Center for Bio/Molecular Science and Engineering, Naval Research Laboratory, Washington DC, 20375, USA.
Health Res Policy Syst. 2012 Jul 4;10:22. doi: 10.1186/1478-4505-10-22.
Resource-limited tropical countries are home to numerous infectious pathogens of both human and zoonotic origin. A capability for early detection to allow rapid outbreak containment and prevent spread to non-endemic regions is severely impaired by inadequate diagnostic laboratory capacity, the absence of a "cold chain" and the lack of highly trained personnel. Building up detection capacity in these countries by direct replication of the systems existing in developed countries is not a feasible approach and instead requires "leapfrogging" to the deployment of the newest diagnostic systems that do not have the infrastructure requirements of systems used in developed countries.
A laboratory for molecular diagnostics of infectious agents was established in Bo, Sierra Leone with a hybrid solar/diesel/battery system to ensure stable power supply and a satellite modem to enable efficient communication. An array of room temperature stabilization and refrigeration technologies for reliable transport and storage of reagents and biological samples were also tested to ensure sustainable laboratory supplies for diagnostic assays.
The laboratory demonstrated its operational proficiency by conducting an investigation of a suspected avian influenza outbreak at a commercial poultry farm at Bo using broad range resequencing microarrays and real time RT-PCR. The results of the investigation excluded influenza viruses as a possible cause of the outbreak and indicated a link between the outbreak and the presence of Klebsiella pneumoniae.
This study demonstrated that by application of a carefully selected set of technologies and sufficient personnel training, it is feasible to deploy and effectively use a broad-range infectious pathogen detection technology in a severely resource-limited setting.
资源有限的热带国家是许多人类和人畜共患传染病原体的家园。由于诊断实验室能力不足、缺乏“冷链”以及缺乏高度训练有素的人员，早期检测以实现快速疫情控制并防止传播到非流行地区的能力严重受损。通过直接复制发达国家现有的系统来建立这些国家的检测能力不是一种可行的方法，而是需要“跨越式发展”，采用最新的诊断系统，这些系统不需要发达国家使用的系统的基础设施要求。
在塞拉利昂的博城建立了一个用于传染病原体分子诊断的实验室，采用混合太阳能/柴油/电池系统以确保稳定的电力供应，并配备卫星调制解调器以实现高效通信。还测试了一系列室温稳定和冷藏技术，以确保试剂和生物样本的可靠运输和储存，从而确保诊断检测的可持续实验室供应。
该实验室通过使用广谱重测序微阵列和实时 RT-PCR 对博城一家商业家禽养殖场的疑似禽流感暴发进行调查，证明了其运行能力。调查结果排除了流感病毒作为暴发的可能原因，并表明暴发与肺炎克雷伯菌的存在有关。
本研究表明，通过应用精心挑选的一组技术和充足的人员培训，可以在资源严重有限的环境中部署和有效使用广谱传染病原体检测技术。
