The East African Community (EAC) mobile laboratory networks in Kenya, Burundi, Tanzania, Rwanda, Uganda, and South Sudan—from project implementation to outbreak response against Dengue, Ebola, COVID-19, and epidemic-prone diseases

Abstract

Background East Africa is home to 170 million people and prone to frequent outbreaks of viral haemorrhagic fevers and various bacterial diseases. A major challenge is that epidemics mostly happen in remote areas, where infrastructure for Biosecurity Level (BSL) 3/4 laboratory capacity is not available. As samples have to be transported from the outbreak area to the National Public Health Laboratories (NPHL) in the capitals or even flown to international reference centres, diagnosis is significantly delayed and epidemics emerge. Main text The East African Community (EAC), an intergovernmental body of Burundi, Rwanda, Tanzania, Kenya, Uganda, and South Sudan, received 10 million € funding from the German Development Bank (KfW) to establish BSL3/4 capacity in the region. Between 2017 and 2020, the EAC in collaboration with the Bernhard-Nocht-Institute for Tropical Medicine (Germany) and the Partner Countries’ Ministries of Health and their respective NPHLs, established a regional network of nine mobile BSL3/4 laboratories. These rapidly deployable laboratories allowed the region to reduce sample turn-around-time (from days to an average of 8h) at the centre of the outbreak and rapidly respond to epidemics. In the present article, the approach for implementing such a regional project is outlined and five major aspects (including recommendations) are described: (i) the overall project coordination activities through the EAC Secretariat and the Partner States, (ii) procurement of equipment, (iii) the established laboratory setup and diagnostic panels, (iv) regional training activities and capacity building of various stakeholders and (v) completed and ongoing field missions. The latter includes an EAC/WHO field simulation exercise that was conducted on the border between Tanzania and Kenya in June 2019, the support in molecular diagnosis during the Tanzanian Dengue outbreak in 2019, the participation in the Ugandan National Ebola response activities in Kisoro district along the Uganda/DRC border in Oct/Nov 2019 and the deployments of the laboratories to assist in SARS-CoV-2 diagnostics throughout the region since early 2020. Conclusions The established EAC mobile laboratory network allows accurate and timely diagnosis of BSL3/4 pathogens in all East African countries, important for individual patient management and to effectively contain the spread of epidemic-prone diseases.

The East African Community’s mobile laboratory network’s rapid response during the first 2 weeks of the Ebola Sudan virus disease (SVD) outbreak in Uganda and pandemic preparedness activities in South Sudan, Rwanda, Tanzania, Burundi, Kenya

“…Therefore, we successfully demonstrated that a regionally hosted mobile laboratory network, paralleled by full knowledge transfer to the NPHLs, can play a significant role in accelerated pandemic preparedness activities on national and regional level in East Africa. Deploying the mobile laboratories to identified high-risk areas (such as the epicentre of the outbreak or cross-border areas), reduces the diagnostic turn-around-time to 7–8 hours, 2 thus avoiding diagnostic delays due to shipment of samples to centralised or regional reference centres. In turn, such fast and accurate patient diagnosis leads to efficient case management, accelerated quarantine measures and will ultimately block ongoing transmission.…”

“…The EAC Mobile laboratories consist of negative pressure gloveboxes (Könnecke, Germany) (see figure 2 ) for sample inactivation and Bio-Rad CFX96 RT-PCR platforms for molecular SVD diagnosis (for further details on the laboratory setup, see Affara et al 2 ). The EAC mobile laboratory networks in Kenya, Burundi, Tanzania, Rwanda, Uganda and South Sudan-from project implementation to outbreak response against Dengue, Ebola, COVID-19 and epidemic-prone diseases.…”

“…Since 2017, and with funding from the German Federal Ministry for Economic Cooperation and Development through the KfW Development Bank, the East African Community (EAC) together with the Bernhard-Nocht-Institute for Tropical Medicine established a network of nine mobile EAC laboratories embedded within the National Public Health Laboratories (NPHLs) of six EAC Partner States (Tanzania, Kenya, Burundi, Rwanda, South Sudan and Uganda). 2 3 These field-deployable mobile laboratories have the capacity to diagnose risk group four pathogens, such as SVD. The EAC project was conceived in response to the West African Ebola epidemic and the EAC mobile laboratories were designed based on the blueprint of the European Mobile Laboratories (EMLabs, www.emlab.eu ), which were successfully deployed to Guinea in 2015.…”

Global Experiences of Community Responses to COVID-19: A Systematic Literature Review

“…Among these, 232 records did not involve the residential community. The topics included other forms of the community during COVID-19, such as “oncology community” ( 29 ), “virtual community” ( 30 ), “nursing community” ( 31 ), “deaf community” ( 32 ), “East African community” ( 33 ), and others. Furthermore, 325 records had no strong correlation with epidemic prevention, and the topics included “risks and vulnerabilities” ( 34 ), “community mobility” ( 35 ), “fear effect” ( 36 ), “mental health” ( 37 ), “economic impacts” ( 38 ), “living experiences” ( 39 ), and so on.…”

Cross Border Population Movement Patterns, Kenya, Uganda, and Rwanda, November 2022

“…The East African region is threatened by numerous emerging and re-emerging diseases of international concern. These include wild polio, yellow fever, Ebola Virus Disease (EVD), Marburg virus disease, Crimean-Congo haemorrhagic fever, hepatitis E virus, and cholera (1). Increased cross-border movements of humans and animals could fuel the spread of these diseases with the resultant effect of affecting population health and straining the health systems in the region (2).…”