Kennedy Stephen B, Dogba John B, Wasunna Christine L, Sahr Philip, Eastman Candace B, Bolay Fatorma K, Mason Gloria T, Kieh Mark W S
Incident Management System, Emergency Operations Center, Ministry of Health, Monrovia, Liberia.
Partnership for Research on Ebola Virus in Liberia, Liberia-US Clinical Research Partnership Program, First Floor, John F. Kennedy Medical Center, Monrovia, Liberia.
Afr J Lab Med. 2016 Oct 31;5(3):508. doi: 10.4102/ajlm.v5i3.508. eCollection 2016.
Prior to the Ebola virus disease outbreak in Liberia, the laboratory system was duplicative, fragmented and minimally coordinated. The National Reference Laboratory was conceptualised to address the existing challenges by promoting the implementation of effective and sustainable laboratory services in Liberia. However, in a resource-limited environment such as Liberia, progress regarding the rebuilding of the health system can be relatively slow, while efforts to sustain the transient gains remain a key challenge for the Ministry of Health. In this paper, we describe the pre-Ebola virus disease laboratory system in Liberia and its prevailing efforts to address future emerging infectious diseases, as well as current Infectious diseases, all of which are exacerbated by poverty. We conclude that laboratory and diagnostic services in Liberia have encountered numerous challenges regarding its efforts to strengthen the healthcare delivery system. These challenges include limited trained human resource capacity, inadequate infrastructure, and a lack of coordination. As with most countries in sub-Saharan Africa, when comparing urban and rural settings, diagnostic and clinical services are generally skewed toward urban health facilities and private, faith-based health facilities. We recommend that structured policy be directed at these challenges for national institutions to develop guidelines to improve, strengthen and sustain diagnostic and curative laboratory services to effectively address current infectious diseases and prepare for future emerging and re-emerging infectious diseases.
在利比里亚爆发埃博拉病毒病之前，实验室系统重复、分散且协调极少。国家参考实验室的设立旨在通过促进在利比里亚实施有效且可持续的实验室服务来应对现有挑战。然而，在利比里亚这样资源有限的环境中，卫生系统重建方面的进展可能相对缓慢，而维持短暂成果的努力仍是卫生部面临的一项关键挑战。在本文中，我们描述了利比里亚埃博拉病毒病爆发前的实验室系统及其应对未来新发传染病以及当前传染病（所有这些都因贫困而加剧）的主要努力。我们得出结论，利比里亚的实验室和诊断服务在加强医疗服务提供系统的努力中面临众多挑战。这些挑战包括训练有素的人力资源能力有限、基础设施不足以及缺乏协调。与撒哈拉以南非洲的大多数国家一样，在比较城乡环境时，诊断和临床服务通常偏向城市卫生设施以及私立、基于信仰的卫生设施。我们建议针对这些挑战制定结构化政策，以便国家机构制定准则来改进、加强和维持诊断及治疗实验室服务，从而有效应对当前的传染病，并为未来新发和再发传染病做好准备。
