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ZIG 4 implements SARS-CoV-2 real-time PCR diagnostic in regional laboratories in Namibia for the Namibia Twinning project (December 2020 and May 2021)

Hands-on training in the newly established SARS-CoV-2 PCR lab in Katima Mulilo in the north-eastern Zambesi region of Namibia, some 1250 km by road from the central NIP laboratory in Windhoek. © ZIG 4/RKIHands-on training in the newly established SARS-CoV-2 PCR lab in Katima Mulilo in the north-eastern Zambesi region of Namibia, some 1250 km by road from the central NIP laboratory in Windhoek. © ZIG 4/RKI

Identification of SARS-CoV-2 infected individuals is crucial to initiate appropriate treatment of COVID-19 patients and to prevent the spread of infections. However, in countries like Namibia there are remote areas where the timely diagnosis of SARS-CoV-2 suspected cases is an enormous challenge due to limited diagnostic capacities on site and long delays due to sample transport over long distance to the central laboratory in Windhoek. When in the context of the GHPP funded Namibia Twinning Project TwiNit an intra-action review (IAR) was performed on the Namibian COVID-19 response in October 2020, these long turn-around times but also limited test capacities of the country were addressed. For the laboratory pillar of the response this resulted in the recommendation to strengthen diagnostic laboratory capacities for COVID-19-testing in regional laboratories, in particular at points of entry (PoE). This recommendation was implemented in several steps:

1) The Ministry of Health and Social Services (MoHSS) together with the National Institute of Pathology (NIP) identified three pilot sites for the implementation of extended molecular testing capacities for COVID-19 diagnostics, i) Katima Mulilo in the Zambesi region as PoE with many travelers to Zambia, Botsuana and Zimbabwe (and 1250 km by road to the central NIP laboratory in Windhoek) and an important transcontinental connection for commercial goods; ii) Walvis Bay in the Erongo region, Namibias major container port on the Atlantic coast with commercial importance for the whole southern region of Africa, and iii) Keetmanshoop in the Kharas region as a center for the whole south of Namibia with PoE from South Africa and Botswana.

2) The selected laboratory sites at local hospitals were assessed during a mission in early December 2020 and a follow-up mission early May 2021 through a team with participants from MoHSS, NIP, University of Namibia (UNAM) and ZIG 4. Together with the local heads and staff of the respective laboratories the group developed plans for the implementation of a real-time PCR work flow that would allow flexible use of PCR assays (also beyond the COVID-19 pandemic) and avoid long delays due to sample transport to Windhoek.
3) RKI procured necessary lab equipment, consumables, and reagents with funding from the COVID-19 response measures from the German Ministry of Health to establish a real-time PCR workflow in the labs.

4) NIP was charged to prepare the laboratory sites according to the needs and plans developed during the assessment missions.
5) During the follow-up mission in May 2021 and with support from UNAM SARS-CoV-2 real-time PCR diagnostic was implemented in Katima Mulilo, the staff was trained, and the lab was provided with material for the first weeks of testing.
In an additional follow-up mission, the two remaining laboratory sites in Walvis Bay and in Keetmanshoop will be equipped and the staff will be trained by the RKI team as soon as preparatory work has been achieved through NIP.

This approach will allow Namibia to analyze samples for SARS-CoV-2 directly on site, avoiding long transport time, and to increase their overall laboratory diagnostic capacities. The installation of the real-time PCR labs in regional sites and the training of staff will sustainably improve diagnostic capacities in Namibia well beyond the current pandemic as an important part of the collaboration between RKI and the Namibia MoHSS to support the implementation of a Namibia Institute of Public Health.

  The Minister of Health, Kalumbi Shangula, visits the SARS-CoV-2 training in Katima Mulilo during a tour of the Zambesi region. © ZIG 4/RKI The Minister of Health, Kalumbi Shangula, visits the SARS-CoV-2 training in Katima Mulilo during a tour of the Zambesi region. © ZIG 4/RKI

Date: 28.07.2021