The NCDC’s strategy to improve COVID-19 testing in Nigeria is based on popular demand are discussed as follows:
The NCDC hopes to achieve a test capacity of 7,500 tests per day to increase the capacity at the time of publishing the document (15th April 2020) by getting 5,000 new tests per day. It is aim to achieve this by taking the following steps:
1. To increase the testing capacity from 9 RT PCR laboratories in 6 states to 15 laboratories in 12 states and Abuja within a thirty-day interval (Deadline 15th of May) by doing so, the Centre hopes to increase the number of tests from 2500 to 3000 daily. To ensure these are achieved by NCDC:
A. Working with state governments and tertiary health facilities with existing PCR capacity and Biosafety level 2 cabinets and this help in leveraging on existing laboratories for Viral Hemorrhage Fever/Polio.
B. Funding sample movement from state capitals to testing laboratories using a private courier company (TRANEX)
C. Expanding the availability of state trained personnel on sample collection.
D. Rolling out the digital tool for surveillance- SORMAS in all testing laboratories to implement real-time data reporting and assigning data clerks to facilities to help with data management.
E. Procuring validated diagnostic kits through multiple sources to ensure the availability of reagents.
2. Leveraging on the high capacity within the HIV molecular laboratories. The NCDC will collaborate with 6 Mega-PCR laboratories to expand COVID-19 testing, these laboratories have Roche Cobas 6800/8800 as well as Abbott M2000 platforms with a combined capacity of 7000 tests daily. The NCDC hopes to covert half of that Capacity for COVID-19. This has been made possible with the development and validation of SARS-CoV2 assay by Roche and Abbott technologies. By taking this steps, the NCDC hopes to increase daily National Testing capacity to at least 5000 by 15th May, 2020. These facilities are in Abuja, Benue, Akwa Ibom, Lagos and Anambra. For this phase to be implemented through the following:
A. The NCDC needs to train existing facility staff and identify additional surge staff.
B. Biosafety, Biosecurity as well as appropriate waste management interventions need to be instituted.
C. Careful planning is required to prevent disruption of HIV workflow.
D. The National integrated sample referral network (NISRN) needs to be activated at state levels to support ongoing transport mechanism of samples and ensure rapid sample referral to the included states.
3. Repurposing point of Care Tuberculosis GeneXpert testing Machines for COVID-19 testing.
By doing this the NCDC hopes to decentralize testing to state levels by converting at least one GeneXpert site in each state to a COVID-19 testing laboratory. Repurposing these GeneXpert machines will be made possible by the use of specially designed Cartridges for COVID-19 testing by Caphied. This will enable states to test about 24 samples daily with a return of results on the same day and bring up national testing capacity to 6,300 tests per day by 30th May, 2020. For this phase to be successfully implemented, the follow noted suggestion need to be noted:
A. Additional investments have to be made to bring up the Biosafety level to level 2 in majority of these facilities, as a significant number of GeneXpert facilities do not currently have biosafety level up to that.
B. Careful planning is required to ensure that TB testing is sustained unimpeded.
C. The current GX-Alert system has to be interfaced with SORMAS for lab data uploading.
4. Inclusion of Private Sector. The NCDC hopes to work with private facilities that have indicated interest to provide an additional about 500 tests daily bringing up the national capacity to 6800 test by 15th June. These private facilities are located in Abuja, Kaduna and Lagos.
To ensure the accuracy and reliability of results the NCDC is working with NAFDAC and the Medical Laboratory Science Council of Nigeria as well as several companies to evaluate test and validate all new PCR kits.
The samples for this testing are Nasopharyngeal or Oropharyngeal Swabs.
500 LEVEL, MEDICAL MICROBIOLOGY/PARASITOLOGY, DEPT. OF MEDICAL LABORATORY SCIENCE, UNIVERSITY OF CALABAR.
TEAM LEAD, MEDLABCONVO.