May 5, 2022

Building COVID-19 diagnostic capacity in the Solomon Islands

After two years of delivering COVID-19 diagnostic training plans remotely to laboratories in Pacific Island Countries, Doherty Institute scientists Professor Patrick Reading and Jean Moselen recently returned from an emergency deployment to the Solomon Islands where they provided assistance in strengthening molecular testing for SARS-CoV-2.

In early February, 2022, the first outbreak of COVID-19 in the Solomon Islands was well underway and community transmission had been reported in most provinces.

With local diagnostic testing capacity severely limited, there was growing concern over increasing case numbers.

The need for urgent assistance was raised by the Solomon Islands Government, resulting in the rapid deployment of diagnostic experts from the Doherty Institute.

Funded by the Department of Foreign Affairs and Trade Indo-Pacific Centre for Health Security through the COMBAT-AMR project, the call for assistance sent Professor Patrick Reading and Jean Moselen, both based at the WHO Collaborating Centre for Reference and Research on Influenza at the Doherty Institute, to work collaboratively on the ground with the National Referral Hospital (NRH) molecular laboratory, Honiara, Solomon Islands to strengthen their diagnostic capacity for detection of SARS-CoV-2.

Arriving via a Royal Australian Air Force (RAAF) C-17 flight, Professor Reading and Ms Moselen commenced their deployment in the Solomon Islands on Tuesday, 22 February in Honiara.

“Travelling in this current COVID climate is nerve racking but the RAAF were very hospitable,” Ms Moselen said.

“Being the only passengers on the C-17, we had great legroom too!”

A major focus during the deployment was delivering training to staff based at the National Referral Hospital in real-time reverse transcription polymerase chain reaction (RT-PCR) testing, the gold standard of diagnostic testing for SARS-CoV-2.

Left to right: Andrew Darcy, Molecular Laboratory technician, First Secretary Health, Kathleen Bombell, Human Development Counsellor, Mika Kontiainen, Permanent Secretary Pauline McNeil, Australian High Commissioner Dr Lachlan Strahan, Minister for Health and Medical Services Dr Culwick Togamana and Alfred Dofai, Director for Laboratory. Photo credit: Australian High Commission

Prior to receiving RT-PCR training, the NRH molecular laboratory primarily relied on GeneXpert testing for molecular diagnosis and detection of SARS-CoV-2 due to requiring fewer technical demands.

“GeneXpert testing has an important place in the toolkit for SARS-CoV-2 testing, as it provides a rapid turnaround of results and the skills required are less technically demanding” Professor Reading said.

“However, real time RT-PCR capacity is very important as it provides a second independent test to confirm any ambiguous results, as well as allowing the laboratory to scale up its overall testing capacity.

“Moreover, real time RT-PCR is a more flexible platform and, with skills established in country, it can adapted to test for a range of other pathogens associated with infectious disease in the future.”

Working closely with colleagues at the Doherty Institute, Pacific Community (SPC), Pacific Paramedical Training Centre (PPTC) and the WHO Representative Office in the South Pacific, a tailored program was developed to cross-train all laboratory staff, led by Ms Moselen.

“It was a privilege to work with and share my molecular knowledge with the skilled scientists at the NRH molecular laboratory,” Ms Moselen said.
Australian High Commissioner Dr Lachlan Strahan and Jean Moselen, scientist from the Peter Doherty Institute for Infection and Immunity Photo credit: Australian High Commission

“In-country training allows for a personalised but intensive schedule of practical laboratory exercises and theory-based seminars.

“Being able to share my skills over this month-long deployment resulted in a high level of competency in real time RT-PCR of the core staff members in the NRH molecular laboratory.”

To support existing testing capacity, a new 16-module GeneXpert machine was purchased by the Department of Foreign Affairs and Trade Indo-Pacific Centre for Health Security for the NRH.

Procurement of this larger machine freed up several 4-module machines, which could be relocated to provincial laboratories across the Solomon Islands and other local sites in Honiara to expand the overall capacity for SARS-CoV-2 testing.

“Increasing the number of GeneXpert machines in provincial laboratories will expand the testing network across the Solomon Islands and reduce testing delays associated with sample transport between the islands” Professor Reading explained.