INFECTIOUS DISEASES
CDC validated the new YF MAC-HD test
kits during the 2016 Angola outbreak
and found that the method was easily
transferable, and that the kit was sensitive
and specific. Now, with support from the
Association of Public Health Laboratories,
CDC, WHO and Gavi, Basile and Goodman
are taking their kits on the road and
teaching other laboratorians how to use
them. This process is providing further
data to validate the use of the YF MAC-HD
in the regions where it will be ultimately
be deployed.
Recent trainings in Cameroon and Senegal
included attendees from over 33 African
countries. In each of the five-day courses,
laboratory staff were trained on molecular
and serologic tests for yellow fever.
Attendees worked in pairs to observe and
perform tests using the new kit. Pre- and
post-workshop testing of attendees’
knowledge showed substantial increases
in their understanding and ability to run
yellow fever diagnostic tests. To reinforce
the learning process, attendees were sent
home with eight kits and a proficiency
panel they could use to practice
performing the test in their own labs.
These types of trainings are crucial for
aligning testing methodologies in the
national laboratories across Africa. Not
only do the workshops provide valuable
face-time for laboratorians to network
and address common challenges, they
also standardize the diagnostic process.
As a result, laboratory capacity to aid in
surveillance efforts for yellow fever is
improved across the continent.
Now the biggest hurdle researchers have
is how to manufacture and distribute
the kits on a large scale. Thankfully,
in an effort to support the laboratory
component of the EYE strategy, Gavi
has proposed funding to address the
difficulties in shipping supplies. When
a yellow fever kit is approved for use by
WHO, funding is expected to create a
market to encourage production. The need
is estimated initially at 1,000-2,000 kits
per year across Africa and South America,
and CDC is working with external
manufacturers to create a sustainable
supply of the YF MAC-HD kits. This is a
challenging process, but Basile notes we
are now closer to achieving EYE diagnostic
goals. She hopes when the next outbreak
happens, laboratory staff will not only
have easy-to-use tests available but also
the training to use them. Reliable test
results will allow the rapid identification
of cases before outbreaks get out of
control, and will contribute to the
elimination of yellow fever epidemics. n
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Winter 2020 LAB MATTERS
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