title: Leapfrog diagnostics: Demonstration of a broad spectrum pathogen identification platform in a resource-limited setting.
abstract: BACKGROUND
  Resource-limited tropical countries are home to numerous infectious pathogens of both human and zoonotic origin. A capability for early detection to allow rapid outbreak containment and prevent spread to non-endemic regions is severely impaired by inadequate diagnostic laboratory capacity, the absence of a "cold chain" and the lack of highly trained personnel. Building up detection capacity in these countries by direct replication of the systems existing in developed countries is not a feasible approach and instead requires "leapfrogging" to the deployment of the newest diagnostic systems that do not have the infrastructure requirements of systems used in developed countries.
  
  
  METHODS
  A laboratory for molecular diagnostics of infectious agents was established in Bo, Sierra Leone with a hybrid solar/diesel/battery system to ensure stable power supply and a satellite modem to enable efficient communication. An array of room temperature stabilization and refrigeration technologies for reliable transport and storage of reagents and biological samples were also tested to ensure sustainable laboratory supplies for diagnostic assays.
  
  
  RESULTS
  The laboratory demonstrated its operational proficiency by conducting an investigation of a suspected avian influenza outbreak at a commercial poultry farm at Bo using broad range resequencing microarrays and real time RT-PCR. The results of the investigation excluded influenza viruses as a possible cause of the outbreak and indicated a link between the outbreak and the presence of Klebsiella pneumoniae.
  
  
  CONCLUSIONS
  This study demonstrated that by application of a carefully selected set of technologies and sufficient personnel training, it is feasible to deploy and effectively use a broad-range infectious pathogen detection technology in a severely resource-limited setting.
authors: Center for Bio/Molecular Science and Engineering, Naval Research Laboratory, Washington DC, 20375, USA. tomasz.leski@nrl.navy.mil
authors: Tomasz A
authors: TA
authors: Leski
authors: Rashid
authors: R
authors: Ansumana
authors: Anthony P
authors: AP
authors: Malanoski
authors: David H
authors: DH
authors: Jimmy
authors: Umaru
authors: U
authors: Bangura
authors: Brian R
authors: BR
authors: Barrows
authors: Morie
authors: M
authors: Alpha
authors: Bashiru M
authors: BM
authors: Koroma
authors: Nina C
authors: NC
authors: Long
authors: Abu J
authors: AJ
authors: Sundufu
authors: Alfred S
authors: AS
authors: Bockarie
authors: Baochuan
authors: B
authors: Lin
authors: David A
authors: DA
authors: Stenger
mesh_terms: D000818:Animals; D003142:Communication; D003906:Developing Countries; D004196:Disease Outbreaks / Q000517:prevention & control* / Q000662:veterinary; D004355:Drug Stability; D042241:Early Diagnosis; D011211:Electric Power Supplies; D007202:Indicators and Reagents; D005585:Influenza in Birds / Q000175:diagnosis* / Q000453:epidemiology; D007710:Klebsiella Infections / Q000175:diagnosis / Q000453:epidemiology / Q000662:veterinary; D007753:Laboratories / Q000458:organization & administration*; D059232:Laboratory Personnel / Q000193:education; D046228:Microarray Analysis / Q000379:methods* / Q000662:veterinary; D025202:Molecular Diagnostic Techniques / Q000379:methods / Q000662:veterinary; D011200:Poultry; D011552:Pseudomonas Infections / Q000175:diagnosis / Q000453:epidemiology / Q000662:veterinary; D020133:Reverse Transcriptase Polymerase Chain Reaction / Q000379:methods* / Q000662:veterinary; D012807:Sierra Leone / Q000453:epidemiology; D013048:Specimen Handling
chemical_list: D007202:Indicators and Reagents