Strengthening Public Health Systems and Services - Laboratory
A strong national public-health laboratory network is the cornerstone of a strong response to HIV/AIDS. Through PEPFAR, CDC is building capacity for high-quality laboratory services to assist with the rapid expansion of HIV treatment, and the accompanying need for HIV diagnosis and associated care.
Systematic Training, Guidance, and Support
CDC collaborates with U.S. government PEPFAR partners, host governments, Ministries of Health, non-governmental organizations, U.S.-based universities, and the private sector to provide systematic training, guidance, and support for laboratories. Specifically, CDC supports:
- HIV diagnostics and HIV incidence testing
- Hematology, chemistry, and CD4 testing
- TB/opportunistic infection (OI) testing
- Antiretroviral therapy resistance testing
- Dried blood spot polymerase chain reaction (DBS-PCR) for early infant diagnosis
- Viral load monitoring
- Quality control and quality assurance of laboratories and testing activities
CDC also assists countries to develop national strategic laboratory plans and supports quality management of national laboratory systems. CDC consults on all technical aspects of laboratory procurement, standardization, quality control and quality assurance. In addition, CDC also works with international accrediting organizations to establish guidance for accreditation of laboratory services in resource-poor settings.
CDC maintains ongoing collaboration with international laboratory experts and national and regional laboratory personnel to resolve technical issues and develop international tools, guidelines, curricula and other resources to improve laboratory capacity in resource-constrained countries. CDC also contributes to the greater body of scientific knowledge through the presentation of laboratory operational research findings at conferences and through publications in peer reviewed journals.
HIV
Rapid Test Training: Working with the World Health Organization (WHO), CDC
supported the development of a rapid testing training package that is being used
in Botswana, Kenya, Namibia, South Africa, Tanzania, Uganda, Zambia and to train
hundreds of counselors and nurses on proper procedures to perform and interpret
HIV rapid testing for diagnosis.
TB
Diagnosis and Drug Resistance Training: CDC provided technical support
and guidance for TB diagnosis and drug resistance testing in Botswana,
Kenya, Namibia and Zambia. A training package was developed on TB smear
microscopy - the test used extensively for TB diagnosis. In addition, new
methodologies are being implemented in national TB reference laboratories,
to build capacity for rapid detection of drug resistant TB.
Regional
Training Center: CDC provided the technical assistance needed to
establish the African Centre for Integrated Laboratory Training (ACILT) in
Johannesburg, South Africa that will serve as a reference lab for TB, HIV,
and other diseases. CDC continues to provide training and technical guidance
to ACILT, which will significantly increase the pool of laboratory
technicians and health care workers trained in TB and HIV diagnostics
throughout Africa.
Early
Infant Diagnosis: Left unidentified and untreated, studies show that
50-60% of HIV-infected infants die by age two. Early Infant Diagnosis (EID)
using dried blood spots gives HIV-infected infants early access to
appropriate care and treatment. With a simple prick, whole blood is placed
onto a card to dry, creating samples which are stable for relatively long
periods without refrigeration, and are simple to transport. CDC has worked
with partners to implement and expand EID services in 15 countries.
HIV
Drug Resistance Protocol Development, Testing and Training:
In Asia, Central America, and Africa,
CDC has provided guidance and technical support for HIV drug resistance (HIVDR)
detection and
participates in encouraging PEPFAR country programs to implement the WHO HIVDR
strategy (http://www.who.int/hiv/topics/drugresistance/en/index.html.
CDC has supported development of protocols for
surveillance of transmission of drug resistant HIV and supported monitoring of
HIV drug resistance in antiretroviral-treated populations. A sensitive
HIVDR detection tool was developed for
use with dried blood spots in resource-limited countries. This tool has been
shown to cut the cost of HIVDR testing by almost 50%.
CDC has also supported development of an HIVDR laboratory training
package, trained laboratory scientists in PEPFAR countries, and assisted
countries in developing laboratory capacity to conduct genotyping.
Last reviewed: August 27, 2008
Content Source:
Global AIDS Program (GAP)
National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention
