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Managing BSL-3 laboratory in a secondary level facility in low income countries – FHI 360 experience


With the emerging threat of DR-TB in Nigeria, the NTBLCP pioneered an initiative to herald the monitoring of resistance to first line anti-TB drugs in the country. In response to this initiative, FHI 360 with funding support from USAID, established the first ever secondary level BSL 3 laboratory in Nigeria. The laboratory was established at Dr. Lawrence Henshaw Memorial Hospital (DLHMH), Calabar, Cross River State. This high technology containment laboratory is characterised by unidirectional airflow, indoor negative pressure, and a lab air exchange of 12 – 24 per hour. The Laboratory uses an automated mechanical plant for its cooling and air extraction; referred to as Heat ventilating and airconditioning (HVAC) system.

Since its establishment about 5 years ago, common operational challenges of the high containment laboratory included frequent breakdown of the HVAC system due to irregular and interruptive power supply from the national grid and inadequate capacity of health facility staff to maintain the equipment locally. To bridge the power supply challenges, FHI 360 in collaboration with the State government, connected the facility to a dedicated line from the national grid, in order to reduce the frequency of power interruptions. The facility was also supported with a 150KVA generator, backed with automatic change-over switch, 60KVA inverter and a 200KVA stabilizer. All major power dependent equipment such as MGIT960, biosafety cabinets, refrigerators, incubators, laboratory access controls, laboratory extractor and cooling systems were connected to the inverter, to ensure constant, uninterrupted power supply.

To address the manpower capacity challenges and ensure planned maintenance of equipment, FHI360 collaborated with the Cross River State government to second dedicated and potentially skilled personnel to the laboratory. As a result, an electrical engineer and three (3) additional medical laboratory technicians were posted by the government and trained by FHI 360, both locally and internationally, on planned preventive maintenance and equipment use, respectively. These are in addition to the local and international technical support and mentoring visits to the laboratory. Additionally, a back-up split air conditioning unit was installed to support the HVAC central cooling system.

Since these interventions were concluded over six (6) months ago, the BSL-3 lab has been functioning with minimal interruptions.


The cooling unit of HVAC system

The cooling unit of HVAC system

One response to “Managing BSL-3 laboratory in a secondary level facility in low income countries – FHI 360 experience”

  1. zonnebloem says:

    To the BSL 3 practices, we add requirements for complete clothing change before entry, a shower on exit and decontamination of all materials prior to leaving the facility.

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