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评估东非和西非区域实验室网络对国家卫生安全能力的影响。

Assessing the impact of regional laboratory networks in East and West Africa on national health security capacities.

作者信息

League Avery, Bangure Donewell, Meyer Mark J, Salyer Stephanie J, Wanjohi Dorcas, Tebeje Yenew Kebede, Sorrell Erin M, Standley Claire J

机构信息

Milken Institute School of Public Health, The George Washington University, Washington, DC, United States of America.

Laboratory Systems and Networks Division, Africa Centres for Disease Control and Prevention, Addis Ababa, Ethiopia.

出版信息

PLOS Glob Public Health. 2023 May 24;3(5):e0001962. doi: 10.1371/journal.pgph.0001962. eCollection 2023.

Abstract

National laboratories are a fundamental capacity for public health, contributing to disease surveillance and outbreak response. The establishment of regional laboratory networks has been posited as a means of improving health security across multiple countries. Our study objective was to assess whether membership in regional laboratory networks in Africa has an effect on national health security capacities and outbreak response. We conducted a literature review to select regional laboratory networks in the Eastern and Western African regions. We examined data from the World Health Organization Joint External Evaluation (JEE) mission reports, the 2018 WHO States Parties Annual Report (SPAR), and the 2019 Global Health Security Index (GHS). We compared the average scores of countries that are members of a regional laboratory network to those that are not. We also assessed country-level diagnostic and testing indicators during the COVID-19 pandemic. We found no significant differences in any of the selected health security metrics for member versus non-member countries of the either the East Africa Public Health Laboratory Networking Project (EAPHLNP) in the Eastern Africa region, nor for the West African Network of Clinical Laboratories (RESAOLAB) in the Western Africa region. No statistically significant differences were observed in COVID-19 testing rates in either region. Small sample sizes and the inherent heterogeneities in governance, health, and other factors between countries within and between regions limited all analyses. These results suggest potential benefit in setting baseline capacity for network inclusion and developing regional metrics for measuring network impact, but also beyond national health security capacities, other effects that may be required to justify continued support for regional laboratory networks.

摘要

国家实验室是公共卫生的一项基本能力,有助于疾病监测和疫情应对。建立区域实验室网络被认为是提高多个国家卫生安全的一种手段。我们的研究目的是评估非洲区域实验室网络的成员资格是否对国家卫生安全能力和疫情应对有影响。我们进行了文献综述,以选定东非和西非地区的区域实验室网络。我们审查了世界卫生组织联合外部评估(JEE)任务报告、2018年世卫组织缔约国年度报告(SPAR)以及2019年全球卫生安全指数(GHS)的数据。我们比较了区域实验室网络成员国与非成员国的平均得分。我们还评估了新冠疫情期间国家层面的诊断和检测指标。我们发现,对于东非地区的东非公共卫生实验室网络项目(EAPHLNP)以及西非地区的西非临床实验室网络(RESAOLAB),其成员国与非成员国在任何选定的卫生安全指标方面均无显著差异。两个地区的新冠病毒检测率均未观察到统计学上的显著差异。样本量小以及区域内和区域间各国在治理、卫生和其他因素方面固有的异质性限制了所有分析。这些结果表明,在设定网络纳入的基线能力以及制定衡量网络影响的区域指标方面可能有益,但除了国家卫生安全能力之外,还可能需要其他影响来证明对区域实验室网络持续支持的合理性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8b2d/10208488/e62b0231a473/pgph.0001962.g001.jpg

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