AMR in low-resource settings: Médecins Sans Frontières bridges surveillance gaps by developing a turnkey solution, the Mini-Lab

BACKGROUND

In low- and middle-income countries (LMICs), data related to antimicrobial resistance (AMR) are often inconsistently collected. Humanitarian, private and non-governmental medical organizations (NGOs), working with or in parallel to public medical systems, are sometimes present in these contexts. Yet, what is the role of NGOs in the fight against AMR, and how can they contribute to AMR data collection in contexts where reporting is scarce? How can context-adapted, high-quality clinical bacteriology be implemented in remote, challenging and underserved areas of the world?

OBJECTIVES

The aim was to provide an overview of AMR data collection challenges in LMICs and describe one initiative, the Mini-Lab project developed by Médecins Sans Frontières (MSF), that attempts to partially address them.

SOURCES

We conducted a literature review using PubMed and Google scholar databases to identify peer-reviewed research and grey literature from publicly available reports and websites.

CONTENT

We address the necessity of and difficulties related to obtaining AMR data in LMICs, as well as the role that actors outside of public medical systems can play in the collection of this information. We then describe how the Mini-Lab can provide simplified bacteriological diagnosis and AMR surveillance in challenging settings.

IMPLICATIONS

NGOs are responsible for a large amount of healthcare provision in some very low-resourced contexts. As a result, they also have a role in AMR control, including bacteriological diagnosis and the collection of AMR-related data. Actors outside the public medical system can actively contribute to implementing and adapting clinical bacteriology in LMICs and can help improve AMR surveillance and data collection.

Knowledge of Biosafety Among Workers in Private and Public Clinical and Research Laboratories in Morocco

Introduction

This study was conducted to assess the biosafety knowledge among laboratory staff working in Morocco.

Methods

A cross-sectional study was conducted among all laboratory staff in public and private clinical diagnostic and research laboratories between December 5, 2018, and January 5, 2018. Data were collected using a self-administered questionnaire distributed via Google Form.

Results

A total of 235 participants completed the study questionnaire with an estimated response rate of 19%. Overall, 79% of respondents had a high or intermediate level of knowledge. Only 17.4% had participated in prior formal biosafety training courses. The level of knowledge did not differ significantly with gender or activity sector, but it increased with work experience. Knowledge was generally intermediate for signage and principles of biosafety levels (42.1%), low for distinction between technical operations that could pose a risk by generating aerosols (30.2%), and high for wearing personal protective equipment and its components (92.8%). There was a very high level of knowledge on proper waste sorting (100%).

Conclusion

These findings underline the need for establishing a biosafety policy and strengthening biosafety training programs in laboratories in Morocco.

Biosafety and biosecurity capacity building: insights from implementation of the NUITM-KEMRI biosafety training model

The NUITM-KEMRI biosafety training program was developed for capacity building of new biosafety level three (BSL-3) laboratory users. The training program comprehensively covers biosafety and biosecurity theory and practice. Its training curriculum is based on the WHO biosafety guidelines, local biosafety standards, and ongoing biosafety level three research activities in the facility, also taking into consideration the emerging public health issues. The program’s training approach enhances the participant’s biosafety and biosecurity knowledge and builds their skills through the hands-on practice sessions and mentorship training. Subsequently, the trainees are able to integrate acquired knowledge and good practices into their routine laboratory procedures. This article describes implementation of the NUITM-KEMRI biosafety training program.