BUILDING LABORATORY SYSTEMS TO ENHANCE DISEASE SURVEILLANCE
Globally, an effective disease control system requires a strong and vibrant laboratory component. As we enter the outbreak season for some diseases such as Lassa fever, Cerebrospinal meningitis and Cholera, the role of the laboratory cannot be over-emphasised. It is therefore important that our laboratory systems are built to standards as we work towards disease control, elimination and eradication. In the last six months, the Nigeria Centre for Disease Control (NCDC) has been strengthening its National Reference Laboratory (NRL) in Abuja, and its network of collaborating laboratories in all geopolitical zones in the country.
Over the next few weeks, weekly editorials will focus on the laboratory and its role in surveillance and disease control. Focus areas of discussion will include functions of the laboratory in surveillance/Epidemiology, establishing laboratory support for Public Health Surveillance and the role of the laboratory before, during and after an outbreak.
Firstly, it is imperative for the functions of the laboratory in Surveillance/Epidemiology to be highlighted. This will provide clarity on the responsibilities and expectations of the laboratory in disease surveillance. The functions include:
Confirmation of etiology of diseases to resolve syndromic presentation
Building data intelligence for
• Antimicrobial resistance monitoring
• Emergence of unusual isolates
• Detection of new pathogens
- Outbreak detection within the laboratory
• Tracing spread through typing and characterization
• Detection of carriers and natural foci of infection
Determine the end of an outbreak
Determine elimination or eradication of disease
Outbreak detection and investigations of which, results inform response activities to be undertaken.
Develop case definition of priority diseases, particularly on identifying markers for specific disease conditions.
Determine case management modalities of some diseases where serial testing of infected individuals can provide estimation of treatment provided e.g. serial testing for Lassa fever cases to ascertain extent of viral load in patients during the course of the treatment
Understand the natural history of disease
Monitor progress towards control
Develop immunization strategies. This will include identification of different serotypes which will inform vaccine development towards a specified serotype of a causative organism
In a bid to drive home the importance of a strong laboratory system, the Nigeria Centre for Disease Control (NCDC) organised a Laboratory Consultative Meeting with partners during the week, to review the NCDC strategy and implementation plan (2017-2021). The focus for the laboratory is to enhance laboratory capacity to support disease surveillance, prevention and control. This meeting served as a platform to brainstorm and harness ideas as well as deepen commitment towards building a strong laboratory network system in the country. The NCDC strategy and implementation plan (2017-2021) can be assessed on the NCDC website www.ncdc.gov.ng