Twenty (25) Officers from Malawi comprising of fifteen (15) laboratory officers and ten (10) surveillance and environmental officers have undergone a practical joint training in Integrated Disease Surveillance and Response (IDSR) and International Health Regulations (IHR, 2005) and laboratory-based surveillance in line with the One Health Approach. The joint training took place in Salima District from 15 – 21 January 2018.
The joint training was attended by officers from three (3) provinces namely; North, South and Central. East Central and Southern Africa Health Community (ECSA-HC) organized the joint training in partnership with the Ministry of Health of Malawi under the Southern Africa Tuberculosis and Health Systems Support (SATBHSS) project. One of the aims of the project is to improve regional capacity for disease surveillance, diagnostics, and management of TB and Occupational Lung Diseases and Malawi is taking lead as the Centre of Excellence (COE) in community TB care and integrated Disease Surveillance on the project.
The main objective of the joint training was to build capacity for surveillance and laboratory officers in outbreak and other health emergency preparedness and response. Participants were also oriented on the progress in implementation of IDSR by Malawi, the IDSR/IHR 2005 guidelines and principles of outbreak management and response and communication. In response to the recent cholera outbreak in Malawi, a significant amount of time was allocated where a series of scenarios developed by the facilitators were used to review strengths, weakness and opportunities for improvement in terms of the country’s preparedness and response from community to government level, and laboratory capacity.
Speaking on behalf of the National TB Manager, Mr. Mabvuto Chiwaula, the National TB Reference Laboratory Manager indicated that this training was the first of its kind where laboratory and surveillance officers are jointly trained. He emphasized that surveillance and outbreak preparedness and response require a joint approach by laboratory and surveillance as well as other sectors like environmental health, water, security, media, education and many others as indicated by the One Health Approach. Therefore, this training served as a platform for establishing a working relationship between surveillance and laboratory officers, which is key in surveillance and outbreak response.
The joint training was delivered in two modules over a period of six days. The first module attended by both surveillance officers and laboratory staff covered general surveillance and laboratory topics while the second module involved only laboratory officers and concentrated more on laboratory technics from preparation and quality control of media to sample collection, transportation, processing and reporting of results. After each didactic session, participants went to the laboratory at Salima District Hospital to put theory into practice. They were taken through the steps of processing and identifying of such organism like Vibrio Cholera, E.Coli, S. Aureus and other non-lactose fermenters of significance like Shigella. Key in Module 2 was the collection and processing of environmental samples. Participants were split into three groups that went on a field visit to the Salima Water Board where they sampled water; two of Salima markets where they sampled different forms of food and the hospital kitchen.
The training was co-facilitated by two Regional experts namely; Mr. Charles Njonjo of Ministry of Health Kenya and Mr. Atek Kagirita of Ministry of Health Uganda. Other facilitators included Dr Talkmore Maruta of ECSA-HC and two local trainers, Mr. Alick Banda and Mr. Edward Chado also conducted the training from the National Microbiology Reference Laboratory the IDSR focal person for Malawi respectively. Facilitators and participants in the joint training proposed the following recommendations:
- To conduct the training close to a facility that is able to offer a laboratory with adequate space, reagents and supplies to ensure all practical are conducted in full.
- Ensure all sensitization, planning meetings and training on surveillance and outbreak preparedness and response have One Health Approach representations (Surveillance, environmental, laboratory and clinicians, veterinary, wildlife)
- Identify laboratories to be strengthened to provide microbiology services such as culture and Drug Susceptibility Testing (DST) as well processing of environmental samples. This include equipment, reagents and supplies, drugs for DST and trained staff.
- An evaluation of readiness (facility, staffing, equipment, reagents) should be conducted.
- A program for sensitization of clinicians and other users of availability of services must be developed