Leveraging gains from African Center for Integrated Laboratory Training to combat HIV epidemic in sub-Saharan Africa

Abstract Background In sub-Saharan Africa, there is dearth of trained laboratorians and strengthened laboratory systems to provide adequate and quality laboratory services for enhanced HIV control. In response to this challenge, in 2007, the African Centre for Integrated Laboratory Training (ACILT) was established in South Africa with a mission to train staffs from countries with high burdens of diseases in skills needed to strengthen sustainable laboratory systems. This study was undertaken to assess the transference of newly gained knowledge and skills to other laboratory staff, and to identify enabling and obstructive factors to their implementation. Methods We used Kirkpatrick model to determine training effectiveness by assessing the transference of newly gained knowledge and skills to participant’s work environment, along with measuring enabling and obstructive factors. In addition to regular course evaluations at ACILT (pre and post training), in 2015 we sent e-questionnaires to 867 participants in 43 countries for course participation between 2008 and 2014. Diagnostics courses included Viral Load, and systems strengthening included strategic planning and Biosafety and Biosecurity. SAS v9.44 and Excel were used to analyze retrospective de-identified data collected at six months pre and post-training. Results Of the 867 participants, 203 (23.4%) responded and reported average improvements in accuracy and timeliness in Viral Load programs and to systems strengthening. For Viral Load testing, frequency of corrective action for unsatisfactory proficiency scores improved from 57 to 91%, testing error rates reduced from 12.9% to 4.9%; 88% responders contributed to the first national strategic plan development and 91% developed strategies to mitigate biosafety risks in their institutions. Key enabling factors were team and management support, and key obstructive factors included insufficient resources and staff’s resistance to change. Conclusions Training at ACILT had a documented positive impact on strengthening the laboratory capacity and laboratory workforce and substantial cost savings. ACILT’s investment produced a multiplier effect whereby national laboratory systems, personnel and leadership reaped training benefits. This laboratory training centre with a global clientele contributed to improve existing laboratory services, systems and networks for the HIV epidemic and is now being leveraged for COVID-19 testing that has infected 41,332,899 people globally.

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How does population viral load vary with the evolution of a large HIV epidemic in sub-Saharan Africa?

AIDS ◽

10.1097/qad.0000000000000211 ◽

2014 ◽

Vol 28 (6) ◽

pp. 927-929 ◽

Cited By ~ 3

Author(s):

Laith J. Abu-Raddad ◽

Susanne F. Awad

Keyword(s):

Viral Load ◽

Sub Saharan Africa ◽

Hiv Epidemic ◽

Sub Saharan

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A cross-case analyses of laboratory professionals-patients interaction for patients accessing laboratory services at University of Cape Coast hospital and Ewim Polyclinic in the Cape Coast Metropolis, Ghana

BMC Health Services Research ◽

10.1186/s12913-021-06560-8 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Patrick Adu

Keyword(s):

Laboratory Testing ◽

Sampling Period ◽

Turnaround Time ◽

Sub Saharan Africa ◽

Cape Coast ◽

Microsoft Excel ◽

Laboratory Staff ◽

Laboratory Services ◽

Staff Interactions ◽

Sub Saharan

Abstract Background There is scarcity of data on experiences of patients who access laboratory services during hospital visits in sub-Saharan Africa. This study sought to evaluate the depth of laboratory professionals-patient interactions during pre- and post-sampling period at two hospitals in Ghana. Methods This study used real time observations of patient-laboratory staff interactions to collect first-hand data. Additionally, two separate sets of semi-structured questionnaires were used to collect data on the experiences of patients and laboratory professionals. Data were entered into Microsoft Excel and analysed using SPSS version 25. Results Inadequate laboratory space is a major factor limiting adequacy of patients-laboratory professionals’ interactions. Overall, even though the laboratory professionals (93.3%) overwhelmingly agreed to the need to inform patients about the turnaround time of the respective laboratory testing, this was not routinely done. Irrespective of patients’ educational attainment, patients were poorly informed about their respective laboratory tests. Although both patients and laboratory professionals (60.0% vs 63.6% respectively) indicated that the test requester has responsibility to inform patients about their laboratory testing, only 29.1% of patients indicated having received such explanations. Furthermore, although 28.1% of patients indicated knowing the specifics of their respective test requisition, only 15% could correctly identify their requested laboratory testing. Conclusion There is the need for standard operating protocols to standardize practitioner-patient interaction at the two facilities. Moreover, there is the need for laboratory staff-test requester engagement to clearly delineate who has what responsibilities regarding informing patients about laboratory testing.

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Potential of Spirulina Platensis as a Nutritional Supplement in Malnourished HIV-Infected Adults in Sub-Saharan Africa: A Randomised, Single-Blind Study

Nutrition and Metabolic Insights ◽

10.4137/nmi.s5862 ◽

2011 ◽

Vol 4 ◽

pp. NMI.S5862 ◽

Cited By ~ 15

Author(s):

M. Azabji-Kenfack ◽

S. Edie Dikosso ◽

E.G. Loni ◽

E.A. Onana ◽

E. Sobngwi ◽

...

Keyword(s):

Body Composition ◽

Viral Load ◽

Serum Albumin ◽

Spirulina Platensis ◽

Sub Saharan Africa ◽

Nutritional Rehabilitation ◽

Group A ◽

The Mean ◽

Sub Saharan ◽

Group B

Background Malnutrition is a major global public health issue and its impact on communities and individuals is more dramatic in Sub-Saharan Africa, where it is compounded by widespread poverty and generalized high prevalence of human immunodeficiency virus (HIV). Therefore, malnutrition should be addressed through a multisectorial approach, and malnourished individuals should have access to nutritional rehabilitation molecules that are affordable, accessible, rich in nutrient and efficient. We thus assessed the efficacy of two affordable and accessible nutritional supplements, spirulina platensis versus soya beans among malnourished HIV-infected adults. Methods Undernourished patients, naïve of, but eligible to antiretroviral treatment (ART), aged 18 to 35 years were enrolled and randomly assigned to two groups. The first group received spirulina (Group A) as food supplement and the second received soya beans (Group B). Patients were initiated ART simultaneously with supplements. Food supplements were auto-administered daily, the quantity being calculated according to weight to provide 1.5 g/kg body weight of proteins with 25% from supplements (spirulina and soya beans). Patients were monitored at baseline and followed-up during twelve weeks for anthropometric parameters, body composition, haemoglobin and serum albumin, CD4 count and viral load. Results Fifty-two patients were enrolled (Group A: 26 and Group B: 26). The mean age was 26.4 ± 4.9 years (Group A) and 28.7 ± 4.8 (Group B) with no significant difference between groups ( P = 0.10). After 12 weeks, weight and BMI significantly improved in both groups ( P < 0.001 within each group). The mean gain in weight and BMI in Group A and B were 4.8 vs. 6.5 kg, ( P = 0.68) and 1.3 vs. 1.90 Kg/m2, ( P = 0.82) respectively. In terms of body composition, fat free mass (FFM) did not significantly increase within each group (40.5 vs. 42.2 Kg, P = 0.56 for Group A; 39.2 vs. 39.0 Kg, P = 0.22 for Group B). But when compared between the two groups at the end of the trial, FFM was significantly higher in the spirulina group (42.2 vs. 39.0 Kg, P = 0.01). The haemoglobin level rose significantly within groups ( P < 0.001 for each group) with no difference between groups ( P = 0.77). Serum albumin level did not increase significantly within groups ( P < 0.90 vs. P < 0.82) with no difference between groups ( P = 0.39). The increase in CD4 cell count within groups was significant ( P < 0.01 in both groups), with a significantly higher CD4 count in the spirulina group compared to subjects on soya beans at the end of the study ( P = 0.02). Within each group, HIV viral load significantly reduced at the end of the study ( P < 0.001 and P = 0.04 for spirulina and soya beans groups respectively). Between the groups, the viral load was similar at baseline but significantly reduced in the spirulina group at the end of the study ( P = 0.02). Conclusion We therefore conclude in this preliminary study, firstly, that both spirulina and soja improve on nutritional status of malnourished HIV-infected patients but in terms of quality of nutritional improvement, subjects on spirulina were better off than subjects on soya beans. Secondly, nutritional rehabilitation improves on immune status with a consequent drop in viral load but further investigations on the antiviral effects of this alga and its clinical implications are strongly needed.

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Laboratory Diagnostics Performance in Uganda: A Survey of Test Availability and Constraints Across 100 Laboratories

10.21203/rs.3.rs-842323/v1 ◽

2021 ◽

Author(s):

Noel Namuhani ◽

Suzanne N Kiwanuka ◽

Martha Akulume ◽

Simeon Kalyesubula ◽

William Bazeyo ◽

...

Keyword(s):

Clinical Laboratory ◽

Disease Diagnosis ◽

Sub Saharan Africa ◽

Essential Medicines ◽

Full Blood Count ◽

Laboratory Diagnostics ◽

Cross Sectional ◽

Laboratory Services ◽

Control And Prevention ◽

Sub Saharan

Abstract Background Clinical laboratory services are a critical component of the health system for effective disease diagnosis, treatment, control and prevention. However, many laboratories in Sub Saharan Africa remain dysfunctional. The high costs of tests in the private sector also remain a hindrance to accessing testing services. This study aimed at assessing the functionality of laboratories based on test menus and the associated constraints in Uganda. Methods This cross sectional quantitative study involved an assessment of 100 laboratories randomly selected in 20 districts from four regions of the country. Sixteen percent of the studied laboratories were regional hub laboratories. Laboratory in charges and managers in each of the selected laboratories were interviewed. A checklist for laboratory supplies adapted from the Essential Medicines and Health supplies list for Uganda, (2012) was used to assess availability of testing supplies. Data was analyzed using excel and STATA 14. Results At the point of assessment, generally, all laboratories were able to perform malaria tests and HIV tests. All the hub laboratories conducted malaria tests and TB screening. Less than half had electrolytes tests due to lack of equipment, nonfunctioning equipment and lack of reagents. Full blood count tests were missing in 25% of the hub laboratories mainly due to lack of equipment. The lack of reagents (66.7%) and the lack of equipment (58.3%) caused the majority 10/16 of the hubs to routinely referred specimens for tests that are supposed to be carried out in these laboratories due to lack of reagents (66.7%) and non-functional equipment (58.3%). Although officially recognized as an operational structure, Hub laboratories lacked a list of essential and vital supplies. Conclusions Most laboratories performed well for the common tests. However, many laboratories did not meet testing requirements especially for the advanced tests according to standard testing menus for Uganda due to non-functioning equipment, lack of equipment and reagents. Hubs lack list of essential supplies. Therefore, there is need to provide equipment to laboratories, repair the non-functional ones and develop an essential list of supplies for the hub laboratories.

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Achieving the 4IR University Library in Sub-Saharan Africa: Trends, Opportunities and Challenges

Folia Toruniensia ◽

10.12775/ft.2021.006 ◽

2021 ◽

Vol 21 ◽

pp. 121-140

Author(s):

Christopher Nkiko ◽

Omorodion Okuonghae

Keyword(s):

Industrial Revolution ◽

Resistance To Change ◽

International Standards ◽

Sub Saharan Africa ◽

Library Management ◽

University Library ◽

Comprehensive Collection ◽

Social Mediation ◽

Sub Saharan ◽

Returns On Investment

Aim: The paper examined the university library in the Fourth Industrial Revolution (4IR) and the preconditions for achieving and sustaining the same in Nigeria. 4IR is characterized by a level of automation, deployment of emerging technologies and artificial intelligence, internet connectivity and accessibility to the global information network, subscription to reputable online databases, quality and comprehensive collection in diverse formats, preponderance of digital natives among patrons, increased demand for seamless access to online resources and virtual operations, new library spaces (learning commons, research commons and makerspace), open scholarly communication, research data management, social mediation applications, digital curation and preservation. The challenges militating against effective crystallization of 4IR university libraries include: financial constraints, inadequate infrastructure, resistance to change, inadequate skills and competencies, security and intrusion issues, lack of exposure to international standards. Conclusions: The paper recommended the following as requisite panacea: leadership, demonstrating and justifying returns on investment, benchmarking practices, anti-intrusion and back-up systems, adequate power supply and bandwidth, endowment and corporate social responsibility, indigenous library management software, and capacity building initiatives.

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