Centre of Laboratory Systems Division, Africa Centres for Disease Control and Prevention, Addis Ababa, Ethiopia.
International Health Regulations Strengthening Project, Health Protection Operations, United Kingdom Health Security Agency, London, United Kingdom.
Front Public Health. 2024 Sep 18;12:1438334. doi: 10.3389/fpubh.2024.1438334. eCollection 2024.
In 2023, Africa experienced 180 public health emergencies, of which 90% were infectious diseases and 75% were related to zoonotic diseases. Testing capacity for epidemic-prone diseases is essential to enable rapid and accurate identification of causative agents, and for action to prevent disease spread. Moreover, testing is pivotal in monitoring disease transmission, evaluating public health interventions and informing targeted resource allocation during outbreaks. An online, self-assessment survey was conducted in African Union Member States to identify major challenges in testing for epidemic-prone diseases. The survey assessed current capacity for diagnosing priority epidemic-prone diseases at different laboratory levels. It explored challenges in establishing and maintaining testing capacity to improve outbreak response and mitigate public health impact. Survey data analysed diagnostic capacity for priority infectious diseases, diagnostic technologies in use, existing surveillance programmes and challenges limiting diagnostic capacity, by country. The survey result from 15 Member States who responded to the survey, showed high variability in testing capacity and technologies across countries and diverse factors limiting testing capacity for certain priority diseases like dengue and Crimean-Congo haemorrhagic fever. At the same time diagnostic capacity is better for coronavirus disease 2019 (COVID-19), polio, and measles due to previous investments. Unfortunately, many countries are not utilizing multiplex testing, despite its potential to improve diagnostic access. The challenges of limited laboratory capacity for testing future outbreaks are indeed significant. Recent disease outbreaks in Africa have underscored the urgent need to strengthen diagnostic capacity and introduce cost-effective technologies. Small sample sizes and differing disease prioritisation within each country limited the analysis. These findings suggest the benefits of evaluating laboratory testing capacity for epidemic-prone diseases and highlight the importance of effectively addressing challenges to detect diseases and prevent future pandemics.
2023 年，非洲共发生 180 次公共卫生突发事件，其中 90%为传染病，75%与动物源性传染病有关。对易发病进行检测对于快速准确识别病原体以及采取行动防止疾病传播至关重要。此外，检测对于监测疾病传播、评估公共卫生干预措施以及在疫情爆发期间为有针对性的资源分配提供信息也非常关键。我们在非洲联盟成员国中进行了一项在线自我评估调查，以确定易发病检测方面的主要挑战。该调查评估了不同实验室层面诊断优先传染病的能力。它探讨了建立和维持检测能力以改善疫情应对和减轻公共卫生影响的挑战。该调查根据各国情况分析了优先传染病的诊断能力、使用的诊断技术、现有的监测计划以及限制诊断能力的挑战。来自 15 个对调查做出回应的成员国的调查结果显示，各国的检测能力和技术存在很大差异，某些优先疾病（如登革热和克里米亚-刚果出血热）的检测能力受到多种因素的限制。与此同时，由于之前的投资，2019 冠状病毒病、脊髓灰质炎和麻疹的诊断能力更好。不幸的是，尽管多重检测具有改善诊断途径的潜力，但许多国家并未利用多重检测。未来疫情检测实验室能力有限的挑战确实很大。非洲最近的疾病爆发突显了加强诊断能力和引入具有成本效益的技术的紧迫性。每个国家的样本量小且疾病优先排序不同，限制了分析。这些发现表明，评估易发病的实验室检测能力具有重要意义，并强调了有效应对检测疾病和预防未来大流行的挑战的重要性。
