AMR microbiology services at five referral hospitals in Timor-Leste

Fleming Fund grantee, Menzies School of Health Research boosts healthcare in Timor-Leste by successfully implementing microbiology laboratory services for antimicrobial resistance (AMR) data surveillance at all five referral hospitals – achieving immediate results by the patient bedside for improved treatment plans.

Located in Baucau, Suai, Maliana, Maubisse and Oecusse, the referral hospital laboratories have been installed with new, advanced equipment for AMR testing. This includes BD Bactecs for blood culture testing, Olympus microscopes, Biosafety Cabinets, incubators, and autoclaves for sample preparation and analysis. The laboratories can now also access AMR results through the software-based solution Laboratory Information Management System (LIMS) to support data collection and analysis.

Image caption: The laboratory director from Maubisse Referral Hospital explaining the process for blood culture testing.

The expansion of microbiology services comes after several years of collaboration in Dili between Menzies, the Timor-Leste Government’s Ministry of Health (MoH), the National Health Laboratory (NHL), and the Hospital Nacional Guido Valadares (HNGV).

The implementation of this equipment has significantly improved the country’s healthcare services, where health practitioners can now electronically access blood tests and culture results at a patient's bedside. This enhanced access speeds up clinical care decisions informed by laboratory results.

Executive Director of the National Health Laboratory, Endang Soares da Silva, said there are several benefits from expanding the microbiology service - increasing access to microbiology diagnostics and decreasing late referrals and delayed or incorrect treatment:

“The introduction of LIMS at the referral hospitals facilitates clinicians with timely reporting of laboratory results, hence, patients are able to access treatment rapidly, resulting in better health outcomes.”

Image caption: Joana Correia Belo, Menzies Laboratory scientist helping the Suai referral hospital laboratory staff with the newly installed biosafety cabinet.

Menzies played a key role in supporting the procurement and installation of microbiology equipment, providing training, and assisting with sample collection and testing – also encouraging clinicians to use the new patient tests available and access their results through the LIMS.

Co-lead of Menzies Timor-Leste projects, Associate Professor Josh Francis, said that the opportunity to work with the Ministry of Health on building healthcare capacity was backed by the commitment of the country’s government to tackle the problem of antibiotic resistance, and to improve the quality of care available for Timorese patients:

“What has been achieved is remarkable. Timor-Leste has rapidly gone from having a very limited capacity for microbiological diagnosis to having state-of-the-art technology functioning in each referral hospital, that enables highly trained Ministry of Health staff to carry out accurate testing for bacterial infections and antibiotic resistance.”

“We have seen evidence of lives that have been saved through these developments, and it is exciting to play a part in this, and to see the leadership from Ministry of Health staff in making it happen.”

This work has been made possible through the Fleming Fund Country Grant to Timor-Leste, managed by Mott MacDonald. Through a One Health approach, the grant supports testing and surveillance for AMR and antimicrobial use (AMU) in human and animal health.

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