Algeria’s main lab anchors COVID-19 response

ALGIERS, Algeria, March 26, 2020/ — When a sample sent to the
referral laboratory in the capital Algiers gave a positive result, the
Ministry of Health announced Algeria’s first COVID-19 case on 26
February, becoming the second African country to confirm the virus.
Since then, dozens of people have caught the infection. Unlike years
past, it now takes just two hours to analyse such specimen. In
addition to speed, the laboratory is also striving to ensure testing
integrity – an important cog in the efforts to halt the spread of
COVID-19.

Sample collection, transportation and analysis are critical steps in
detecting the virus. To be effective, the collection of laboratory
samples must be done in accordance with strict rules.  The diagnostic
test consists of a swab — a long stick with a piece of cotton or
gauze at the end — taken from the throat and nose of the suspect
case. “When suspect cases are sent to referral hospitals and placed in
isolation, the samples are sent to our laboratory to confirm if they
have COVID-19. Once the sample arrives at the lab, it is logged and
placed in a microbiological security station for analysis,” says Dr
Fawzi Derrar, the acting director of the Institut Pasteur d’Alger
(IPA).

The collection is just the start of the process. Subsequent steps are
crucial, too. “There are cases where samples are declared
inadmissible. For example, it’s only valid if it’s accompanied by the
right documentation,” Dr Jonas Nsenda Nkongolo, a World Health
Organization (WHO) expert on infectious diseases, said during a Rapid
Response Team training course in Algiers in early March.

“Correct documentation should ensure that the identity of the person
is clearly and legibly stated. When this is not done properly, the
test result will not be assigned to the right person and as a result
any measures that follow, such as isolation or care, will be
distorted,” he added.

Handle with care

The IPA is working to overcome other challenges including the proper
handling and transportation of samples to the laboratory in Algiers.
“According to common standards, for precise results, the samples must
be handled with the utmost care. Unfortunately, we have come across
cases where the officers who transport the material mishandle it,” Dr
Derrar explains, adding that training is essential to tackle such
obstacles.

“It is also important to respect the timeframe for transporting the
sample, and in particular, to ensure that it is stored and transported
at a temperature of 4°C, so in a refrigerated cooler, say. If it is
placed outside this ideal temperature, it no longer conforms to the
standard. It must also be transported correctly and not placed in a
horizontal position or upside down. For this reason, it is important
to place the samples in a rack that indicates the direction of storage
with an arrow to keep them upright throughout the journey,” he says.

“Long before this outbreak, WHO had already supported us through staff
training. The support of WHO has helped us to perform better and we
can now meet the high demand resulting from the coronavirus epidemic,”
says Dr Derrar.

“In recent years, we have put in place uniform procedures for the
receipt of samples and laboratory analysis. WHO has provided us with
sufficient laboratory equipment, diagnostic tests, means of transport
and detection kits. This has made a notable difference. A few years
ago, especially for the MERS coronavirus in 2014, it took us a full
day to confirm a case. With COVID-19, we get the results in two
hours.” Dr Derrar explained that now only 0.1% of the samples are
invalid. Since the start of the outbreak the laboratory has received
some 3000 samples of which 302 turned out positive for COVID-19 as of
25 March 2020.

Decentralizing

As the coronavirus epidemic was spreading in other regions, WHO was
already stepping up its support to African countries, in particular by
providing laboratories such as the one at the IPA with a large
quantity of test kits to strengthen their diagnostic capacity. To
accelerate its capacity to diagnose COVID-19 and overcome the
obstacles posed by the long distances involved in transporting
samples, four laboratories have been identified in other Algerian
provinces to serve as referral laboratories under the supervision of
the IPA lab.

Given its expertise and the current context, the IPA has become a key
player in the response to coronavirus, routinely consulted and
involved in decision-making. “When we confirmed the coronavirus and
with the trend we observed, our technical advice was to instantly
limit the movement of people and put an end to mass gatherings in
order to stop the spread of the disease,” says Derrar.

Distributed by APO Group on behalf of WHO Regional Office for Africa.

Source: WHO Regional Office for Africa