Cross-contamination in molecular laboratories: A challenge to COVID-19 testing in Bangladesh

2021 ◽  
Vol 2 (5) ◽  
Author(s):  
Mohammad Jahidur Rahman Khan ◽  
◽  
Selim Reza ◽  
Farzana Mim ◽  
Md Abdullah Rumman ◽  
...  
Keyword(s):  
Public Health ◽  
Large Scale ◽  
Diagnostic Testing ◽  
Diagnostic Errors ◽  
Laboratory Diagnosis ◽  
Cross Contamination ◽  
Rt Pcr ◽  
Public Health Response ◽  
Surveillance Programs ◽  
The Government

Rapid and accurate laboratory diagnosis of SARS-CoV-2 infection is crucial for the management of COVID-19 patients and control of the spread of the virus. At the start of the COVID-19 pandemic, Bangladesh had only one government molecular laboratory where real-time RT-PCR will be performed to diagnose SARS-CoV-2 infection. With the increasing number of suspected cases requiring confirmation diagnostic testing, there was a requirement to quickly expand capacity for large-scale testing. The government of Bangladesh established over 100 molecular laboratories within one year to test COVID-19. To fulfil the requirement for expanded testing, the government was compelled to recruit laboratory employees with inadequate experience, technical knowledge, and skills in molecular assays, particularly in processing specimens, interpreting results, recognizing errors, and troubleshooting. As a result, the risk of diagnostic errors, such as cross-contamination, is increased, as is that the risk of false-positive results, which might risk the patient’s health and undermine the efficacy of public health policies, public health response, surveillance programs, and restrictive measures aimed toward containing the outbreak. This review article aims to explain different sources of crosscontamination in the COVID-19 RT-PCR laboratories and the way to forestall them in efficient and practical ways.

scholarly journals Confronting the Moscow Healthcare System with the Shocks of COVID-19

2021 ◽  
Vol 2 (1) ◽  
pp. 41-46
Author(s):  
Aleksandr N. Tsibin ◽  
Munira F. Latypova ◽  
Olga I. Ivanushkina
Keyword(s):  
Public Health ◽  
Large Scale ◽  
Virus Disease ◽  
Laboratory Diagnosis ◽  
Capital City ◽  
Laboratory Diagnostics ◽  
Successful Implementation ◽  
Laboratory Service ◽  
The Government ◽  
Challenging Situation

Introduction. Transmissible coronavirus SARS-CoV-2I is the seventh known coronavirus that causes an acute infectious disease predominantly affecting the lungs (Corona Virus Disease 2019, COVID-19). The COVID-19 pandemic exposed serious gaps in health systems preparedness. The epidemic urgently required priority organizational measures to contain and reduce the spread of COVID-19. Public health authorities had to make decisions in a challenging situation where there was a lack of knowledge, experience, and great confidence, and the number of infected was steadily increasing. Purpose. The purpose of this article is to present the unique experience of Moscow in organizing a large-scale laboratory examination of the population of a metropolis with about 12.6 million inhabitants to meet the needs of the capital in testing for SARS-CoV-2 virus and combating its circulation in conditions of the COVID-19 pandemic. Materials and Methods. The decisions made and the measures taken by the Government of Moscow, the Moscow Operational Staff, the DZM and the DZM Laboratory Service to slow the growth of the COVID-19 epidemic among the population of the capital are listed step-by-step. Results. In the course of organizational activities, sufficient capacity to maintain the public health infrastructure in terms of laboratory diagnosis of the new coronavirus infection was ensured by the joint efforts. Safe laboratory diagnostics for detecting, treating, and isolating COVID-19 cases and contacts have been established in the capital city. Thanks to the successful implementation of timely decisions, the spread of infection in the city of Moscow has been slowed. The Moscow government has reported a steady decline in cases of the new coronavirus disease and most hospitals have switched to a safe treatment regimen for patients requiring hospitalization. Centralized laboratories with readiness to perform screening and referral studies for COVID-19 outbreaks have been established within the structure of the DZM.

scholarly journals An Update on Advances in COVID-19 Laboratory Diagnosis and Testing Guidelines in India

2021 ◽  
Vol 9 ◽  
Author(s):  
K. S. Rajesh Kumar ◽  
Suhail Sayeed Mufti ◽  
Vinu Sarathy ◽  
Diganta Hazarika ◽  
Radheshyam Naik
Keyword(s):  
Large Scale ◽  
Vaccine Development ◽  
Point Of Care ◽  
Diagnostic Testing ◽  
Public Health Intervention ◽  
Laboratory Diagnosis ◽  
Accurate Diagnosis ◽  
Nucleic Acid Amplification ◽  
Rt Pcr ◽  
Outbreak Management

The declaration of COVID-19 as a global pandemic has warranted the urgent need for technologies and tools to be deployed for confirming diagnosis of suspected cases. Diagnostic testing for COVID-19 is critical for understanding epidemiology, contract-tracing, case management, and to repress the transmission of the SARS-CoV-2. Currently, the Nucleic Acid Amplification Test (NAAT)-based RT-PCR technique is a gold standard test used for routine diagnosis of COVID-19 infection. While there are many commercially available RT-PCR assay kits available in the market, selection of highly sensitive, specific, and validated assays is most crucial for the accurate diagnosis of COVID-19 infection. Laboratory diagnosis of SARS-CoV-2 is extremely important in the disease and outbreak management. Development of rapid point of care tests with better sensitivity and specificity is the critical need of the hour as this will help accurate diagnosis and aid in containing the spread of SARS-CoV-2 infection. Early detection of viral infection greatly enhances implementation of specific public health intervention, such as infection control, environmental decontamination, and the closure of specific high-risk zones. Large-scale sequencing of SARS-CoV-2 genome isolated from affected populations across the world needs to be carried to monitor mutations that might affect performance of molecular tests. Creation of genome repositories and open-source genetic databases for use by global researchers is clearly the way forward to manage COVID-19 outbreak and accelerate vaccine development. This review summarizes various molecular diagnostics methods, technical guidelines, and advanced testing strategies adopted in India for laboratory diagnosis of COVID-19.

scholarly journals Cross-contamination in Molecular Diagnostic Laboratories in Low- and Middle-income Countries: A Challenge to COVID-19 Testing

2020 ◽  
Vol 5 (2) ◽  
pp. 7-11
Author(s):  
Pia Marie Albano ◽  
Keyword(s):  
Public Health ◽  
The Philippines ◽  
Molecular Diagnostic ◽  
Reference Laboratory ◽  
Cross Contamination ◽  
Rt Pcr ◽  
Public Health Response ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low And Middle Income

At the start of the pandemic, the Philippines had to send swab samples to the Victorian Infectious Diseases Reference Laboratory in Melbourne, Australia for COVID-19 confirmation. With the increasing number of suspected cases needing confirmatory diagnostic testing, there was a demand to rapidly expand the capacity for widescale testing. Remarkably, within 200 days from announcement of the first confirmed COVID-19 case in the Philippines in January 30, 2020, the country has been able to expand its testing capacity from one national reference laboratory, the Research Institute for Tropical Medicine (RITM), to more than 100 licensed reverse transcription-polymerase chain reaction (RT-PCR) and cartridge-based PCR laboratories across the country. Due to the shortage of a trained clinical laboratory workforce, diagnostic centers are forced to hire additional personnel who have limited experience and technical knowledge and skills of molecular assays, especially in processing specimens, interpreting the results, identifying errors, and troubleshooting, in order to meet the demand of increased testing. Thus, the vulnerability to diagnostic errors, including cross-contamination, is increased and with the tendency for generating false positive results that can compromise the health of the patient and disrupt the efficacy of public health policies and public health response, surveillance programs, and restrictive measures for containing the outbreak. Hence, this review article aims to present the different sources of contamination in the laboratory setting where RT-PCR assays are conducted, as well as provide efficient, effective and feasible solutions to address these issues, most especially in low- and middle-income countries (LMICs) like the Philippines.

scholarly journals Public Health Workforce Burnout in the COVID-19 Response in the U.S.

2021 ◽  
Vol 18 (8) ◽  
pp. 4369
Author(s):  
Kahler W. Stone ◽  
Kristina W. Kintziger ◽  
Meredith A. Jagger ◽  
Jennifer A. Horney
Keyword(s):  
Public Health ◽  
Health Workforce ◽  
Work Experience ◽  
Large Scale ◽  
Health Workers ◽  
Public Health Workforce ◽  
Cross Sectional Survey ◽  
Public Health Response ◽  
Cross Sectional ◽  
The U.S

While the health impacts of the COVID-19 pandemic on frontline health care workers have been well described, the effects of the COVID-19 response on the U.S. public health workforce, which has been impacted by the prolonged public health response to the pandemic, has not been adequately characterized. A cross-sectional survey of public health professionals was conducted to assess mental and physical health, risk and protective factors for burnout, and short- and long-term career decisions during the pandemic response. The survey was completed online using the Qualtrics survey platform. Descriptive statistics and prevalence ratios (95% confidence intervals) were calculated. Among responses received from 23 August and 11 September 2020, 66.2% of public health workers reported burnout. Those with more work experience (1–4 vs. <1 years: prevalence ratio (PR) = 1.90, 95% confidence interval (CI) = 1.08−3.36; 5–9 vs. <1 years: PR = 1.89, CI = 1.07−3.34) or working in academic settings (vs. practice: PR = 1.31, CI = 1.08–1.58) were most likely to report burnout. As of September 2020, 23.6% fewer respondents planned to remain in the U.S. public health workforce for three or more years compared to their retrospectively reported January 2020 plans. A large-scale public health emergency response places unsustainable burdens on an already underfunded and understaffed public health workforce. Pandemic-related burnout threatens the U.S. public health workforce’s future when many challenges related to the ongoing COVID-19 response remain unaddressed.

scholarly journals Early introductions and community transmission of SARS-CoV-2 variant B.1.1.7 in the United States

2021 ◽  
Author(s):  
Tara Alpert ◽  
Erica Lasek-Nesselquist ◽  
Anderson F. Brito ◽  
Andrew L. Valesano ◽  
Jessica Rothman ◽  
...  
Keyword(s):  
Public Health ◽  
United States ◽  
New York ◽  
Diagnostic Testing ◽  
The United States ◽  
International Travel ◽  
Health Concern ◽  
Public Health Response ◽  
Community Transmission ◽  
The Uk

SummaryThe emergence and spread of SARS-CoV-2 lineage B.1.1.7, first detected in the United Kingdom, has become a national public health concern in the United States because of its increased transmissibility. Over 500 COVID-19 cases associated with this variant have been detected since December 2020, but its local establishment and pathways of spread are relatively unknown. Using travel, genomic, and diagnostic testing data, we highlight the primary ports of entry for B.1.1.7 in the US and locations of possible underreporting of B.1.1.7 cases. New York, which receives the most international travel from the UK, is likely one of the key hubs for introductions and domestic spread. Finally, we provide evidence for increased community transmission in several states. Thus, genomic surveillance for B.1.1.7 and other variants urgently needs to be enhanced to better inform the public health response.

scholarly journals Potential preanalytical and analytical vulnerabilities in the laboratory diagnosis of coronavirus disease 2019 (COVID-19)

2020 ◽  
Vol 58 (7) ◽  
pp. 1070-1076 ◽  
Author(s):  
Giuseppe Lippi ◽  
Ana-Maria Simundic ◽  
Mario Plebani
Keyword(s):  
Diagnostic Accuracy ◽  
Diagnostic Errors ◽  
Laboratory Diagnosis ◽  
Test Results ◽  
Rt Pcr ◽  
Viral Recombination ◽  
Technical Issues ◽  
Diagnostic Window ◽  
Novel Coronavirus ◽  
And Storage

AbstractA novel zoonotic coronavirus outbreak is spreading all over the world. This pandemic disease has now been defined as novel coronavirus disease 2019 (COVID-19), and is sustained by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). As the current gold standard for the etiological diagnosis of SARS-CoV-2 infection is (real time) reverse transcription polymerase chain reaction (rRT-PCR) on respiratory tract specimens, the diagnostic accuracy of this technique shall be considered a foremost prerequisite. Overall, potential RT-PCR vulnerabilities include general preanalytical issues such as identification problems, inadequate procedures for collection, handling, transport and storage of the swabs, collection of inappropriate or inadequate material (for quality or volume), presence of interfering substances, manual errors, as well as specific aspects such as sample contamination and testing patients receiving antiretroviral therapy. Some analytical problems may also contribute to jeopardize the diagnostic accuracy, including testing outside the diagnostic window, active viral recombination, use of inadequately validated assays, insufficient harmonization, instrument malfunctioning, along with other specific technical issues. Some practical indications can hence be identified for minimizing the risk of diagnostic errors, encompassing the improvement of diagnostic accuracy by combining clinical evidence with results of chest computed tomography (CT) and RT-PCR, interpretation of RT-PCR results according to epidemiologic, clinical and radiological factors, recollection and testing of upper (or lower) respiratory specimens in patients with negative RT-PCR test results and high suspicion or probability of infection, dissemination of clear instructions for specimen (especially swab) collection, management and storage, together with refinement of molecular target(s) and thorough compliance with analytical procedures, including quality assurance.

scholarly journals Childhood detention during COVID-19 in Italy: building momentum for a comprehensive child protection agenda

2020 ◽  
Author(s):  
Silvia Logar ◽  
Maggie Leese
Keyword(s):  
Public Health ◽  
Child Protection ◽  
State Responsibility ◽  
Infectious Agents ◽  
Public Health Response ◽  
The Public ◽  
Health Response ◽  
The Government ◽  
Detention Facilities

Abstract Childhood detention represents an integral part of the public health response to the COVID-19 emergency. Prison conditions in Italy put detained minors at grave risk of contracting sudden acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. To date (29 April 2020), the Italian penitentiary system is housing 161 minors (147 males), most of them in pre-trial custody, as well as 50 children &lt;3 y of age residing with their mothers in detention. Furthermore, the government reported 5265 unaccompanied minor migrants, mainly from Gambia and Egypt. The fundamental approach to be followed in childhood detention during COVID-19 is prevention of the introduction of infectious agents into detention facilities, limiting the spread within the prison and reducing the possibility of spread from the prison to the outside community. This appears challenging in countries like Italy with intense SARS-CoV-2 transmission. The current COVID-19 pandemic shows the need to provide a comprehensive childhood protection agenda, as the provision of healthcare for people in prisons and other places of detention is a state responsibility.

scholarly journals Round table: Re-thinking health inequalities

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
Keyword(s):  
Public Health ◽  
Health Inequalities ◽  
Large Scale ◽  
Social Inequalities ◽  
Causal Effect ◽  
Round Table ◽  
Living Conditions ◽  
Causal Pathways ◽  
Research Findings ◽  
The Government

Abstract Health inequalities - systematically higher rates of morbidity and mortality among people with a lower socioeconomic position - have been on the public health agenda for decades now. However, despite massive research efforts (and somewhat less massive policy efforts) health inequalities have not narrowed - on the contrary, relative inequalities have widened considerably. It is therefore time for a re-think: after decades of research we need to step back and ask ourselves: what went wrong? Johan Mackenbach argues, in a book published by Oxford University Press (2019), that the main problem is that public health researchers and policy-makers have misunderstood the nature of health inequalities. They have too often ignored insights from other disciplines, such as economics (which has a stricter attitude to issues of causality) and sociology (which has a subtler understanding the nature of social inequality). They have also failed to integrate contradictory research findings into mainstream thinking. This workshop will focus on three such contradictions, and will discuss whether it is possible to re-think health inequalities in a way that will allow more effective policy approaches. (1) It has been surprisingly difficult to find convincing scientific evidence for a causal effect of socioeconomic disadvantage on health. Should public health reconsider its idea that health inequalities are caused by social inequalities, and widen their scope to give more room to social selection, genetic factors and other non-causal pathways in their analysis? (2) There is not a single country in Europe where over the past decades health inequalities, as measured on a relative scale, have narrowed. This is due to the fact that all groups have improved their health, but higher socioeconomic groups have improved more. This is even true in the only European country (i.e., England) in which the government has pursued a large-scale policy program to reduce health inequalities. Should public health accept that reducing relative inequalities in health is impossible, and focus on reducing absolute health inequalities instead? (3) The Nordic countries, which have been more successful than other European countries in reducing inequalities in material living conditions, do not have smaller health inequalities. It is as if inequalities in other factors, such as psychosocial and behavioural factors, in these countries have filled the gap left by reduced inequalities in material living conditions. Should public health reconsider its idea that material living conditions are the foundation for health, and re-focus on psychological, cultural and other less tangible factors instead? In this round table Johan Mackenbach will present and illustrate these contradictions and propose his answers to these contentious issues. Then, the four panelists will present their view-points, followed by a general discussion between panelists and the audience. Key messages After four decades of research into health inequalities, it is necessary to step back and ask ourselves why it has so far been impossible to reduce health inequalities. More effective policies to tackle health inequalities will only be possible when public health has come to grips with contradictory research findings. Johan Mackenbach Contact: [email protected] Johannes Siegrist Contact: [email protected] Alastair Leyland Contact: [email protected] Olle Lundberg Contact: [email protected] Ramune Kalediene Contact: [email protected]

scholarly journals Assessing the South Korean Model of Emergency Management during the COVID-19 Pandemic

2021 ◽  
Author(s):  
MH Kim ◽  
Wonhyuk Cho ◽  
H Choi ◽  
JY Hur
Keyword(s):  
Public Health ◽  
Good Governance ◽  
Diagnostic Testing ◽  
Contact Tracing ◽  
Global Public Health ◽  
Asian Studies ◽  
Health Crisis ◽  
South Korean ◽  
Public Health Professionals ◽  
The Government

© 2020, © 2020 Asian Studies Association of Australia. The COVID-19 pandemic has led to an unprecedented global public health crisis, and governments have implemented various responses with varying degrees of effectiveness. South Korea’s approach, which has involved minimal lockdown in order to “flatten the curve”, and which offers an alternative for many democracies, has attracted much attention. Based on in-depth interviews with public health professionals and policy advisors in government agencies, this article analyses how well South Korea’s response to COVID-19 complies with the expectations of good governance, and assesses the strengths and challenges of the Korean model. Our analysis shows that South Korea has been reactive rather than preventive/passive amid waves of clusters such as outbreaks in nightclubs, e-commerce warehouses, schools, hospitals and religious gatherings. The government has used a range of countermeasures, including contact tracing, diagnostic testing, media briefings and text alerts. At the same time, the challenges for the Korean approach have been concerns about privacy, fatigue over emergency alerts and politicisation.

scholarly journals Public Health response to an outbreak of SARS-CoV2 infection in a Barcelona prison

2020 ◽  
Author(s):  
A Marco ◽  
C Gallego ◽  
V Pérez-Cáceres ◽  
RA Guerrero ◽  
M Sánchez-Roig ◽  
...  
Keyword(s):  
Public Health ◽  
Health Worker ◽  
One Health ◽  
Clinical Deterioration ◽  
Rt Pcr ◽  
Public Health Response ◽  
Prison Staff ◽  
Staff Members ◽  
Health Response ◽  
Optimal Coordination

AbstractAn outbreak of SARS-CoV2 infection in a Barcelona prison was studied after seven cases appeared in nine days. One hundred and eighty-four people (148 inmates and 36 prison staff) were evaluated by rt-PCR. Thirty-nine (24.1%) were positive: 33 inmates and six staff members. The inmates were isolated in prison module 4, which was converted into an emergency COVID unit. Two people (one inmate and one health worker) were admitted to hospital for clinical deterioration. There were no deaths. Outbreaks pose a huge risk, must be detected early, are difficult to manage, and require optimal coordination between health and prison authorities.

Sign in / Sign up

Export Citation Format

Share Document