Create a Flexible Diagnostics Capacity – Calculate the Cumulative Testing Capacity for Zachistan – Nursing Assignment Help

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Assignment Task :

Disease Overview:

Dunyamwera is an infectious disease that has been classified as a pandemic by all major global health agencies. Since the outbreak was first reported three months earlier, almost 3 million cases have been confirmed globally, with many more unconfirmed cases expected to manifest in the near future. In Zachistan, a large African country with a population of 50 million, 380 cases have been confirmed over the past month, and the government has assembled a team of key officials, research institutions, development partners, and pharmaceutical company leaders to tackle the challenge of the pandemic. Testing, tracking and tracing is essential to the government’s strategy for action, and the government hopes to undertake a rapid assessment of the diagnostics capacity of the country. CHAI has been tasked with supporting the government in conducting this analysis, which is expected to inform key policy decisions.

Current diagnostics scenario:

Presently, the diagnostic procedure for identifying Dunyamwera virus involves the collection of Buccal Swabs from suspected patients. Phlebotomists (experts in patient sample collection) visit the suspected patients and collect the samples using buccal brushes from inside the mouths of the patients, from the cheek tissue. The procedure does not require collection of blood specimens. The buccal swab is then transported to the diagnostic labs in a secure, temperature-controlled carrier. Presently, there are 200 labs spread across the country, and each lab has 1 RT-PCR machine.

At the lab, the lab technicians use RT-PCR machines to confirm the presence of the Dunyamwera virus in the samples. The DNA from the swab is extracted using a manual extraction method by the lab technicians, and the process is time consuming. For running the diagnostic tests in the RT-PCR machines, screening test kits are used, which contain a mix of chemicals and control samples. The extracted DNA is mixed with the reagents in the testing kits, and this mixture is loaded in one of the slots in the RT-PCR machine. One test kit is required per sample. The test kits are supplied by a number of local and international manufacturers. Due to the global demand, orders for test kits have to be placed much in advance, as the lead times for procurement are substantial.

The national guidelines presently recommend that for each tested sample which shows a positive presence of the virus in the screening test, a confirmatory test be conducted. Due to this reason, some capacity of the RT-PCR machines is allocated to confirmatory tests in each batch, thus reducing the available capacity for screening tests.

The Challenge:

The challenge being faced in all African countries is that presently the visibility into diagnostic capability of the countries is limited, and hence policy decisions are being made on inaccurate estimates of testing capacity. The government of Zachistan has declared a lockdown of routine businesses, and has mandated enforcement of social distancing measures to prevent the transmission of the infection. CHAI is working with the Ministry of Health of Zachistan to estimate the testing capacity of the country over the next 6 months (180 days), supported by strong quantitative analysis, to enable the ministry in making sound data based decisions. 

Further, orders for test kits need to placed with different manufacturers, who are asking for advance payments to confirm orders. This will ensure supply security of test kits over the next few months.

Since procurement lead times may vary, the government has asked CHAI to create a flexible capacity assessment model, which the decision makers can use to compare various alternate scenarios, by varying the inputs related to procurement lead times of combination testing kits and automated extraction machines.

Requirements:

1. Create a flexible diagnostics capacity assessment excel model which lets the decision makers vary the inputs (coverage of interventions, and days of switch for automated extraction machines and combination testing) to compare various scenarios of daily and cumulative testing capacity for the next six months (180 days) in Zachistan. Use this model to calculate the cumulative testing capacity for Zachistan with intervention details as listed in Appendix B and Appendix C. 

2. Estimate the quantity of combination test kits and non-combination test kits required over the next 6 months (180 days), assuming all machines are utilized to their full capacity.

3. Present this analysis in 3-4 slide PowerPoint which is to be used by CHAI to present to the Ministry of Health officials from Zachistan.

 

 

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