Especially during pandemics, like the COVID-19 outbreak, it is a top priority for the clinical management to have laboratory experts rapidly collect and test appropriate specimens from patients who are suspected of having contracted the virus. To address this need, over last year, with the support from WHO, an extensive lab network was established throughout the country, involving the labs under the Ministry of Health and Family Welfare (MOHFW), various other ministries, the private sector and academic labs of public universities.
At the beginning of the COVID-19 emergency, in March 2020, the Government of Bangladesh initiated testing practices to promptly detect and confirm COVID-19 cases, using only 1 Real-Time Reverse Transcription-Polymerase Chain Reaction (rRT-PCR) laboratory, which detects unique sequences of virus Ribonucleic Acid (RNA) by Nucleic Acid Application Test (NAAT), at the Institute of Epidemiology Disease Control and Research (IEDCR).
.jpg?Status=Master&sfvrsn=4dcfec14_7)
Testing kits provided by WHO to Government of Bangladesh. WHO Bangladesh
Only 7 months later, in December 2020, Bangladesh had a total of 118 COVID-19 testing laboratories. 15 of them are GeneXpert, and 103 are rRT-PCR laboratories, with a distribution of 68 laboratories in Dhaka City and 50 covering the rest of the country. The laboratories' non-uniform distribution led to a correspondent non-equal number of tests, as around 60% of them were carried out only in Dhaka City.
Several rural areas, hard to reach and with very limited access to laboratories, saw a significant increase in COVID-19 cases, which could not be promptly detected to limit the infection's spread. Upon request of the Directorate General of Health Services (DGHS), the WHO provided 240 000 Antigen-based Rapid Diagnostic Test (Ag. RDT) for 1 159 125 US dollars to ensure a better-distributed testing coverage throughout the country. To support the governments in selecting appropriate testing kits, WHO maintains an Emergency Use Listing procedure (EUL), which includes 20 NAAT and 2 Ag. RDT.
.jpg?Status=Master&sfvrsn=9a8b7835_9)
Medical equipment provided by WHO to Government of Bangladesh. WHO Bangladesh
From the beginning of December 2020, the government established 1 Ag. RDT testing centre in each of the 10 health facilities distributed in as many districts, also providing appropriate on-site, hands-on training to the health personnel. Two weeks later, the Ag. RDT testing centres increased from 10 to 40 all over the country. By January 2021, a total of 60 Ag. RDT testing centres were fully operational in Bangladesh.
This number keeps increasing so much that, as of March 2021, 73 centres are testing patients with COVID-19 symptoms. 22 of these testing sites are at Tertiary Level Hospitals, 49 are at District Level Hospitals, and two are at Sub-district (Upazila) Level Hospitals covering all 8 Divisions across the country. With the addition of the Ag. RDT testing centres, to the already functioning rRT-PCR and GeneXpert method of COVID-19 diagnosis, all the 64 Districts, including 11 City Corporations throughout Bangladesh, are covered with at least one lab testing facility.
Upon the deployment of this testing method, as of 29 March 2021, over 16 033 tests have been conducted using Ag. RDT significantly contributing to the management of the COVID-19 outbreak and building on towards more equal access to health care.