The COVID-19 laboratory response in Timor-Leste: a story of collaboration

National cross-sectional cluster survey of tuberculosis prevalence in Timor-Leste: a study protocol

“…Two sputum samples will be collected from eligible participants, including one spot sputum collected at the screening site, and a second sample collected at least 1 hour after the first sample. Samples will be collected and packaged in accordance with national guidelines and transported daily under cold chain conditions, to a laboratory with GeneXpert MTB/RIF Ultra (Cepheid, USA) (Ultra) testing capability within the same municipality, or to the National TB Reference Laboratory in the capital, Dili 12. An aliquot of both samples will be tested individually by Ultra.…”

“…Samples will be collected and packaged in accordance with national guidelines and transported daily under cold chain conditions, to a laboratory with GeneXpert MTB/RIF Ultra (Cepheid, USA) (Ultra) testing capability within the same municipality, or to the National TB Reference Laboratory in the capital, Dili. 12 An aliquot of both samples will be tested individually by Ultra. Participants who test positive by Ultra (including trace results) will have two sputum samples sent to the National TB Reference Laboratory for confirmatory testing.…”

The response to COVID-19 in Timor-Leste: lessons learnt

“…In 2016, the WHO supported the National Health Laboratory (NHL) to establish capacity for real-time PCR testing for influenza 11. This capacity provided the basis for the subsequent expansion of PCR testing during the COVID-19 pandemic 8. The Korea International Cooperation Agency contributed significantly to strengthening tuberculosis diagnostic capacity, including for PCR testing 12.…”

“…PCR testing capacity in Timor-Leste enabled the rapid diagnosis and isolation of COVID-19 cases in quarantine facilities, contributing to the prevention of community transmission during 2020. During the three COVID-19 waves in 2021 and 2022, capacity was further scaled up to respond to increased demand for testing, with capacity for PCR testing established in all 13 municipalities and NHL capability increased such that up to 2000 tests could be conducted daily 8. This supported the public health response by identifying positive cases in the municipalities who were either referred to local isolation facilities or instructed to isolate in their homes.…”

A pilot study investigating severe community-acquired febrile illness through implementation of an innovative microbiological and nucleic acid amplification testing strategy in Timor-Leste (ISIN-MANAS-TL)

“…Timor-Leste is a half-island nation located between Indonesia and Australia with a population of 1.3 million. Despite significant recent improvements in diagnostic laboratory and infectious disease surveillance capacity, including the implementation of bacterial culture and molecular diagnostic platforms for SARS-CoV-2 and tuberculosis at multiple sites across the country, there have been no prospective studies of AFI in Timor-Leste [20 , 21] . In 2008-2010, a retrospective review of pediatric hospitalizations at the Hospital Nacional Guido Valadares (HNGV), Dili found that AFI was the most common reason for admission; however, only limited etiological, treatment-related and outcome data were available in this study [22] .…”