Lab Matters Spring 2019 | Page 19

GLOBAL HEALTH APHL Closes Productive Decade of Work in Sierra Leone by Sherrie Staley, MPH, manager, Global Health; Palmira Mangae, specialist, Global Health; and Lucy Maryogo-Robinson, MPH, director, Global Health In January of 2019, APHL officially handed over its Sierra Leone portfolio to the country’s Ministry of Health after a decade of involvement, including four years helping to develop the nation’s lab system during the worst Ebola outbreak in history. With that outbreak ended, Sierra Leone has emerged a stronger country committed to continued growth and development, including that of its laboratory system. delivery and outbreak preparedness from 2015 to the present. 3. Supporting laboratories throughout the country, specifically CPHRL, Princess Christian Maternity Hospital, Ola During Children’s Hospital and Jenner Wright Laboratories. APHL support to these sites included: • Activation of clinical diagnostic labs for hematology and clinical chemistry APHL has always sought to strengthen the laboratory system in Sierra Leone. It is with this vision in mind that our subsidiary opened with a staff of four in January 2016 to respond to the Ebola crisis. APHL began work in Sierra Leone many years before this, however, with a focus on supporting HIV Ante Natal Clinic (ANC) surveys. Over the course of the last four years, our PEPFAR work expanded as did our Global Health Security Agenda initiatives. • Application of the laboratories to an accredited international EQA program • Procurement of laboratory equipment and consumables • Development of quality manuals and written standard operating procedures such as the national laboratory rapid response manual, national testing algorithm, national policy and health and safety manual, and the national laboratory reporting tools Between 2015 and January 2019, APHL worked closely with the Sierra Leone Ministry of Health, the Centers for Disease Control and Prevention, and other key stakeholders. During our tenure, some of our key accomplishments include: • Supported the development of a national priority plan and the national laboratory strategic plan • Sponsored high level and extended workshops in quality management systems, laboratory validation protocols, and equipment management in the laboratory 4. Supported microbiology activation at Ola During and Princess Christian Hospital laboratories. At baseline (May 2017) the laboratory scored zero stars on the SLIPTA checklist. But as of December 2018, the score on the same checklist was two stars. Today, the microbiology laboratory is a referral facility for bacteriology culture analyses and supports outbreak responses for epidemic prone diseases such as cholera and meningitis. 5. Provided onsite and remote continuous mentorship in microbiology and tuberculosis testing at CPHRL and TB Reference Lab. A robust laboratory system underpins every strong health system. It has been APHL’s honor and privilege to contribute to the health of Sierra Leone’s people by strengthening its laboratories. n 1. Completing the renovation of the Central Public Health Laboratory (CPHRL) to include storage and external quality assurance (EQA) facilities, resulting in a more secure and safe environment for laboratory testing 2. Providing training and mentorship of 26 university science graduates on Ebola epidemiology, diagnosis and related data management, health and safety. These graduates, known as the Public Health Laboratory Response Team (or RRTs) received additional training on epidemic-prone diseases (HIV early infant diagnosis (EID) & viral load, measles, rubella, rotavirus) and enteric bacterial diseases. These high caliber laboratory scientists have provided sustainable testing, service PublicHealthLabs @APHL The APHL team with representatives from the Ministry of Health and CDC Sierra Leone at the Handover Ceremony Spring 2019 LAB MATTERS 17