Immediate access to TB and HIV testing means faster diagnosis and treatment for patients in remote areas

Use of a new mobile medical laboratory is boosting access to quality diagnostic testing for patients in remote areas of South Africa, while slashing turnaround times and courier costs. This German-built mobile clinical laboratory performs high complexity testing and may provide a new model for diagnostic testing for other developing countries.

Fraunhofer Institute for Biomedical Engineering (IBMT) in Saarland, Germany, built the $2 million mobile medical laboratory in collaboration with the government of the Western Cape, a province in southwest South Africa.

The clinical lab-on-wheels operates as an extension of the Caledon Hospital. This is a 75-bed community hospital located in the Overberg district, about 62 miles east of Cape Town. Specimens are sent to the mobile laboratory from health facilities in the surrounding area.

Medical Lab-on-Wheels Means Faster Diagnosis for HIV and TB Patients

According to Theuns Botha, Provincial Minister of Health, Western Cape Government, the addition of the mobile clinical laboratory to the portfolio of health facilities in the Overberg has, in a short period, made a huge impact on service delivery in the region, as reported in a story published by AllAfrica.

The leading cause of death in the Overberg is tuberculosis (TB), followed closely by HIV and AIDS, Botha explained. “The fact that the mobile laboratory can perform detailed TB and HIV testing within a short period of time, helps healthcare workers start counseling and treatment immediately, thus restricting the further infection of healthy patients.”

This is the mobile medical laboratory driving through South Africa. It is capable of performing high complexity clinical laboratory testing. The mobile laboratory was designed by Fraunhofer Institute for Biomedical Engineering in Saarland, Germany. (Photo is copyright Bernd Miller/Fraunhofer.)

The key to this success is that the mobile lab brings high complexity clinical laboratory testing directly into in the remote area. This shortens the waiting times for results and reduces the cost and time involved in having couriers transport specimens to the region’s reference laboratory, stated a press release issued by the National Health Laboratory Service.

Use of the new mobile medical laboratory has dramatically cut turnaround times. Test results that often took up to several days are now available to clinicians in just one to 12 hours.

Prior to the availability of the mobile medical laboratory, pathology lab specimens had to be sent to Cape Town for diagnostic testing, causing slow turnaround times. “This has a considerable effect on the quality of the samples and the accuracy of the diagnosis,” said Uwe Schoen, a physicist and Group Manager at IBMT, in an interview published on IBMT’s website. “Should the sample deteriorate, or should the result reach the recipient only several weeks later, this presents a big problem for those who anxiously await their results,” added Schoen, who was responsible for the construction of the mobile clinical laboratory.

Tests performed at the mobile medical lab include HIV rapid tests, TB, complete blood count (CBC), cholesterol, blood glucose, liver functions, urea, and electrolytes. NHLS provides a medical technologist and a technician to staff the mobile medical laboratory. In a four-month period, the lab processed more than 2,900 specimens. That number is expected to increase as the network of couriers expands.

Biosafety and Cryotechnology Increase Mobile Diagnostic Possibilities

There is another milestone achieved by this mobile medical laboratory. Its design meets the requirements for biosafety level 3 certification“As far as we are aware, our laboratory truck is the first mobile laboratory of its kind to receive official certification in this biosafety class,” stated Schoen. The biosafety level 3 certification allows the lab staff to work with infectious material while ensuring protection for lab staff, patients, and the environment.

Here is the interior of the mobile medical laboratory that is new serving rural areas of South Africa. Shown are a medical laboratory scientist and a physician looking at lab test results. (Photo is copyright Bernd Miller/Fraunhofer.)

The mobile clinical laboratory with biosafety opens up additional diagnostic possibilities. For example, it offers state-of-the-art, on-board technology for freezing patients’ samples at the point of collection. “Immune cells are extremely sensitive,” noted Hagen von Briesen, Ph.D., Head of Department, Fraunhofer-Institut für Biomedizinische Technik, IBMT. “If a sample is left at room temperature, these cells change, and the immune response which they trigger can no longer be measured properly,” he explained. “That’s why it’s important to freeze the samples within no more than six hours.”

According to Sagie Pillay, MBA, CEO of NHLS, the mobile medical laboratory’s significance has been enormous. “[Patients] can now access a variety of pathology tests without travelling long distances,” he stated in AllAfrica. “The rural communities are really the ones who have benefitted from this initiative as medical facilities can now diagnose faster which improves effective treatment to these patients.”

“Over the past year, the project has been a learning curve for all partners involved, and will have a huge impact on the future development of mobile laboratories,” said Guenther Fuhr, Ph.D., Head of the Fraunhofer Institute for Bio-Medical Engineering.

And it appears the future may hold some off-roading for the concept of the mobile clinical laboratory. “To be able to reach remote areas in Africa you need an off-road version,” observed Hagen von Briesen, Head of Department, Fraunhofer-Institut für Biomedizinische Technik, IBMT. “The idea of a vehicle of this type is already the subject of developments underway at Fraunhofer.”

Certainly this mobile clinical pathology laboratory shows that today’s technology makes it feasible to perform complex testing in remote areas that are off the grid. Kudos to the scientists and academics in Germany who conceptualized this mobile medical laboratory, then took it from idea to reality—where it is now saving lives in South Africa and improving patient outcomes in the underserved rural areas of this nation.

—Pamela Scherer McLeod

Related Information:

South Africa: German Mobile Laboratory Increase Tests Volumes in Overberg

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Mobile Laboratory In Caledon Improves Turnaround Times For Patients’ Test Results

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