Qaqish Bara'a, Sallam Malik, Al-Khateeb Maysa, Reisdorf Erik, Mahafzah Azmi
Abt Associates, United States Agency for International Development (USAID) Funded Local Health System Sustainability Project (LHSS), Amman 11822, Jordan.
Department of Pathology, Microbiology and Forensic Medicine, School of Medicine, The University of Jordan, Amman 11942, Jordan.
Diagnostics (Basel). 2022 Apr 6;12(4):909. doi: 10.3390/diagnostics12040909.
Coronavirus disease 2019 (COVID-19) pandemic control measures rely on the accurate and timely diagnosis of infected individuals. Real-time polymerase chain reaction (qPCR) remains the gold-standard method for laboratory diagnosis of the disease. Delayed diagnosis due to challenges that face laboratories performing COVID-19 testing can hinder public health control measures. Such challenges may be related to shortages in staff, equipment or materials, improper inventory management, flawed workflow, or long turnaround time (TAT). The aim of the current study was to assess the overall COVID-19 molecular testing capacity in Jordan as of April 2021. In addition, the study’s objectives included the identification of potential defects that could comprise the utility of the COVID-19 molecular testing capacity in the country. All laboratories certified by the Ministry of Health (MoH) in Jordan to conduct molecular testing for SARS-CoV-2 were invited to participate in this study. Data were obtained from the participating laboratories (those which agreed to participate) by either telephone interviews or a self-reported written questionnaire with items assessing the key aspects of COVID-19 molecular testing. The full molecular testing capacity in each laboratory was self-reported considering 24 working hours. The total number of participating laboratories was 51 out of 77 (66.2%), with the majority being affiliated with MoH (n = 17) and private laboratories (n = 20). The total molecular COVID-19 testing capacity among the participating laboratories was estimated at 574,441 tests per week, while the actual highest number of tests performed over a single week was 310,047 (54.0%, reported in March 2021). Laboratories affiliated with the MoH were operating at a level closer to their maximum capacity (87.2% of their estimated full capacity for COVID-19 testing) compared to private hospital laboratories (41.3%, p = 0.004), private laboratories (20.8%, p < 0.001), and academic/research laboratories (14.7%, p < 0.001, ANOVA). The national average daily COVID-19 molecular testing was 349.2 tests per 100,000 people in April 2021. The average TAT over the first week of April 2021 for COVID-19 testing was 932 min among the participating laboratories, with the longest TAT among MoH laboratories (mean: 1959 min) compared to private laboratories (mean: 333 min, p < 0.001). Molecular COVID-19 testing potential in Jordan has not been fully utilized, particularly for private laboratories and those belonging to academic/research centers. Supply-chain challenges and shortages in staff were identified as potential obstacles hindering the exploitation of full molecular testing capacity for COVID-19 in the country.
2019冠状病毒病（COVID-19）大流行的控制措施依赖于对感染者的准确及时诊断。实时聚合酶链反应（qPCR）仍然是该疾病实验室诊断的金标准方法。由于进行COVID-19检测的实验室面临各种挑战而导致的诊断延迟，可能会阻碍公共卫生控制措施。此类挑战可能与人员、设备或材料短缺、库存管理不当、工作流程存在缺陷或周转时间（TAT）过长有关。本研究的目的是评估截至2021年4月约旦的整体COVID-19分子检测能力。此外，该研究的目标还包括识别可能影响该国COVID-19分子检测能力效用的潜在缺陷。约旦卫生部（MoH）认证的所有进行SARS-CoV-2分子检测的实验室均受邀参与本研究。通过电话访谈或一份自我报告的书面问卷从参与的实验室（同意参与的实验室）获取数据，问卷中的项目用于评估COVID-19分子检测的关键方面。每个实验室的完整分子检测能力是按照24个工作小时自我报告的。参与的实验室共有51家，占77家实验室的66.2%，其中大多数隶属于卫生部（n = 17）和私立实验室（n = 20）。参与实验室的COVID-19分子检测总能力估计为每周574,441次检测，而单周实际进行的最高检测次数为310,047次（54.0%，2021年3月报告）。与私立医院实验室（41.3%，p = 0.004）、私立实验室（20.8%，p < 0.001）和学术/研究实验室（14.7%，p < 0.001，方差分析）相比，隶属于卫生部的实验室的运行水平更接近其最大能力（其估计的COVID-19检测满负荷能力的87.2%）。2021年4月，该国平均每日COVID-19分子检测量为每10万人349.2次检测。参与实验室在2021年4月第一周进行COVID-19检测的平均周转时间为932分钟，其中卫生部实验室的周转时间最长（平均：1959分钟），而私立实验室的周转时间平均为333分钟（p < 0.001）。约旦的COVID-19分子检测潜力尚未得到充分利用，特别是私立实验室以及学术/研究中心所属的实验室。供应链挑战和人员短缺被确定为阻碍该国充分利用COVID-19分子检测能力的潜在障碍。
