Lab Matters Winter 2023 | Page 27

GLOBAL HEALTH

By Jully Okonji , senior laboratory specialist , APHL Kenya ; Romeo Kithuka , laboratory specialist , APHL Kenya ; Edwin Ochieng , senior laboratory technical manager ; APHL Kenya ; and Maria Landron , senior specialist , Global Health

Kenya hosts the largest refugee population in East and Central Africa and , as vulnerable populations , they are under the protection of United Nations High Commissioner on Refugees ( UNHCR ). The International Rescue Committee ( IRC ) is a UNHCR impementing partner in health services for refugees and oversees the laboratory operations in camps located in Kakuma and Dadaab . The US Centers for Disease Control and Prevention ( CDC ) Refugee Program and the Ministry of Health in Kenya , with support from UNHCR-affiliated agencies , has consistently conducted passive surveillance of infectious diseases like polio , measles and other upper respiratory diseases in the region , targeting both host communities and refugee populations .

Since August 2021 , APHL , through a cooperative agreement with CDC , has provided laboratory strengthening support to the two refugee laboratories through quality management systems implementation training to staff , provision of laboratory commodities , purchase of molecular equipment and molecular mentorship . The main objective was to improve laboratory molecular testing services for SARS-CoV-2 and diagnostics for other infectious diseases that are prone to the two camps . Despite the harsh environmental conditions due to extreme heat and bad terrains and the nature of the vulnerable populations served , there was need to ensure quality of services were not compromised and these factors did not deter the APHL team from relentlessly providing services to the two camp sites .

The outcomes of the ongoing APHL / CDC cooperative agreement resulted in molecular laboratories being established in the Dadaab and Kakuma locations , improvement in laboratory

Laboratory staff at the IRC Kakuma Refugee Camp perform RT-PCR for SARS-CoV-2 following successful molecular PCR training by APHL staff

APHL Kenya staff conduct a laboratory quality management system mentoring session

quality services as attested by the IRC clinical teams and a UNHCR lead who had an impromptu visit to the IRC-Kakuma laboratory and organized laboratory workspaces . Further , there was improvement in staff knowledge through mentorship programs conducted . Currently , the laboratory in IRC-Kakuma is preparing for assessment by the accrediting body for ISO 15189:2022 and would be among the first laboratories in Kenya to be audited and accredited based on the revised standard . The IRC-Dadaab laboratory is under a laboratory continuous quality improvement program . The APHL team identified gaps in data utilization that led to the IRC team being trained in data analysis and interpretation . The laboratory infrastructure developed would be able to support outbreak investigations , antimicrobial resistance gene detection , among other laboratory services that remain important for the Kenya surveillance team . g

This project was 100 % funded with federal funds from a federal program of $ 4,068,027 . This project and the production of this article was supported by Cooperative Agreement # NU2HGH000032 , funded by the US Centers for Disease Control and Prevention ( CDC ). Its contents are solely the responsibility of the authors and do not necessarily represent the official views of , nor an endorsement by , CDC , HHS or the US Government .