HomeDREAMWhen the DREAM programme was founded, it was decided it would set up laboratories that would make a service of excellence available to fight AIDS in Africa, like in the Western countries.
03 - Jun - 2021

It was the year 2000 and DREAM had just started operating in Mozambique. A complex laboratory was immediately set up in Maputo, and it had areas for haematology and biochemistry, with automatic and semi-automatic equipment for the evaluation of basic haematological and biochemical parameters. There was also a cytometry area for counting the CD4 cells, the HIV target cells. Above all though, it had a molecular biology department, the first one that was not to be used for research but for clinical practice, to measure the HIV viral load. This parameter is in fact essential for finding out the initial situation of the disease in patients but it is particularly important for monitoring the effectiveness of their therapy and is an early indicator of the onset of problems like drug resistance.

Some of the areas to be used for molecular biology had to be rebuilt and some were built from scratch according to the international guidelines, so the spaces had to be made completely separate from each other. The electrical systems were adapted to guarantee that the freezers would always work properly, which is necessary for storing the reagents. The local staff were given intensive, specific training so they could learn to work under different conditions, which for some of them were completely new conditions.

This led to the definition of a model of clinical and molecular biology laboratories in Africa, managed entirely by local staff. These laboratories are accessible and free of charge for all the patients on the DREAM programme but also for those from other organisations and public healthcare centres, subject to agreements with, and support from the various countries’ Ministries of Health.

All the basic tests for monitoring the patients’ health can be carried out routinely at the DREAM laboratories.

The molecular biology department has instruments that use the real time PCR method and automatic extractors so it is possible to manage even large numbers of tests. Some laboratories can perform molecular biology analyses on over 350 samples a day, as well as the rest of their activity. The molecular biology department of the Balaka laboratory processes an average of 3,700 viral load samples a month. Last year the Maputo laboratory performed almost 35,000 tests on various parameters.

The molecular biology department is now also used for the molecular analysis of tuberculosis and resistance to tuberculosis drugs, and with the outbreak of the covid-19 pandemic, swab tests for Sars Cov-2 have been added too. The laboratory in Beira for example, analyses over 2,000 swabs a months.

The laboratories have also taken part in various operational research projects, and their work has contributed to achieving important results.

Some laboratories have participated in the international validation of new methods, for example the Dry Blood Spot (DBS) collection of samples for viral load measurements. In Malawi, the Blantyre laboratory has developed a homemade method for studying HIV drug resistances, and this method is now being adopted in other countries too.

All the DREAM laboratories have worked for many years respecting the quality management system according to the international ISO 15189 standard, some of them have been accredited and some are in the process of being accredited.


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