Hamadoun Kassambara, MPH, is Chief of Party, GHSA, and Mamadou Diango Traoré, MS, is Data Manager, GHSA; both in the Department of Health, Catholic Relief Services, Bamako, Mali.Marjorie Larson Nana, MPH, is a Program Officer, Johns Hopkins Center for Communications Programs, Johns Hopkins University, Baltimore, MD.Famory Samassa, MPH, is Senior Technical Advisor for Health, Management Science for Health, Bamako, Mali. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the US Centers for Disease Control and Prevention.
Health Secur. 2020 Jan;18(S1):S92-S97. doi: 10.1089/hs.2019.0061.
In Mali, qualified laboratories for testing of dangerous pathogens are centralized in Bamako. Creating a specimen transport system respecting timeline, specimen quality, biosafety, and biosecurity standards is a challenge. The current ad hoc system that relies on untrained public transport companies carries risks of spoilage, accidental release of pathogens, and delays, which compromise specimen quality. This pilot study aimed to evaluate the effectiveness (ie, timeline, quality of specimen, and cost) of using the trained postal service for sample transportation from district to central level, compared with the current system. The postal service intervention ran from mid-2016 to mid-2017 and covered 3 districts. Data were collected in the same districts during the same period of the preceding year for comparison. In all, 41 specimens were shipped using public transportation and 51 were shipped using the postal service. These included suspected meningitis, measles, yellow fever, and polio samples. Only 46% of samples sent by public transportation were received in Bamako within 72 hours of collection, compared to 71% of samples shipped via the postal service ( < .05). Further, 93% of samples shipped by public transportation arrived in good condition at the receiving laboratory, compared to 98% by postal service. Although cost comparisons were difficult (flat fee vs per-specimen fare), the average cost per specimen was 8 times higher with the postal service. Shipment of specimens from districts to central level using the postal service was feasible and appeared to be faster than public transportation, thus allowing specimen quality to be preserved. Further analysis regarding the most efficient costing mechanism is needed.
在马里，用于检测危险病原体的合格实验室集中在巴马科。建立一个符合时间要求、标本质量、生物安全和生物安保标准的标本运输系统是一项挑战。目前，依靠未经培训的公共交通公司的临时系统存在标本变质、病原体意外释放和延迟的风险，这会影响标本质量。本试点研究旨在评估使用经过培训的邮政服务从地区到中央一级运输样本的效果（即时间安排、标本质量和成本），并与现行系统进行比较。邮政服务干预于 2016 年年中至 2017 年年中进行，覆盖 3 个区。为进行比较，同期在同一地区收集数据。共有 41 个标本通过公共交通和 51 个标本通过邮政服务运输。这些标本包括疑似脑膜炎、麻疹、黄热病和脊髓灰质炎样本。只有 46%通过公共交通发送的标本在采集后 72 小时内运抵巴马科，而通过邮政服务运输的标本为 71%（ < .05）。此外，93%通过公共交通运输的标本到达接收实验室时状况良好，而通过邮政服务运输的标本为 98%。尽管成本比较困难（固定费用与按标本收费），但通过邮政服务运输的每个标本的平均成本要高出 8 倍。使用邮政服务从地区向中央一级运输标本是可行的，而且似乎比公共交通更快，从而可以保持标本质量。需要进一步分析最有效的成本机制。
