Olumide Adenmosun: How Nigeria can remain #EbolaFree

by Olumide Adenmosun

As Ebola seems to have taken a pandemic toll, a group of Nigerian scientists in diaspora have been able to validate and adapt a widely published methodology for gene amplification in 30minutes. Originally designed by some Japanese scientists, the rapid gene amplification method to detect such RNA viruses like Ebola is called RT-LAMP (Reverse Transcription – Loop mediated isothermal amplification). Unlike the current widely used method of detecting Ebola Virus genes called RT-PCR (Reverse Transcription – Polymerase Chain Reaction), which requires about four to six hours of tedious laboratory procedures from sample decontamination to RNA extraction to gene amplification monitored in real time or confirmed from gel-electrophoresis; the RT-LAMP excludes all those long processes to proceed with gene amplification in just one step at a single temperature. With the use of a water bath or a dry heating block, gene amplification for the detection of Ebola viral genes in a sample can be achieved in resource-limited laboratories in Africa.

Nigeria has successfully contained its Ebola outbreak since it began in July 2014 – where a traveler from Liberia arrived the country already symptomatic. It led to a total of twenty cases, eight deaths and twelve discharges – among them were people who survived the disease and are now immune against it. Nigeria has not had any new case since September, 2014 and is now being officially declared Ebola free today by the WHO. However the epidemic still persists in other West African countries including Liberia, Guinea and Sierra-Leone where the death toll has cumulatively risen to more than four thousand. It is being estimated that the death toll due to Ebola Virus Disease may hit a few millions in early 2015 if not contained in time at those hot zones.

Some of the reasons for Nigeria’s success at containing the Ebola Virus Disease Outbreak among others were attributed to strict adherence to public health protocols on contact tracing and monitoring – and readily available diagnostic points coordinated by two reference laboratories which are situated in academic institutions – LUTH (Lagos University Teaching Hospital) and RUN (Redeemers University) respectively. These institutions were able to provide provisional diagnosis by the current gold standard – the RT-PCR method. Though it is such a tedious time-consuming laboratory process, suspected subjects were still being assessed and kept under surveillance through the period of the outbreak in Nigeria.

However, since the outbreak still persists in other West African countries; Nigeria and the rest of Africa may still be at risk – from seemingly innocent asymptomatic subjects that may slip through the ports of entry undetected – just like the case currently being encountered in the USA. The current bio-surveillance measures utilize a questionnaire-based screening tool and a non-touch temperature check to track the onset of symptoms typical of Ebola Virus Disease. While the questionnaire-based screening tool is prone to deliberate human errors and a temperature check can only figure out a symptomatic patient at the onset of a high fever; a repeat of the outbreak may be easily replicated at all clear zones in Africa and beyond. But with a rapid genetic test at all ports of entries, all potential – even yet to be symptomatic cases at some points – may be figured out and referred to isolation units for further observation and treatment. Such is the rapid genetic test currently being adapted by some Nigerian scientists.

The widely published LAMP method (Loop-mediated isothermal amplification) has been tested on every pathogen there is – from the malaria parasite to the tuberculosis bug, to HIV, SARS virus and now to Ebola virus. Far back in 2007, a group of Japanese scientists had already perfected the rapid method of detecting Ebola Virus genes in a run time of 30mins from body fluids – after a sample decontamination protocol. A group of Nigerian scientists led by Olumide Adenmosun – an alumni of the biological sciences graduate programme at Florida Atlantic University, USA and currently a visiting associate lecturer to Bowen University, Nigeria (where he was also a pioneering student) have been able to adapt the LAMP method to suit limited resource laboratories in Nigeria and the rest of West Africa badly hit by the epidemic.

RNA extraction from decontaminated samples to gene amplification for end-point diagnosis can be performed in just a single reaction-mixture step at 650C using a water bath or a dry heating block. A positive sample will show visible turbidity in the reaction tubes or glow under UV-light with the addition of a fluorescent reagent. The adaptation protocol was also reviewed by a group of scientists at Bioinnovation Solutions, Switzerland – led by Harvard trained Nigerian scientist – Yemi Adesokan. “Sequence-based diagnostics is the core of our business, and we are excited at helping Nigeria and the rest of West Africa keep up with bio-surveillance by providing these rapid diagnostic tests for RT-LAMP” – Dr. Adesokan says.

With a technical support team on ground – the rapid genetic tests are being proposed for use at all ports of entry and equally at secondary and tertiary health care institutions. Each test kit will be able to run about 50 samples quite easily and affordably with no need for expert training or acquisition of next-gen sequencing or amplification equipment. The access point for the test kits in Nigeria will be with May & Baker – in the coming weeks. At least if we will not join the rest of the “un-informed nations” to close our borders – stifling commerce, exchange of technical, intellectual and medical aid in the process – we can at least rev-up our bio-surveillance measures which will help Nigeria #ToRemainEbolaFree.

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Op-ed pieces and contributions are the opinions of the writers only and do not represent the opinions of Y!/YNaija.

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