Combatting Global Infectious Diseases: A Network Effect of Specimen Referral Systems

Peter N. Fonjungo George A. Alemnji Yenew Kebede Alex Opio Christina Mwangi Thomas J. Spira R. Suzanne Beard John N. Nkengasong

The recent Ebola virus outbreak in West Africa clearly demonstrated the critical role of laboratory systems and networks in responding to epidemics. Because of the huge challenges in establishing functional laboratories at all tiers of health systems in developing countries, strengthening specimen referral networks is critical. In this review article, we propose a platform strategy for developing specimen referral networks based on 2 models: centralized and decentralized laboratory specimen referral networks. These models have been shown to be effective in patient management in programs in resource-limited settings. Both models lead to reduced turnaround time and retain flexibility for integrating different specimen types. In Haiti, decentralized specimen referral systems resulted in a 182% increase in patients enrolling in human immunodeficiency virus treatment programs within 6 months. In Uganda, cost savings of up to 62% were observed with a centralized model. A platform strategy will create a network effect that will benefit multiple disease programs.

March 16, 2017
Year of publication
Ebola, laboratory systems, epidemics, specimen referral networks, referral networks, patient management, resource-limited settings, decentralization, referral systems, cost savings, Uganda, infectious diseases, geographic information system (GIS), health systems, treatment, antiretroviral therapy, ART, TB, tuberculosis, diagnosis