Field Actions Science Reports www.field-actions-sci-rep.net 1867-139X 1867-8521 1 1 2008 10.5194/facts-1-1-2008 http://www.field-actions-sci-rep.net/1/1/2008/ http://www.field-actions-sci-rep.net/1/1/2008/facts-1-1-2008.html http://www.field-actions-sci-rep.net/1/1/2008/facts-1-1-2008.pdf 1 7 2008-11-26 Mobile laboratory to improve response to meningitis epidemics, Burkina Faso epidemic season 2004 R. T. Ouedraogo B.-M. Njanpop-Lafourcade P. Jaillard Y. Traoré J. E. Mueller J.-F. Aguilera M. Dabal S. R. Tiendrébéogo W. Goehde A. da Silva B. D. Gessner P. Stoeckel Laboratoire de l'Hôpital Pédiatrique Charles de Gaulle, Ouagadougou, Burkina Faso Agence de Médecine Préventive, Paris, France Université de Ouagadougou, Ouagadougou, Burkina Faso Direction de la Lutte contre la Maladie, Ministère de la Santé, Ouagadougou, Burkina Faso Westfäliche Wilhelms-Universität, Münster, Germany A Mobile Laboratory was developed for use primarily during the epidemic meningitis season in Burkina Faso. This report describes the Mobile Laboratory characteristics, its use to date, problems encountered and their resolution, and future directions. During 2004, the mobile laboratory intervention in three remote Burkina Faso districts experiencing meningitis epidemics led to more specific case management and led directly to vaccination of one district. However, in a second district, the intervention occurred too late to allow vaccination. During 2006, the Mobile Laboratory was used to conduct an emergency carriage study that for the first time occurred during the peak of a meningococcal serogroup A epidemic. This information is critical for the design of meningococcal conjugate vaccine schedules and vaccine approaches. During 2004-6, technicians in 11 district laboratories received training by Mobile Laboratory staff. Numerous problems with the initial prototype laboratory were identified, namely that the solar power cells could not provide enough energy to the refrigerator and incubator to maintain appropriate temperatures and having a single integrated unit required use of a separate vehicle for specimen transport. A second laboratory was developed during 2005-6 that used a generator or local energy source for power and that had a laboratory that could be detached from the vehicle. Currently the main limitation of the Mobile Laboratory is that it has not been integrated into routine Ministry of Health activities, limiting its use both during and between meningitis seasons. Friedland, I. R. and Klugman, K. P.: Failure of chloramphenicol therapy in penicillin-resistant pneumococcal meningitis, Lancet, 339, 405–408, 1992. Hussey, G., Hitchcock, J., Hanslo, D., Schaaf, S., Klugman, K., and Coetzee, G.: Epidemiology, antimicrobial resistance patterns and serotype distribution of \textitStreptococcus pneumoniae infections in Cape Town children, Annual Research Day, Department of Paediatrics and Child Health, University of Cape Town, 1996. Muhe, L. and Klugman, K. P.: Pneumococcal and \textitHaemophilus influenzae meningitis in a children's hospital in Ethiopia: serotypes and susceptibility patterns, Trop. Med. Int. Health, 4, 421–427, 1999. Parent du Chatelet, I., Traore, Y., Gessner, B. D., Antignac, A., Naccro, B., Njanpop-Lafourcade, B. M., Ouedraogo, M. S., Tiendrebeogo, S. R., Varon, E., Taha, M. K.: Bacterial meningitis in Burkina Faso: surveillance using field-based polymerase chain reaction testing, Clin. Infect. Dis., 40, 17–25, 2005. Taha, M. K., Parent du Chatelet, I., Schlumberger, M., Sanou, I., Djibo, S., De Chabalier, F., and Alonso, J. M.: \textitNeisseria meningitidis serogroups W135 and A were equally prevalent among meningitis cases occurring at the end of the 2001 epidemics in Burkina Faso and Niger, J. Clin. Microbiol., 40, 1083–1084, 2002. Vazquez, J. A., Arreaza, L., Block, C., et al.: Interlaboratory comparison of agar dilution and Etest methods for determining the MICs of antibiotics used in management of \textitNeisseria meningitidis infections, Antimicrob. Agents Chemother, 47, 3430–3434, 2003. Weekly Epidemiological Record: Detecting meningococcal meningitis epidemics in highly endemic African countries, Weekly Epidemiological Record, 75, 306–310, 2000. World Health Organization: Antimicrobial and support therapy for bacterial meningitis in children: report of the meeting of 18–20 June 1997, Geneva, Switzerland, WHO/EMC/BAC/98.6, Geneva, World Health Organization, 1998. World Health Organization: Recommended surveillance standards (2nd Ed.), WHO/CDS/CSR/ISR/99.2, Geneva, World Health Organization, 1999. World Health Organisation: Meningococcal meningitis, Fact sheet number 141, Revised May 2003, available at: http://www.who.int/mediacentre/factsheets/fs141/en/, last access: 7~March~2005.