1 / 21

Accelerating Progress towards Measles & Rubella Elimination

Update from Regional Measles & Rubella Laboratory Network, African Region. Discusses surveillance programs, laboratory activities, performance indicators, challenges, and the way forward towards elimination.

rogerhenry
Download Presentation

Accelerating Progress towards Measles & Rubella Elimination

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Accelerating Progress towards Measles & Rubella Elimination Update from Regional Measles & Rubella Laboratory Network, African Region Hotel Royal, Geneva, Switzerland, 21-23 June 2016

  2. Outline • Measles & rubella surveillance program • Distribution of laboratories • Main activities • Laboratory performance indicators • Detected genotypes • Main Challenges • Way forward

  3. AFR Measles Rubella Program • Measles elimination target by 2020 • Measles (M) or Measles & Rubella (MR ) SIAs going on in the Region : • WHO/AFR MR weekly partners updated by teleconference • CRS (congenital rubella syndrome) surveillance implemented in countries that have / are about to introduce rubella containing vaccine • Regular monitoring of surveillance performance indicators • Measles outbreaks: gaps in population immunity (low routine and SIAs coverage), and shift of epidemiological susceptibility to older age groups. • Measles verification process: not initiated yet

  4. Measles Surveillance Performance Indicators: AFR, 2010-2016

  5. Distribution of MR Laboratories • N=49 labs • Newly established: SEY & MAS • One lab/country except NIE (4) & ETH (3) • No lab: EQG, STP, CAV • Funding: MR initiative National Lab Sub National Lab Regional Ref. Lab

  6. Implementation of internal/external quality control system Training (bench work & data management) Weekly lab data reporting & analysis Monitoring of performance indicators & ensuring follow up actions Strengthening quality assurance Accreditation reviews & lab annual directors meeting WHO support: kits, basic supplies, funds for operationnal cost Main Lab. AFR Network Activities

  7. Laboratory Training conducted, 2015-16 Above training was conducted in Eastern & Southern Africa

  8. Main Laboratory Performance Indicators

  9. Workload at laboratory East Southern labs tested highest number of specimens. Of the 3 RRLs, IPCIV received the least number of specimens

  10. Timeliness & Completeness in Sharing Database Suboptimal completeness & timeliness in sharing database on a weekly basis due to challenges in internet connectivity, competing activities

  11. IgM Results Turn Around Time Stock out of kits adversely affected this indicator especially in 2016

  12. 2015 Measles & Rubella Proficiency Test Reporting by website submission: challenging for some labs, ultimately used old system

  13. Lab. Accreditation Exercises Accreditation process by desk review (correspondence): to be selectively intensified in 2016

  14. Recent Measles Outbreaks • Ethiopia – 2015 and 2016 (throat swabs collected- B3 genotype) • Nigeria – 2015 (59 throat swabs collected- B3 genotype) • DR Congo – 2016 (54 throat swabs collected- B3 genotype) • Uganda – 2015 (73 OFs and 14 throat swabs – B3 genotype) • Sierra Leone – early 2016, Liberia • Namibia – 2015, Equatorial Guinea – 2015 and 2016 • Gabon – early 2016 (12 throat swabs collected- B3 genotype)

  15. Measles Genotype Identified: 2005-2016* • Identified from specimens collected from outbreak & QC • Sequencing lab: NICD,UVRI, IPCIV & CDC • B3 genotype largely circulating (In 2016 identified in DRC, GAB, NIE & TOG) • Submission on MeaNS done B3 B2 D4 D2 D10

  16. 1st Report of Rubella genotype 2B in West Africa (IPCIV) Branch of rubella genotype 1G tree: contains sequences from CIV, Ghana, and Nigeria Branch of rubella genotype 2B tree: contains sequences from DRC, Burundi, and India

  17. Main Challenges • Suboptimal weekly reporting timeliness/completeness • Internet connectivity problems • Competing laboratory activities • Regular stock out of measles & rubella kits • Lack of reagents for PCR & sequencing activities • Insufficient /inadequate coordination between lab & surveillance • Missed opportunity to collect specimens for virus isolation/genotyping

  18. Main Challenges (cn’t) • Suboptimal collection of specimens for virus detection and logistics for it • Refusal from DHL carrier to carry blood specimens since Ebola outbreak event (West & Central Africa) • Insufficient funds to cover lab activities • To purchase kits, sequencing reagents/supplies, consumables • To organize trainings, • For lab operations

  19. Way Forward • Advocate for additional funding for the lab network - 2,4 Millions USD needed per annum • Strengthen collaboration between lab & surveillance to monitor for outbreaks and allow timely collection of specimens for genotyping • Complete accreditation reviews • Additional training on rubella sequencing needed by CIV RRL • Secure alternative carriers to transport specimens for QC

  20. Acknowledgements • NLs & Surveillance teams • 3 RRLs • WHO/HQ • CDC

  21. Reported progress on completion of GAPIII, Phase I Phase 1 completed Planned PEF EMRO Countries

More Related