Priscilla Belbir AtimBBLT (MUK), MSc. MBS (MUK) and ) & Fellowship in Public Health Laboratory Leadership (UNIPH/MOH) Host Site: Infectious Diseases Institute (IDI) Core Laboratory
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ABOUT THE FELLOWI hold a Master of Science degree in Molecular Biology and a Bachelor’s degree in Biomedical Laboratory Technology, both from Makerere University. I have a keen interest in infectious diseases, laboratory systems strengthening, laboratory quality assurance, and translational laboratory research. My passion lies in understanding drug resistance dynamics and leveraging laboratory data to play a crucial role in diagnosing and tracking infectious diseases. During the fellowship, I was attached to the Infectious Diseases Institute (IDI) Core Laboratory—a College of American Pathologist (CAP) accredited laboratory where I was also employed as a laboratory supervisor. The IDI Core Lab conducts over 300,000 tests annually, playing communication, quality management, surveillance, outbreak investigation, and response including data analysis, interpretation, and use enhancing my understanding of the national laboratory system. These experiences utilized my leadership skills to foster laboratory collaboration, communication, coordination, resource mobilization, and support for laboratory capacity building during outbreak investigations. Achievements at the Host Site– Designed, shared and analysed a customer satisfaction survey – Led the laboratory team through an audit by Pharmaceutical Product Development an organisation contracted by patient safety monitoring in international laboratories that runs clinical trial laboratory tests with the laboratory – Designed and implemented a quality improvement project – Chaired the validation and review of the biospecimen management and referral network curriculum in Africa as an expert reviewer before its rollout to member states. This was done with collaboration with Africa CDC. – Facilitated training on leadership and laboratory quality management systems using a One Health approach with Africa CDC. – Participated in the evaluation of external quality assessment with Africa CDC, piloting the establishment of an EQA laboratory network among member states to enhance access to quality control materials and quality systems. Fellowship program specific achievementsGuideline review/ development – Participated in developing and reviewing the national laboratory guidelines for emergency preparedness and response, and in creating training materials based on these guidelines. Scientific article critique – Critiqued two scientific articles. i.e. – Re-testing as a method of implementing external quality assessment program for COVID-19 real time PCR testing in Uganda – Rapid establishment of a frontline field laboratory in response to an imported outbreak of Ebola virus disease in western Uganda, June 2019 Health emergency coordination, participation and evaluation – Coordinated laboratory response activities of two health emergencies.
– Participated in three other health emergencies 1. Suspected cholera outbreak investigation in Buvuma Island in January 2023
Article submission – Submitted six articles for publication (three in new vision and three in the Uganda Public Health Bulletin). All were published. – Publications in the new vision included; 1. 1. Laboratories are shaping the future of healthcare services
– Published in the Uganda Public Health Bulletin; 1. Cyanide poisoning investigation, Terego District, Uganda, February 2023 – I was also part of the editorial team for the Uganda public health bulletin in April 2023 Manuscript submission – Four manuscripts are undergoing clearance prior submission to a peer review journal for publication. – Co-authored one manuscript that was submitted to a peer review journal for publication – Undergoing clearance include:
– Submitted for publication include
Summary of Epidemiological Study:Title: Development of an Internal Quality Control Program for Rapid Diagnostic Tests at Health Laboratories in Uganda: A Case Study of Mubende District Background: Internal Quality Control Programs (IQCP) ensure the accuracy and reliability of tests. Rapid Diagnostic Tests (RDTs), which are quick and easy to use account for approximately 80% of tests used in lower health facilities in Uganda. However, the implementation of IQCP for RDTs is inconsistent, leading to compromised test accuracy, non-compliance with standards, delayed error detection, and loss of confidence among laboratory clients. ISO 22870 and ISO 15189 standards mandate the development and implementation of IQCP for all tests including RDTs and require training for laboratory professionals on these protocols. This project aimed to develop RDT IQCP guidelines for public health facilities in Mubende district in July 2024. Methods: A reviewed of existing standards and practices using a questionnaire administered to district laboratory staff; benchmarking at the Rakai Health Science Program Laboratory, an accredited healthcare facility, and implementing IQCP, which provided a framework for best practices; In-depth discussion with six Subject Matter Experts (SME) to integrate the existing standards, recommended best practices with standardized documents from WHO and CDC to create a framework for the IQC guidelines; a comprehensive risk assessment (RA) to identify and assess potential risks associated with the implementation and maintenance of the IQC guidelines. Important factors considered in the RA included evaluating IQC material storage to determine optimal conditions for maintaining material integrity, material availability, cost considerations, control matrix, and control run frequency. Results: IQCP guidelines, practical tools and Standard Operating Procedures (SOPs) were developed for RDTs of malaria, HIV, syphilis, serum CrAg, hepatitis B, hCG, and microscopy tests. These guidelines provide a structured approach to internal quality control and ensure that all necessary steps are taken to maintain the accuracy and reliability of RDT results. Conclusion: These IQCP guidelines for RDTs in Mubende District are a significant step towards improving the quality and reliability of diagnostic testing in lower health facilities. These guidelines are expected to enhance compliance with international standards, restore confidence among laboratory clients and support ongoing quality control efforts. Key lessons learnt during the fellowshipThe skills I gained have enhanced both my wet laboratory and leadership capabilities, allowing me to see the bigger picture of laboratory operations during emergencies. My experiences and knowledge gained have equipped me to contribute effectively to public health efforts and laboratory systems strengthening, ensuring better preparedness and response to infectious disease outbreaks. I have also enhanced my communication skills through articles and facilitating training sessions. Leading outbreak investigations has developed my leadership skills. Finally, I learned to adapt to challenges that I faced during disease investigations and came up with innovative solutions and proactive approaches to address diagnostic challenges and gaps. Next StepsI plan to leverage the skills and knowledge I have gained to make a significant impact in the laboratory profession. Pictorial
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