Strengthening Laboratory Systems in Kenya
Laboratorian working under a biosafety cabinet while preparing samples for analysis. Photo credit: Justin Williams
CDC Kenya works to strengthen laboratories and support diagnostic capacity, appropriate specimen-handling, quality assurance systems, and adequate biosafety standards both in Kenya and across the region. In 2017, CDC Kenya supported laboratories responded to 57 outbreaks, of which 40 received laboratory support and 30 yielded a confirmed laboratory diagnosis which identified the pathogen cause, including influenza virus, Vibrio cholerae, hepatitis A virus, Chikungunya virus, and dengue virus. Other causes were rabies virus, Aeromonas hydrophilia, Salmonella, Bacillus anthraces, and measles virus.
Establishing Laboratory Systems in Refugee Camps
In northwestern Kenya, the Kakuma camp is home to over 160,000 refugees from over 18 countries. Infectious disease threats are of critical concern within the refugee population because an outbreak in Kakuma could quickly overwhelm health systems in the region if allowed to spread. A lack of a functional laboratory in Kakuma has hampered the ability of clinicians to determine causes of common diseases and manage them in a timely manner. Some of the refugees in Kakuma are admitted to the United States Refugee Admissions Program. This makes Kakuma a significant target for health protection of the American public, which can be achieved by improving laboratory capacity in the camp.
To address this issue, CDC Kenya together with other collaborative partners in 2017 supported the International Rescue Committee (IRC) efforts in building a laboratory and providing equipment to the Kakuma camp’s General Hospital. Laboratory staff were also trained to test blood and stool samples for infectious diseases. As a result, the turnaround time for receiving lab results reduced from 14 to 5 days because of the ability to test specimens onsite. With these investments, health officials can quickly identify and respond to disease threats in the camp.
Ensuring Access to Laboratory Services in Rural Areas
Another example of CDC Kenya’s health system strengthening improvements were seen at the Lodwar County Referral Hospital (CRH). In the rural areas of Turkana County, Lodwar CRH serves Kenyans as well as the Kakuma Refugee Camp. Despite the large population, the Lodwar CRH offered minimal laboratory services. CDC Kenya through a public-private-partnership and with other PEPFAR partners improved the quality of laboratory services and expanded the menu of available tests. This was accomplished through mentorship focused on laboratory quality systems management mentorship, training and the creation of platforms for stakeholder engagement. The population of Turkana County and those in the surrounding area now have access to quality laboratory services, which serves a key factor in ensuring that they receive accurate and timely disease detection and management.
Ensuring Quality Care Begins with Ensuring Reliable Biomedical Equipment
An improperly calibrated pipette could set the course for HIV misdiagnosis, leading to psychological trauma and the unnecessary use of medication. Laboratory equipment management is an essential element in providing quality diagnosis. However, in many parts of Kenya, preventive and corrective equipment maintenance remains poor due to a lack of qualified biomedical engineering personnel, expensive service technicians, and limited training opportunities. Improperly maintained laboratory equipment can result in:
- Diminished effectiveness of new technologies,
- Failure to meet accreditation standards, and
- A higher probability of inaccurate test results thereby compromising the quality of care to patients.
To address the challenges resulting from equipment breakdown, CDC Kenya (through PEPFAR support) collaborated with the MOH, the Association of Public Health Laboratories, and the American International Health Alliance to deliver a series of hands-on equipment maintenance and calibration training to local MOH engineers. Thirty MOH engineers from across the country and the National Public Health Laboratory were selected for this intensive training.
The engineers participated in two separate week-long courses and learned to properly diagnose and troubleshoot equipment issues, repair them and provide continuous preventive maintenance. The engineers were also provided with an advanced equipment service toolkit. Following the training, the trainees received technical assistance and mentorship at their assigned sites to reinforce their newly acquired skills.
By ensuring the reliability of laboratory equipment, CDC Kenya’s support builds the capacity of local engineers and helps create a sustainable health system. These engineers now take pride that their work directly supports Kenya’s population in knowing and trusting their HIV status.
