Assessment of laboratory specimen referral and transport in 17 CDC partner countries: measuring progress in Global Health Security Agenda implementation Open Access

Abstract

This thesis examines the relationship between the laboratory specimen referral and transport indicator and other indicators within the biosafety and biosecurity, national laboratory systems, real time surveillance, reporting, emergency response operations, and workforce development technical areas of the World Health Organization’s Joint External Evaluation (JEE) Tool version 1.0 among 17 US Centers for Disease Control and Prevention (CDC) partner countries between October 2016 and September 2019. This time frame was studied because the JEE version 1.0 was used during this time, and some indicators changed in the JEE version 2.0 beginning in October 2019. Data were collected from the US government Global Health Security Agenda interagency progress reports, which are used by the CDC, US Agency for International Development, and the US Department of State to assess a country’s capacity in several technical areas. Countries are required to complete these interagency reports twice per fiscal year. Descriptive and multivariate models were assessed using linear regression. After obtaining a final multivariate model, collinearity and interaction assessments were analyzed. Our results showed that two indicators, effective modern point of care and laboratory-based diagnostics and reporting network and protocols in country, were significantly associated with the outcome variable (p=0.05 and 0.04, respectively), the laboratory specimen referral and transport indicator. The interaction assessments yielded a non-statistically significant p-value of 0.19 with our outcome variable. Although this assessment did not include country-specific information for each indicator, this analysis can be beneficial to countries by allowing them to make informed decisions for any outcome indicator by including additional country-specific data into the model. By including this other information, a country will also have the ability to determine relationships between indicators within other technical areas. 

Table of Contents

Introduction.....page 8

Methods...........page 9

Results.............page 13

Discussion........page 14

Limitations.......page 16

Conclusion.......page 17

References........page 18

Table A.............page 22

Table 1.............page 26

Table 1A...........page 27

Table 1B...........page 28

Table 1C...........page 29

Table 1D...........page 30

Table 2.............page 31

Table 3.............page 32

Table 4.............page 33

Figure 1............page 34

Appendix I........page 35

About this Master's Thesis

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School	Rollins School of Public Health
Department	Epidemiology
Subfield / Discipline	Epidemiology - MPH & MSPH
Degree	M.P.H.
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Public Health
Keyword	Global Health Security Agenda global health GHSA
Committee Chair / Thesis Advisor	Sarita Shah, Emory University
Committee Members	Cynthia H. Cassell, US Centers for Disease Control and Prevention

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