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Strengthening laboratory systems in Malawi.

The rapidly growing global interconnectedness, urbanization, and overdependence on natural ecosystems, among others, have facilitated the spread of pathogens and increased the likelihood of transmission of infectious diseases. The establishment of the international health regulations (IHR) aims to prevent, protect against, and provide a public health response to the international spread of diseases. Public health laboratories are a critical component of global communicable disease detection and play a significant part in each of the IHR's primary operations, including event monitoring, detection, assessment, and response. However, in many low and middle-income countries (LMICs), access to quality laboratory testing is still limited. This may lead to misdiagnosis, delayed diagnosis, inadequate and poor treatment, and ultimately higher rates of morbidity and mortality. Laboratory service systems and personnel in LMICs thus need considerable capacity building. It will take functioning national, subnational, and community systems to reach sufficient capacities. Therefore, the regular processes that are used to identify and record incidents ought to be strengthened as part of the laboratory capacity building for IHR core capacity (Masanza al, 2010).

The implementation of the HIVQuant pilot study at the Zomba Central Hospital, which seeks to investigate the use of the HIVQuant® assay for quantification of plasma HIV-1 RNA viral load alongside quantification of intracellular HIV-1 DNA from peripheral blood mononuclear cells or crude whole blood lysates as alternative point-of-care protocols for treatment monitoring in resource-constrained clinics, is part of our efforts to strengthen the country’s clinical laboratory systems. The first stage of our capacity-building approach involves enhancing the knowledge and strengthening the required competence of the laboratory personnel at the Zomba Central Hospital in alternative point-of-care(POC) viral load monitoring systems. Additional capacity-building activities focused on equipment maintenance, calibration, and validation, including IQ,PQ, and OQ validations, will be conducted as part of the main study, which will seek to evaluate the efficacy of the HIVQuant assay.

Lucy Mbewe, a molecular technologist, and her other colleagues at the Zomba Central Hospital received training on the utilization of the HIVQuant kit for early HIV diagnosis and viral load monitoring among patients receiving antiretroviral therapy. Lucy Mbewe’s role at the hospital focuses on the extraction, purification, and quantification of total HIV-1 nucleic acid in plasma and PBMC, performing aseptic techniques to safeguard and maintain the integrity of patient samples, reagents, and test systems utilized, among others.

"I was particularly excited to be among the first laboratory scientists to be exposed to this laboratory-developed assay. It provides a better option to enable quicker screening of thousands of samples at a cheaper cost and labor with greater diagnostic accuracy and precision.

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