The Mérieux Foundation takes a network-based approach to supporting laboratories and improving the surveillance of diseases that have the potential to cause an epidemic. Thanks to this approach, laboratories from the same country or region are able to pool resources and share expertise, while they also gain greater independence in their activities.
Certain labs in Madagascar lack sufficient equipment and personnel to perform basic analyses in line with good practices.
The Mérieux Foundation is therefore creating a network of laboratories in Madagascar to train personnel and improve the quality of care for patients.
Provide technical support to set up biomedical analyses for the diagnosis and surveillance of infectious diseases in around 15 public and private hospitals in Madagascar.
- Renovate the laboratories participating in this project, which was launched in late 2006;
- Equip the labs with sufficient reagents and supplies to start operating;
- Put in place new microbiology analyses;
- Support epidemiological surveillance;
- Provide training for technicians and laboratory biologists;
- Set up a quality assurance system;
- Organize committees for laboratory management;
- Organization of specialized workshops on antibiotic resistance in seven laboratories strengthened in microbiology.
In 2017, the Mérieux Foundation worked to strengthen bacteriology in seven laboratories in five regions, namely the Joseph Raseta Befelatanana, Joseph Ravoahangy Andrianavalona, Tsaralalana Mother-Child, Androva de Majunga and Morafeno de Tamatave hospitals, as well as the CHRRs of Antsirabe and Ambatondrazaka. These seven laboratories were equipped with reagents and consumables necessary to start new bacteriology analyses.
An 80/20 and 60/40 cost recovery management system has been implemented in five hospitals.
External quality assessment was continued this year in the laboratories, with the integration of new laboratories. Technicians and biologists from the laboratories of the network received a training in quality assurance.
Finally, the implementation of the free, open source DHIS2 health data management platform, recommended by the World Health Organization, was launched for laboratories that have used the LabBook laboratory information management system, a free and open-source software developed by the Mérieux Foundation. This platform makes it possible to strengthen the epidemiological surveillance of diseases in Madagascar.
Three laboratories joined the RESAMAD network: the laboratory at the Morafeno Teaching Hospital in Tamatave, the Andapa District Hospital Center (CHD) laboratory, and the Ifanadiana CHD laboratory. Two sessions provided training on quality assurance, equipment maintenance and how to use LabBook laboratory management software.
The Mérieux Foundation also helped set up a bacteriology unit at the laboratory of the Morafeno Teaching Hospital in Tamatave. This lab was equipped with the reagents and materials necessary to begin performing new bacteriology analyses.
In addition, External Quality Assessment (EQA), which assesses the effectiveness and performance of laboratory analyses, was set up in the pilot laboratories.
The Mérieux Foundation is also overseeing a pilot project to set up a medical bacteriology laboratory and ensure its long-term operations at the Befelatanana Teaching Hospital in Antananarivo. The goal is to create a top-notch laboratory for the surveillance of antibiotic resistance in Madagascar. According to WHO, antibiotic resistance is one of the most serious threats to public health worldwide, causing 700,000 deaths each year, largely in developing countries like Madagascar.
In 2016, the Befelatanana Teaching Hospital focused its efforts on bacteriology in order to establish a minimal package of bacteriology analyses on a pilot basis. Over the course of the year, it received 2,276 samples for 11 different types of analysis. For example, it detected 47% of MRSA (methicillin-resistant Staphylococcus aureus), compared to 17% in France. Beyond the technical value of this project, it helps the laboratory achieve financial independence and sustainability.
Three hospital laboratories were renovated: the Befelatanana Teaching Hospital Bacteriology Laboratories, the Sambava CHRR (Regional Hospital Center of Reference) Laboratory, and the Andapa Adventist Hospital Laboratory. New microbiological analysis were set up and the labs were equipped with the necessary reagents and supplies to begin performing these medical analyses.
The Mérieux Foundation also helped organize theoretical and practical training at the Charles Mérieux Center for Infectious Disease in Antananarivo, and provided validation and monitoring as the new analyses were set up. External Quality Assessment (EQA) was implemented in 12 laboratories.
Three laboratories were renovated: the Mahajanga Teaching Hospital Bacteriology Laboratory, the Tsaralalana Mother-Child Hospital Laboratory in Antananarivo and the Tsiroanomandidy Hospital Center Laboratory in the western part of the country. Each site has received the necessary equipment, reagents and supplies to start performing new analyses.
A training session including theory and practice was organized at the Charles Mérieux Center for Infectious Diseases, as well as in each laboratory, with the aid of interns in bacteriology.
In addition, a computerized laboratory management system was installed at the Medical Biology Laboratory of the Tsaralalana Mother-Child Hospital and at eight regional hospital laboratories.
A biologist was trained abroad in microbiology and became the local technical adviser to support the laboratories of the network.
First, the program provided technical support to regional laboratories members of the network.
Next, at the request of the Malagasy Ministry of Public Health, the Mérieux Foundation provided logistical assistance to seven regional laboratories, supplying reagents and materials, and helped them launch microbiology and immunology activities.
The Mérieux Foundation organized a training session for laboratory technicians in seven regional hospital laboratories, in partnership with the Ministry of Public Health, with the financial support of Agence Française de Développement. Malian instructors who are familiar with challenges similar to those encountered in Madagascar led the training sessions.
The Mérieux Foundation took part in laboratory technician training at three District Hospital Centers and helped train laboratory personnel at the CHRR laboratory in Fort-Dauphin.
2010 marked the launch of the Charles Mérieux Center for Infectious Disease based on the campus of the University of Antananarivo.
Covering a surface area of 540 m2, the Center houses a classroom, a practice room and the Rodolphe Mérieux Laboratory (242 m2), which includes offices, a BSL-2 confinement area and laboratories equipped for molecular biology procedures.
The Mérieux Foundation contributed to renovating and equipping the CHRR laboratory in Fort-Dauphin.
The renovation of the medical analysis laboratory of the Antsirabe public hospital, which began in April 2008, contributes to improving the quality of healthcare for patients in this region. The Mérieux Foundation trains laboratory personnel so that they will ultimately be able to work on their own.
The Mérieux Foundation renovated the medical analysis laboratory at the Antsirabé public hospital and provided supplies and reagents.
This laboratory is the only local medical-surgical healthcare facility for the entire region. Now that it has been renovated to meet international quality standards, it can perform on-site analyses. Previously, most samples had to be sent to the capital city of Antananarivo, located about three hours by car, for analysis, which generated a number of problems related to cost, cold chain failure and the reliability of results.
- Laboratory Development Department of the Ministry of Public Health
- Charles Mérieux Center for Infectious Disease
- Indian Ocean Commission