Molecular Virology
Saturday, August 18, 2018
   
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Molecular Virology Unit

Unit Head
Christopher Chime
B.MLS,MPH, Dip. HIV Innov. Mgt. & Care, Dip. HSM

 

Despite availability of effective ART and comprehensive HIV care in sub-Saharan Africa, nearly 50% of HIV infected infants die undiagnosed within two years because of limited definitive Infant Virological Testing (IVT) capacity. The Institute of Human Virology Nigeria (IHVN) pioneered IVT formerly known as Early Infant Diagnosis (EID) capacity in 2006, under the CDC PEPFAR funding, as a system-strengthening program to support the Government of Nigeria (GON) for better national coverage. This was achieved through development of infrastructure, introduction and use of newer technology, and quality systems management.

IHVN's molecular diagnostic unit was developed and led by the late Richard Enzama. The unit is now headed by Christopher Chime. Typically, the PCR laboratories to support the molecular diagnostics are developed using a phased assessment of selected facilities to identify gaps in infrastructural, equipment and personnel capacity. This information is then incorporated into the design and renovation of PCR laboratories; procurement and installation of equipment; human capacity development in PCR technology and health workers in Dried Blood Spot (DBS) collection.

The PCR unit is involved in DNA PCR assay for IVT, of exposed infants <18 months of age, and viral load assay for monitoring of patients on antiretroviral therapy. These laboratories also provide training to other laboratory personnel in molecular technology.

ACHIEVEMENT

  1. IHVN has established 17 PCR laboratories and is currently overseeing five with automated capacity. They all support the national EID programs and viral load testing.
  2. All IHVN supported PCR laboratories participate in the CDC Atlanta proficiency program.
  3. Two of IHVN supported laboratories namely, Asokoro Laboratory Training Center and Plateau State Human Virology Research Center (PLASVIREC) were involved in the pilot on the use of electronic dispatch of results using Laboratory Information Management System (LMIS) to improve the time taken to meet laboratory requests.
  4. 36 laboratory scientists have been trained on the use of PCR facilities for IVTs and 842 healthcare workers have been trained on Dried Blood Spot and viral load sample collection.
  5. Blood dot samples tested by IHVN supported PCR facilities between 2006 and 2017 are 175, 558 with an average positivity of 6.4%. A total of 142, 249 viral load samples have been tested since 2006. This is likely to increase with the need to monitor viral load for each patient not just for those clinically failing their ARV regimen.
  6. PLASVIREC, one of the two IVT national reference centers, coordinates External Quality Assessment (EQA) between CDC Atlanta and all other IVT testing laboratories within Nigeria and tests a selected number of assayed DBS by other laboratories as part of quality assurance for the country.
  7. There is ongoing preparation for the WHO-Afro Step Wise Accreditation, planning for integration, country ownership and sustainability.
  8. IHVN molecular diagnostic unit participates in the National Laboratory Technical Working Group and offers Technical Assistance to Federal Ministry of Health, Government of Nigeria and other Implementing Partners. 
  9. All PCR laboratories have LMIS installed in them for sample registration and electronic result dispatch. The unit is currently working on linking LIMS to facility-based Electronic Medical Records (EMR) for improved turnaround time and quality patient care.

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:: Support and Funding

The Institute of Human Virology, Nigeria AITRP Training Programmes are supported and funded by the Fogarty International Center.
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