a migration lens as it is exacerbating xenophobic and discriminatory treatment. Protection measures to mitigate the outbreak of a pandemic, such as social distancing, may reduce social support for certain categories relied on for their day-to-day activities. The mental health of people would definitely be affected by the additional psychosocial burden of the pandemic, particularly in vulnerable groups. Integrated approaches are therefore mandatory to assist these groups and contain the pandemic.

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Section: Integrated Strategic Approaches Against the Covid-19 Pandemic And Lesson Learned In Combating The Crises Mirroring Ways To Safegmentioning

confidence: 99%

Section: Integrated Strategic Approaches Against the Covid-19 Pandemic And Lesson Learned In Combating The Crises Mirroring Ways To Safegmentioning

confidence: 99%

Expected Impacts of COVID-19: Considering Resource-Limited Countries and Vulnerable Population

Gashaw

Hagos

Sisay

2021

Front. Public Health

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“…30 In Ethiopia, Abera et al reported using Malaria and Neglected Tropical Diseases laboratories for COVID-19 testing. 31 Tolia et al described the implementation of a testing programme within a hospital emergency department. 32…”

Section: Open Accessmentioning

confidence: 99%

Lessons from countries implementing find, test, trace, isolation and support policies in the rapid response of the COVID-19 pandemic: a systematic review

et al. 2021

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ObjectiveTo systematically learn lessons from the experiences of countries implementing find, test, trace, isolate, support (FTTIS) in the first wave of the COVID-19 pandemic.Design, data sources and eligibility criteriaWe searched MEDLINE (PubMed), Cochrane Library, SCOPUS and JSTOR, initially between 31 May 2019 and 21 January 2021. Research articles and reviews on the use of contact tracing, testing, self-isolation and quarantine for COVID-19 management were included in the review.Data extraction and synthesisWe extracted information including study objective, design, methods, main findings and implications. These were tabulated and a narrative synthesis was undertaken given the diverse research designs, methods and implications.ResultsWe identified and included 118 eligible studies. We identified the core elements of an effective find, test, trace, isolate, support (FTTIS) system needed to interrupt the spread of a novel infectious disease, where treatment or vaccination was not yet available, as pertained in the initial stages of the COVID-19 pandemic. We report methods used to shorten case finding time, improve accuracy and efficiency of tests, coordinate stakeholders and actors involved in an FTTIS system, support individuals isolating and make appropriate use of digital tools.ConclusionsWe identified in our systematic review the key components of an FTTIS system. These include border controls, restricted entry, inbound traveller quarantine and comprehensive case finding; repeated testing to minimise false diagnoses and pooled testing in resource-limited circumstances; extended quarantine period and the use of digital tools for contact tracing and self-isolation. Support for mental or physical health and livelihoods is needed for individuals undergoing self-isolation/quarantine. An integrated system with rolling-wave planning can best use effective FTTIS tools to respond to the fast-changing COVID-19 pandemic. Results of the review may inform countries considering implementing these measures.

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“…In Ethiopia, so far there are 3,574,218 total tests using RT-PCR, which equates to 30,136 tests per million population, since the first COVID-19 case was reported and the subsequent declaration of global pandemic [ 15 , 17 ]. Even though the country has come a long way in increasing the testing capacity through redirecting and mobilizing resources and organizing testing campaigns, the tests per the total population are still very low and need due attention [ 18 , 19 ].…”

Section: Introductionmentioning

confidence: 99%

“…Evidence indicated that, in many countries all available test kits have been used including rapid diagnostic tests that detects the virus either an antibody or an antigen based, whereas Ethiopia uses both RT-PCR and Ag RDT for the diagnosis of SARS CoV- 2 [ 8 , 18 , 24 ]. Indeed, evidence based information on the diagnostic performance of the commercially available test assays in the country and currently used by most COVID-19 testing laboratories are critical and timely for the program managers and have its impact in the containment strategy of the virus through quality test kit selection on their prioritization and continuous quality improvements on its development as part of the control of the pandemic [ 9 ].…”

Section: Introductionmentioning

confidence: 99%

Diagnostic accuracy of three commercially available one step RT-PCR assays for the detection of SARS-CoV-2 in resource limited settings

et al. 2022

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Background COVID-19 is an ongoing public health pandemic regardless of the countless efforts made by various actors. Quality diagnostic tests are important for early detection and control. Notably, several commercially available one step RT-PCR based assays have been recommended by the WHO. Yet, their analytic and diagnostic performances have not been well documented in resource-limited settings. Hence, this study aimed to evaluate the diagnostic sensitivities and specificities of three commercially available one step reverse transcriptase-polymerase chain reaction (RT-PCR) assays in Ethiopia in clinical setting. Methods A cross-sectional study was conducted from April to June, 2021 on 279 respiratory swabs originating from community surveillance, contact cases and suspect cases. RNA was extracted using manual extraction method. Master-mix preparation, amplification and result interpretation was done as per the respective manufacturer. Agreements between RT-PCRs were analyzed using kappa values. Bayesian latent class models (BLCM) were fitted to obtain reliable estimates of diagnostic sensitivities, specificities of the three assays and prevalence in the absence of a true gold standard. Results Among the 279 respiratory samples, 50(18%), 59(21.2%), and 69(24.7%) were tested positive by TIB, Da An, and BGI assays, respectively. Moderate to substantial level of agreement was reported among the three assays with kappa value between 0 .55 and 0.72. Based on the BLCM relatively high specificities (95% CI) of 0.991(0.973–1.000), 0.961(0.930–0.991) and 0.916(0.875–0.952) and considerably lower sensitivities with 0.813(0.658–0.938), 0.836(0.712–0.940) and 0.810(0.687–0.920) for TIB MOLBIOL, Da An and BGI respectively were found. Conclusions While all the three RT-PCR assays displayed comparable sensitivities, the specificities of TIB MOLBIOL and Da An were considerably higher than BGI. These results help adjust the apparent prevalence determined by the three RT-PCRs and thus support public health decisions in resource limited settings and consider alternatives as per their prioritization matrix.

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Establishment of COVID-19 testing laboratory in resource-limited settings: challenges and prospects reported from Ethiopia

Cited by 16 publications

References 3 publications

Expected Impacts of COVID-19: Considering Resource-Limited Countries and Vulnerable Population

Expected Impacts of COVID-19: Considering Resource-Limited Countries and Vulnerable Population

Lessons from countries implementing find, test, trace, isolation and support policies in the rapid response of the COVID-19 pandemic: a systematic review

Diagnostic accuracy of three commercially available one step RT-PCR assays for the detection of SARS-CoV-2 in resource limited settings

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