Standardization of Minimally Invasive Tissue Sampling Specimen Collection and Pathology Training for the Child Health and Mortality Prevention Surveillance Network

Abstract Background Minimally invasive tissue sampling (MITS) is a simplified postmortem examination technique that has shown to be an adequate approach for cause of death investigation in low-resource settings. It requires relatively low level of infrastructures and can be performed by health professionals with no background in pathology. A training program has been developed for the Child Health and Mortality Prevention Surveillance (CHAMPS) network to guarantee standardization of specimen collection techniques, procedures, and laboratory methods. Methods The training program has included assessment of the site capacities and training on a standardized protocol of MITS sampling and histological processing. The project has also introduced a program of training for trainers for the personnel from Mozambique. To guarantee the adequacy of the procedure in each site, a trainer accompanied the local teams when the activities started. Training outcomes were assessed by evaluating the quality of the samples obtained and the quality of the slides produced locally. Results Between June 2016 and October 2018, the laboratories of 7 sites (Bangladesh, Ethiopia, Kenya, Mali, Mozambique, Sierra Leone, and South Africa) have been evaluated and upgraded. Training has been delivered to 63 staff members from all sites. More than 600 MITS procedures have been performed. The quantity of tissue obtained in the MITS by the local teams was sufficient or abundant in 73%, and 87% of the slides were considered as technically acceptable or excellent. Conclusions Satisfactory standardization of MITS and histology procedures has been achieved across all CHAMPS sites through organized capacity-building plans.

[1]  Q. Bassat,et al.  Healthcare providers' views and perceptions on post-mortem procedures for cause of death determination in Southern Mozambique , 2018, PloS one.

[2]  Michael L Wilson,et al.  Access to pathology and laboratory medicine services: a crucial gap , 2018, The Lancet.

[3]  Michael L Wilson,et al.  Improving pathology and laboratory medicine in low-income and middle-income countries: roadmap to solutions , 2018, The Lancet.

[4]  Q. Bassat,et al.  Validity of a minimally invasive autopsy for cause of death determination in maternal deaths in Mozambique: An observational study , 2017, PLoS medicine.

[5]  J. Ordi,et al.  Risk factors and pregnancy outcomes associated with placental malaria in a prospective cohort of Papua New Guinean women , 2017, Malaria Journal.

[6]  C. Menéndez,et al.  Burden and impact of Plasmodium vivax in pregnancy: A multi-centre prospective observational study , 2017, PLoS neglected tropical diseases.

[7]  Q. Bassat,et al.  Validity of a minimally invasive autopsy for cause of death determination in stillborn babies and neonates in Mozambique: An observational study , 2017, PLoS medicine.

[8]  Q. Bassat,et al.  Validity of a minimally invasive autopsy tool for cause of death determination in pediatric deaths in Mozambique: An observational study , 2017, PLoS medicine.

[9]  S. Madhi,et al.  Standardization of Clinical Assessment and Sample Collection Across All PERCH Study Sites , 2017, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[10]  Q. Bassat,et al.  Validity of a Minimally Invasive Autopsy for Cause of Death Determination in Adults in Mozambique: An Observational Study , 2016, PLoS medicine.

[11]  Q. Bassat,et al.  Willingness to Know the Cause of Death and Hypothetical Acceptability of the Minimally Invasive Autopsy in Six Diverse African and Asian Settings: A Mixed Methods Socio-Behavioural Study , 2016, PLoS medicine.

[12]  Pedro L. Alonso,et al.  Resuscitating the Dying Autopsy , 2016, PLoS medicine.

[13]  Q. Bassat,et al.  Pathological Methods Applied to the Investigation of Causes of Death in Developing Countries: Minimally Invasive Autopsy Approach , 2015, PloS one.

[14]  Q. Bassat,et al.  Development of a post-mortem procedure to reduce the uncertainty regarding causes of death in developing countries. , 2013, The Lancet. Global health.

[15]  M. Jacobs,et al.  Ensuring Quality in AFRINEST and SATT , 2013, The Pediatric infectious disease journal.

[16]  C. Menéndez,et al.  Placental infection with Plasmodium vivax: a histopathological and molecular study. , 2012, The Journal of infectious diseases.

[17]  Q. Bassat,et al.  Infectious cause of death determination using minimally invasive autopsies in developing countries. , 2016, Diagnostic microbiology and infectious disease.