Laboratory capacity in COVID-19 diagnosis and the need to enhance molecular testing in Ghana

Abstract

COVID-19 pandemic has posed an unprecedented threat to both public health and the global economy. In an effort to manage and contain this pandemic, the World Health Organization (WHO) has prioritised laboratory testing (https://www.who.int/dg/speeches/detail/who-director-general-s-opening-remarks-at-the-media-briefing-on-covid-19—16-march-2020). We examine the testing capacity of the laboratory system in Ghana during the COVID-19 pandemic. According to WHO, gold standard for COVID-19 diagnosis is real-time reverse-transcriptase–polymerase chain reaction (RT-PCR). However, this molecular technique is not widely used in Ghana for disease diagnosis because of lack of infrastructure, lack of trained laboratory staff, high maintenance cost, and scarcity of reagents. Ghana has a three-tier health delivery system, with limited molecular diagnostic capacity. Three of the four public health laboratories (PHLs) have the capacity to perform molecular diagnosis of certain diseases. There are two main biomedical research institutions that are well-equipped to perform various molecular diagnostic tests. Nonetheless, their testing capacity is significantly limited in critical situations such as the current COVID-19 pandemic, which has led to testing backlogs and delays in returning test results at early stages of the pandemic. In an effort to address this situation, capacities of PHLs and nonclinical laboratories have been increased. Plans to use GeneXpert platform in certain areas of the country have been instituted in sixteen facilities, following system upgrades, risk assessments, and quality-checks. Enhanced molecular diagnostic testing in Ghana will help ensure a swift, accurate, and timely response to COVID-19 and future outbreaks. The data gained from these testing improvements may also help stimulate a robust bioeconomy because they can be used to improve the health of Ghanaians, as well as increase productivity through the implementation of data-driven and evidence-based policies. As outlined in WHO’s Joint External Evaluation report for Ghana, the country faces several challenges, including the need to build strong laboratory systems and capacities that connect disease-specific areas.

Keywords

• covid-19
• molecular testing
• ghana
• rt-pcr
• sars-cov-2