Download GABRIEL network

GABRIEL network
Clinical Epidemiology and Global Health (2012),
http://doi:10.1016/j.cegh.2012.11.002
 GABRIEL is an international network of research laboratories in
low income countries:



health and research professionals
academic institutions
Non Governmental Organizations
 Initiated by Fondation Mérieux in January 2008
 Coordinated by the Fondation Mérieux Scientific Department and
the GABRIEL steering committee
GABRIEL mission:
to strengthen research capacities of local laboratories in
developing countries
GABRIEL mission
 To develop and evaluate new laboratory tests
 To provide training and support
 To transfer technologies through training
 To conduct collaborative studies
Members of GABRIEL in 2014
UKRAINE
MONGOLIA
GEORGIA
CHINA
FRANCE
HAITI
LAOS
LEBANON
BANGLADESH
MALI
BRAZIL
CAMEROON
PARAGUAY
CAMBODIA
MADAGASCAR
GABRIEL activities
Collaborative research
Technology transfer
Pneumonia
Tuberculosis
Influenza surveillance
Foodborne disease
Training and
Knowlegde sharing
Human Resource Strengthening
Communication
Quality Assurance
External Quality Assessment
Good practices & guidelines
Protocols, SOP, audits
Pilot Multicentric Case Control on Pneumonia
ASUNCION - PARAGUAY
Instituciones y colaboradores del proyecto
Investigador Coordinador
Dra. Graciela Russomando, Jefe Dpto. de Biología Molecular y Genética- Instituto de Investigaciones en Ciencias de la
Salud- Universidad Nacional de Asunción.
Email: grusso@rieder.net.py
Tel: 595 21 424520 Fax: 595 21 480185
Investigador Coordinador Clínico
Dra. Wilma Basualdo, Médico Pediatra-Infectólogo. Jefe del Dpto. de Epidemiología - Hospital General Pediátrico Niños
de Acosta Ñu (HGP Niños Acosta Ñu)- Ministerio de Salud Pública y Bienestar Social (MSPyBS)
Email: wdb@rieder.net.py, wilmabasualdo@hotmail.com Tel: 595 971 252748
Co-investigadores de Biología Molecular
Lic. Emilio Espínola, MSc. Biólogo. Area Virología Molecular-Dpto. Biología Molecular y Genética-IICS-UNA
Dra Rosa Guillen, PhD. Bioquímica. Area Bacteriología Molecular- Dpto. Biología Molecular y Genética-IICS-UNA
Sra Graciela Meza, Técnico de laboratorio. Dpto. Biología Molecular y Genética-IICS-UNA
Co-investigadores Médicos del Hospital General Pediátrico Niños de Acosta Ñu (MSPyBS)
Dra Viviana Pavlicich, Médico Pediatra. Jefe de Servicio de Urgencias.
Dra Gloria Martínez, Médico Pediatra. Jefe de Sala.
Dr Carlos Caballero, Médico Pediatra. Jefe de Sala y de Terapia Intermedia.
Dra Amalia Duarte, Médico Pediatra. Jefe de Terapia Intensiva.
Dr Hector Castro, Médico Pediatra-Infectólogo.
Dra Carolina Aquino, Bioquímica. Jefe de Laboratorio.
Lic. Laura Maldonado, Enfermera. HGP Niños Acosta Ñu-MSPyBS
Pilot Multicentric
Case Control on Pneumonia
National Surveillance in Hospitals
Epidem. week 1 to 47, 2011
PARAGUAY
n=362/ 2.137 (16.9%)
Ep. week 1 to 47, 2011
AdV
10%
FluA/H
3
24%
RSV
59%
Respiratory Viruses Detected in the
National Surveillance, years 2010 and 2011
n=298/ 1.807 (16.5%)
Ep. Week 1 to 47, year 2010
RSV
36%
FluA
/H3
25%
Community-Acquired
Pneumonia (CAP)
VIMENE- Paraguay. Years 2007-2011
5%
N=4.500
NAC
CAP
CAPC/with
/ positive
NAC
aislamiento
hemoculture
bacteriano
68%
S.pneumoniae
95%
Arza- Fernández S. ISPPD-8 POSTER . MARCH 11-15. 2012
CASES
PATHOGENS IDENTIFICATION ACCORDING TO THE AGE GROUP
Number of cases
Age group
Pathogens
At least one bacteria in NA: 81% Co-infection bacteria and virus: 69%
At least one virus in NA: 85%
Viral co-infection: 26%
CONTROLS
PATHOGENS IDENTIFICATION ACCORDING TO THE AGE GROUP
Number of cases
Age group
Pathogens
At least one bacteria in NS: 52 % Co-infection bacteria and virus: 23%
At least one virus in NS: 37%
Viral co-infection: 9%
Nasal Swaps Preliminary Results
74 Respiratory Pathogens Detected in 44 CONTROLS
CONTROLS
44 positives/ 75
(59%)
Nº Pathogens
Conclusion
The impact of this study in Paraguay:
• We standarized a new test for laboratory surveillance of
respiratory pathogens in the largest Public Health Children
Hospital.
• The introduction of the Pneumococcal vaccine, PCV10
(Sinflorix), was in March 2012 and the implication of this study
results prior and post this vaccine introduction.
• It was described for the first time the circulation of non-common
respiratory viruses either alone or in co-infections with other
respiratory viruses such as CoVs, BoV, hMPV and EV.
• There is a demand of the Pediatricians Society to increase the
number of samples
• We aware about 71% severe bronchiolitis cases with
viral/bacterial pathogens detected. Could be considered as
increased risk for bacterial pneumonia.
Conclusion
• Interpreting co-pathogen data is problematic
due to the difficulty in differentiating acute
disease from long-term shedding.
• We need a biomarker for clinicians to answer
in less than 24 hours: VIRUS or BACTERIA?
Quality initiative
13
MALI
Rodolphe Mérieux Laboratory
in Bamako
RESAOLAB Laboratories
BANGLADESH
ICDDR,B
LAOS
Rodolphe Mérieux Laboratory in Vientiane
HAITI
Rodolphe Mérieux Laboratory in
Port au Prince
PARAGUAY
Instituto de Investigaciones en Ciencias de la
Salud - Universidad Nacional de Asunción
Quality initiative
• Expected outcomes
o An assessment of the 4 selected laboratories and identification of
necessary improvements
o An action plan to assist laboratories in meeting international quality
standards
o A “self-assessment” questionnaire for all GABRIEL members
 Developed with Fiocruz, Brazil
 Gathering information on their current Quality Assurance Management
Audit
LQSI checklist adapted by IQLS
• MS Excel spreadsheet
• Modular structure
• Drop down list with open questions (only Yes or
No)
• Automated indicator calculations
• Includes summary and export
pages
• Includes tables with module
and phase
scoring
Indicators
• Phase questions have
been split by topics
within the same module
• Examples:
 Modules
 Indicators
Results example
Results example – LQSI Phase based
GRACIAS!!!
“Life is not measured by the breaks that
we take but by the moments that take
your breath”.