Bridging infrastructure gaps for effective microbiology labs in developing nations


The World Health Organisation (WHO) claims that antimicrobial resistance (AMR) is one of the leading public health and development threats in the world. The global health agency estimates that in 2019, 1.27 million deaths were a direct consequence of AMR. In total, AMR contributed to an astounding 4.95 million deaths that year.


With many infections becoming harder to treat and routine medical procedures becoming more risky, AMR has undoubtedly put some of the gains of modern medicine at risk. Caused by the overuse and misuse of antimicrobials in treating humans, animals and plants, drug-resistant pathogens affect people of all income levels in all regions of the world. Nevertheless, poverty and inequality make a difficult problem even worse. It’s no surprise that low- and middle-income countries (LMICs) are worst affected.


More R&D is needed to find effective drugs for infections caused by now-resistant pathogens. Better surveillance is also the need of the hour to track newly developing resistance and nip it in the bud.


The fight against AMR has certainly become stronger in recent years. An editorial in Clinical Microbiology and Infection cites collaborations between laboratories, countries, and international organisations, in addition to interventions to improve antimicrobial stewardship. The editorial also cites the limited focus on microbiology, which can help diagnose and prevent communicable diseases, improve patient care, enhance early outbreak detection, and exponentially fortify the fight against AMR.


Now, more than ever before, LMICs need to bridge infrastructure gaps to make effective microbiology labs available to their populations.


Tackling the infectious disease burden in LMICs


The burden of infectious diseases is the highest in LMICs, where health systems are less equipped to provide a large number of patients with adequate care. Antimicrobial resistance is an added pressure.


With or without AMR, good-quality clinical microbiology labs are vital components of any robust health system. By detecting infectious disease outbreaks and guiding treatment plans, they play an unmatched role in tackling infectious diseases.


Specifically, in the fight against AMR, clinical microbiology lab networks are indispensable for effective AMR surveillance and control, especially when implemented at the population level. As they expand in scale and scope, these labs will revolutionise how LMICs use microbiological data – they will set the stage for the maximum utilisation of routine patient care data in AMR surveillance, antimicrobial stewardship, and infection control in general.


Research has highlighted just how important this data – and by extension, microbiological lab facilities – is/are. AMR surveillance data is the basis for the development and implementation of national AMR plans. Case-based and routine microbiology data can be collected as a part of standard care in LMICs. The authors of the study in question were strongly in support of increasing the use of microbiology testing, with the caveat that its cost falls and quality rises.


Challenges and solutions to expanding clinical microbiology labs in LMICs


The pursuit of more and better microbiology labs in LMICs is not without its fair share of hurdles. Though each city, country, and region has its unique challenges, these challenges are largely infrastructural, technical, and people-related. To have a high-quality and effective microbiological lab network, countries need cutting-edge equipment, skilled workers, and cleanroom lab infrastructure that meets international standards in addition to regulatory development and standardisation.


In the absence of a strong supportive environment, it is difficult for LMICs to establish fully functional, technology-ready, and highly advanced microbiology labs overnight. But they can get awfully close. How, you ask? The answer lies in mobile labs.


It is true that in many resource-constrained developing countries, microbiology lab capacity is minimal to non-existent. But polymerase chain reaction (PCR) diagnostics and point-of-care testing – indispensable during disease surveillance and outbreak control – don’t always need large hospital-associated microbiological labs. Management of the 2013-2014 West Africa Ebola virus outbreaks has shown that mobile laboratories can do just as well. Médecins Sans Frontières (MSF), or Doctors Without Borders, has also explored a more comprehensive approach to the necessity and performance of mobile diagnostic facilities.


Importantly, researchers have pointed out that simple, adaptable, and context-specific clinical microbiology labs can do the trick. A study has shed light on initiatives like the Mini-Lab that could bridge infrastructural gaps until full-scale microbiological facilities can be implemented. A pilot implementation of the Mini-Lab in Haiti showed that such an intervention was acceptable and feasible in resource-constrained settings.


Today, point-of-care diagnostics don’t even require laboratory settings to test patients. Nonetheless, microbiology labs play a vital supportive role. They not only ensure the quality of tests but also facilitate confirmatory testing. As such, labs offer technical, training and supervisory support to introduce and implement simple diagnostics, making them indispensable parts of robust health service delivery.


Essentially, effective and accessible microbiology labs aren’t just about AMR. They are about infectious disease prevention, diagnosis and treatment, everyday patient care, and pandemic preparedness and response.


Modular cleanrooms to plug microbiology gaps


Microbiology laboratories must have controlled environments – limited airborne particles; controlled humidity, temperature, and pressure. These factors are essential to protect the integrity of lab processes. Adding to the challenge in LMICs, cost, quality and long timelines are major impediments to developing effective microbiological lab infrastructure.


PodTech™’s cleanroom solutions make the entire process a whole lot easier.


PodTech™’s modular cleanrooms are supplied with integrated HVAC and air management systems. The self-contained units provide autonomous control over various environmental factors, eliminating worries about unwanted particles, chemicals, and bacteria in the controlled lab environment. In short, they meet the rigorous cleanliness standards that microbiology labs demand.


Prefabricated units must simply be assembled onsite. This plug-and-play feature makes the time to deployment far shorter than for conventional setups – perfectly suited to time-sensitive situations like disease outbreaks.


These modular structures are also portable, bespoke, flexible, and scalable. They can be designed specifically for your needs and can be easily moved from one place to another. That’s why they are ideal for health emergencies, when surveillance teams may need to temporarily install facilities which will eventually be moved to other locations.


Most importantly, cost. Modular laboratory systems are more economical than conventional construction because they do not need structural support from existing buildings, are fully self-contained, can be operated independently, and have lower time and labour requirements for installation.


In short, modular construction is the best, most effective way to set up a microbiological laboratory in low-resource settings. The best way to improve disease surveillance in a short span of time. The best way to improve healthcare delivery and patient outcomes.


PodTech™ is the answer.


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