At the frontlines of Nigeria’s COVID-19 response: The Laboratory

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Ultra-low freezers hum and beep continuously in the biorespository room, supporting the non-stop diagnostic activities at the National Public Health Reference Laboratory in Gaduwa, Abuja, on a relatively quiet Friday afternoon. This is one of the reference laboratories of the Nigeria Centre for Disease Control (NCDC). The laboratory is open 24 hours a day as Nigeria is currently responding to the global pandemic of Coronavirus disease (COVID-19). At the same time, the NCDC is also responding to the largest Lassa fever outbreak in Nigeria.

Important for the government’s outbreak response by providing testing for samples of suspected cases, the National Public Health Reference Laboratory is one of seven laboratories in the NCDC’s laboratory network with the capacity to test and diagnose the disease. The other six labs are dotted around the country, with two in Lagos, and one each in Osun, Edo, Oyo, and Ebonyi State.

Setting up the laboratories and building up the capacity of scientists to diagnose the disease is part of the preparedness effort of the NCDC  as outlined in the National Action Plan on Health Security (NAPHS). These preparations were critical because, as the Roman Writer Publius Flavius Renatus put it, “In time of peace prepare for war”.

The National Public Health Reference Laboratory in Gaduwa. Beyond the building are the people who work round the clock to test samples of suspected COVID-19 cases. They put great passion and energy into the work they do.

Mrs Nwando Mba, Director Public Health Laboratory Services Department said  that once they understood that COVID is a respiratory infection, they quickly brought out Nigeria’s influenza pandemic preparedness plan. “This became our blueprint because influenza surveillance is the bedrock of our COVID response,” She works in sync with other people and gives the young people in her team opportunity to take lead.

Celestina Obiekea (centre) is the Network Coordinator of COVID-19 Laboratories in Nigeria. She says she was in Dakar when the index case was reported in Nigeria, and life has not been the same since. She is still able to smile and maintain a positive energy for her team, despite the gruelling long days at the laboratory.

Quality laboratory investigation and dissemination of results can only be guaranteed with correct sample collection. A young scientist is ready to set out with his team for sample collection to test for COVID-19. He has his material and personal protective equipment in the red bag.

The first point of contact with the lab once samples are collected is the sample collection unit. It is located beside the main laboratory building, away from areas with frequent human access.

Erasogie Evbuomwan and another team member dressed in Personal Protective Equipment (PPE) receive, document and prepare the samples for transfer to the next phase in the testing process.

Once samples are received and documented, the sample transportation containers are disinfected and handed back to the collection team. The lab currently receives samples for both COVID-19 and Lassa Fever. On the day our team visited, they had already received 31 samples… with more on the way.

From the collection area, samples are taken to the processing area for inactivation. This is an important step because any potentially harmful virus in the sample is rendered harmless to protect the people working with it.

The process is performed in an enclosed class 3 biosafety cabinet commonly called a glove box to ensure no dangerous pathogens escape. Shamsu Munzali uses one of the two boxes and is quick to describe the complex scientific principles behind the inactivation procedure once engaged.

Christopher Chukwu and other team members got trained on COVID-19 diagnosis from the African Centres for Disease Control and Prevention in Dakar before the first case of COVID-19 in Nigeria. He had been trained on molecular diagnostics previously from numerous trainings courses, including training delivered by Public Health England in 2019.

Nneamaka Uba says even though the outbreak has changed a lot for her, she still enjoys doing her work and giving it her best. “My work is my life,” she said. While it is not  easy working with samples that are potentially infectious, Uba said she is confident that the PPE will protect her if it is used correctly.

Samples are ready for movement to the next laboratory for extraction and Polymerase Chain Reaction (PCR) amplification which is the only validated procedure used to diagnose COVID-19.

The PCR inactivation room has restricted access to only relevant laboratory staff and movement is in one direction. Mrs Mba said the training the team had received in molecular diagnostics made it easier to evolve to diagnosing COVID-19 before the first case of COVID-19 in Nigeria.

The laboratory manager, Mr Akinpelu Afolabi said their work has been intense since the outbreak. “Unlike before, we now work 24 hours. I came here around 11pm yesterday and left by 6am today. By 12pm, I returned and as of now (5pm), I’m not sure  when I’ll leave,” he said.

Once done testing, materials such as PPE and other disposables are taken outside for incineration and the process ends for those batch of samples. But you can be rest assured, another is on its way to the laboratory.

Obiekea says it can be challenging when everyone wants to be tested, as it takes a  toll on both human and material resources. She advises that people stick to the advisory from the NCDC and Federal Ministry of Health to stay at home, practice social distancing, self-isolate if they feel they have been exposed to someone who has COVID-19, and to call the NCDC toll free numbers if they are having symptoms.

Discussion17 Comments

  1. Adedamola Aderoju fnim

    What else can I say kudos to you all from Dr. Chikwe to Madam MBA to every staff involved in turning out excellent results by observing details compying with set instructions everytime either for routine or specific investigations. Thank you for your resilience ‘ passion ‘zeal and patriotism together we shall all win this war. I only hope the political class will learn to take serious the needs of these class of people when ever it comes to their table for approval so that we are better prepared for times like this. May God bless and protect Nigeria. Again Kudos Kudos Kudos!!! Adedamola Aderoju fnim

    • Nigeria Health Watch

      Thank you Adedamola, thank you for your comment. As a nation, we really need to prioritise adequate funding for our health security. Sustained funding will ensure that we are able to build up our laboratory infrastructure and human resources.

  2. Thank you Chibuike and all at Nigeria Health Watch, This is a rare and wonderful glimpse into what laboratory workers and others are doing to protect public health. Really great photos and commentary. Thank you to all for doing this vital job so professionally and selflessly.
    Best wishes, Neil

    Let’s build a future where people are no longer dying for lack of healthcare information – Join HIFA: http://www.hifa.org

    HIFA profile: Neil Pakenham-Walsh is coordinator of the HIFA global health campaign (Healthcare Information For All – http://www.hifa.org ), a global community with more than 19,000 members in 177 countries, interacting on six global forums in four languages. Twitter: @hifa_org FB: facebook.com/HIFAdotORG neil@hifa.org

    • Nigeria Health Watch

      Thank you Neil for your comment. At this time when there is so much focus on the science between the COVID-19 outbreak, it is important for Nigerians to get a glimpse of what a laboratory looks like and also to see and be inspired by the dedicated team at the Nigeria Centre for Disease Control, working round the clock to ensure samples are collected, tested and results returned to patients in the most efficient way.

  3. Kudos to every staff of National Reference Laboratory Gaduwa Abuja who work effortlessly to curbing this COVID-19 Pandemic . As you apply the personal protective equipments (PPE), and other SOPs, may you have divine protection Amen.

    Also Kudos to staff of Nigeria health watch and please permit me to thank in a special way, Alagboso Chibuike for his altruistic follow up and ambition. I commend you all.

    However, I have a recommendation to make to Nigeria health watch, which is to align with the other media journals to work hand in hand with the government and for the masses.

    Doing so will bring to the notice of the government the genuine challenges of the subjects of your journals and the overall view of the citizens such as in this present situations, the ” genuine ” challenges of the national reference laboratory and your overall views with the masses.

    God bless us all and see us through this pandemic. Amen.

    Nwoha Raymond
    MD/CEO Freelance Consultants
    MD/CEO Raynonzo company limited

  4. Franklin Eguogwu (BMLS)

    Thank you Chibuike and the Nigeria Healthwatch team for keeping us abreast with behind the scene events that culminates in the announcement of either a positive or a negative COVID-19 test result. Kudos to the Laboratory Scientists and other laboratory staff who are working round the clock in this critical and challenging time of our human existence. Together we shall overcome this pandemic.

  5. Dr Bunmi Negedu-Momoh

    NCDC NRL lab team are doing great job. Helping us in the war front to detect COVID-19 cases. Kudos to the great team

  6. Kudos to the medical professionals. Still, are the medical team members in the lab not suppose to use Face Mask.

    I could see pictures of them wearing gloves, but where are their masks.

    Just a taught 🤔

    Thank you.

  7. Daniel Joel Bitrus

    Great job, the Centre is doing! But I would like to know if there are efforts at finding a vaccine, locally?

  8. Kudos to all the laboratory staff of NCDC National reference laboratory, we really appreciate all your effort in diagnoses of covid19, I want to encouraged Nigeria government to extend this gesture to federal medical center & teaching hospitals.

    • Nigeria Health Watch

      Thank you, for your comment. We need more active citizenship for health in Nigeria. We hope that Nigerians are now more aware of the health challenges we face in this country and raise their voices more and get more involved in ensuring that if they encounter sub-optimal facilities or services they feel empowered to address the issues with relevant authorities.

      The National Reference Laboratory in Abuja was a barely functional almost empty building about 3.5 years ago. What you see here was built up since then, purely due to the dogged determination of the NCDC leadership and support from development partners. Teaching hospitals and Federal Medical Medical Centres need to take more ownership of their facilities and improve and train the human resources that work there, and also to ensure they are fully equipped.

  9. Victor Emmanuel

    I really appreciate this fight for against covid 19,the government are doing all their best to curb this pandemic,most especially the lockdown policy & other medical services been provided,but the most pressing question is this what are the measure the government are putting in place for people to survive with during this lockdown? People are dieing of hunger in their houses due to this lockdown,& the government are not thinking about it,most especially here in Ogun state, please our government needs to do something about this before hunger 2020 becomes a pandemic

  10. God bless all the health workers
    God bless everyone shining a light on them
    God bless us all.
    We all have a part to play.

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