COMBAT-AMR is supporting Pacific Island Countries with implementation of laboratory diagnostics for COVID-19, in collaboration with The Pacific Community and the Department of Foreign Affairs and Trade (DFAT) Indo-Pacific Centre for Health Security. The sub-project is being implemented by a team of experts across three major public health, reference and diagnostic laboratories at the Doherty Institute.

Implementation of molecular diagnostic testing for COVID-19

‍Advice on building renovations, procurement, validation and set up of equipment and consumables has been provided to enable the implementation of real-time polymerase chain reaction (PCR) testing in the Solomon Islands, Kiribati, Cook Islands, Tonga, Tuvalu, Vanuatu, Samoa and Nauru. This work has been closely aligned with the support for purchase of materials for molecular diagnostics provided by both DFAT and other regional organisations.

Evaluation of emerging point of care tests

‍We have conducted evaluation that supports the implementation of point-of-care molecular diagnostics and point-of care serology tests in Pacific Island Countries. The project team will provide advice on the integration of new technology with existing capability, protocol development, quality of results, ease of use, and technical support for testing and confirmation.

‍Laboratory quality and biosafety

‍To ensure molecular diagnostic testing is accessible in Pacific Island Countries, positive control materials have been provided to key diagnostic laboratories. These materials are required for validation of testing for SARS-CoV-2. Support for testing of reverse transcription polymerase chain reaction (RT-PCR) will be provided by a comprehensive validation panel to six Pacific Islands Countries. The project has worked closely with The Pacific Community to advise on quality and safety as required, in line with  international standards.

‍Laboratory staff training and capacity building

‍Ongoing remote training sessions are being provided online to regional laboratories to support testing of COVID-19 at diagnostic laboratories. The training has included the development and delivery of videos, webinars and manuals for laboratory staff to support implementation of PCR workflows and techniques locally. Mentoring and troubleshooting support is available to laboratory staff, including webinars for diagnostic testing, and development of guidance documents and protocols to support capacity building.

Increasing capacity for SARS-CoV-2 diagnostics

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

A major focus during the COMBAT-AMR Solomon Islands March 2022 deployment was delivering training to staff based at the National Referral Hospital (NRH) in real-time reverse transcription polymerase chain reaction (RT-PCR) testing, the gold standard of diagnostic testing for SARS-CoV-2. 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. While GeneXpert testing provides a rapid turnaround of results and the skills required are less technically demanding, 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.

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Procurement of laboratory equipment

To support existing testing capacity in the Solomon Islands, a new 16-module GeneXpert machine was purchased by the Department of Foreign Affairs and Trade Indo-Pacific Centre for Health Security for the National Referral Hospital (NRH) molecular laboratory, Honiara, during a deployment visit by the COMBAT-AMR team in March 2022. 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.

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