Sierra Leone: a Short History of the Laboratory that has ‘Saved’ 100,000 People.

11934501_923677061012439_1797701724480429384_oThe laboratory (MBIL) to test for and combat Ebola was born as an idea when the epidemic was at its height. The intention and the project took on a specific form in the autumn of 2014 thanks to the work of the ‘Brothers of Ebola’ round table and the contribution of the Italian Bishops’ Conference and Caritas.

The activities that have been engaged in have been of three types: diagnostic (PCR) and immunological (Elisa) activities; those involved with formation and training; and those involved with the transfer of technology and research.

These activities have been engaged in thanks to cooperation with the University of Tor Vergata of Rome, the Camillian task Fo.rce and the Holy Spirit Hospital of the diocese.

The MIBL was principally activated in order to allow the reopening of the Holy Spirit Hospital of Makeni which had been closed in 2014 because of the spread of the epidemic in the district of Bombali. The MBIL was equipped to carry out molecular and blood diagnoses for the Ebola virus and other emerging or re-emerging viruses, such as the HIV virus and the hepatitis B and hepatitis C viruses. All of the equipment and the methodologies that have been used are fully up to standard and respect good laboratory practice.

The activity involving molecular diagnosis (PCT) has become a routine activity which is engaged in at any hour of the day, by the technical personnel of the hospital as well. For the moment, the analyses are always checked and certified by the presence of at least an Italian expert or one from Cameroon. In recent months the MBIL has carried out more than 50 negative tests for the Ebola virus through PCT. In this way it was excluded that patients inside the hospital were infected by the Ebola .

The activity involving immunological diagnosis is based on the search for anti-Ebola anti-bodies – using the Elise method (a commercial kit) – in the blood of patients or individuals who run a high risk of having the infection. Over 500 blood analyses have been carried out both with individuals who survived Ebola and with those who were at high risk (people subject to quarantine). This led to the identification of the large number of individuals (over 11%) without symptoms but infected by the virus and identifiable as such because of specific anti-bodies in their blood.

11056614_923676937679118_8393947381400262195_o   The activity involving formation has been of three kinds: 1) lessons and training for twenty laboratory technicians of the state and private hospitals of Makeni; 2) lessons for the forty students of the School of Public Health of the University of Mekeni; 3) the strengthening of the Faculty of Medicine of the University of Sierra Leone.

Both the courses in Makeni were followed in a constant way for over four months both by the technicians and by the students. The activity that was engaged in also involved the academic authorities of the University of Mekeni which proposed a modification and strengthening of the curriculum of the master’s degree in public health in the cooperation of the University of Tor Vergata in Rome and the University of Cambridge. Dr. Raoul Emeric Guetiya Wadoum was employed for three years by the University of Makeni specifically to continue this activity involving formation, as well as that involving diagnosis and research at the MBIL.

As regards the Faculty of Medicine of the University of Sierra Leone at the University Hospital of Cannought in Freetown, meetings and lessons were organised with the aim of sensitising the lecturers to the need to establish a Laboratory of Advanced Formation and Technology for the control and prevention of infectious diseases. All the research activity has been carried out within the framework of a specific project of blood surveillance approved by the Ethical and Scientific Committee of the Ministry of Health of Sierra Leone. The activities have been carried out in cooperation with the national (Ministry, HSD) and international (WHO, African Union) institutions that work in the district of Makeni, An abstract was accepted and published at the Conference on Ebola in Paris of July 2015, and two scientific works are currently being published.

The University of Cambridge decided to move the laboratory of virology to the University of Makeni (including the unit for viral sequencing) which worked until July 2015 at the Centre for EVD Treatment of Mateneh (Makeni). Given the extensive scientific cooperation established with the MBIL, and that both the institutions of reference (the University of Makeni and the Holy Spirit Hospital) adhere to the Diocese of Makeni, a project has been developed to create the Makeni Biotech and Biomedical Research Platform (MBBRP). This technological platform will become a point of reference for the Ministry of Health not only for scientific research on the Ebola virus but also for other emerging infections in the country. In this way the Italian investments in this country will become sustainable in the future as well and will be sufficiently flexible for other infectious diseases.

The activity involving the transfer of technology and research, including the platform of Makeni, will be officially presented during the course of the Merck African Research Summit of 19-20 October in Geneva organised by Merck, UNESCO, and the University of Cambridge and the University of Torvergata, Rome. The laboratory has become a place of experimentation. It is an important sign that starting with the laboratory and the experience of Ebola the future of the people of Sierra Leone is being thought about.


Edited by Vittorio Colizzi and Marco Iazzolino .