Mise en place de LabBook à Madagascar

Many laboratories do not have a computer system that allows them to process data automatically. Patient information and test results are collected in paper format, which involves creating large numbers of copies. The patient data and analyses to be performed are first generally recorded on a bench-top log book, based on the data noted on the request (prescription) forms. The biologist or laboratory technician then performs the analyses, notes the controls and calibrations performed in another log book, and copies the analysis results to the bench-top log book. He then manually completes the analysis report, which he gives to the clinician. The risk of error is therefore high and the information is difficult to compile and process. When the laboratory needs to provide statistics and activity reports, it must reread its paper records and count the patients, identify sexes and ages, as well as the number and type of analyses without digital tools.

This computerised laboratory management system (CLMS) allows for computerised management of the laboratory’s numerical and alphanumeric data, namely:

patients (their age, sex, address, clinical particularities)
analyses (numeric and alphanumeric)
prescribers and samplers
records (a prescriber, a patient, one or more analyses)
capture and validation of results
management of quality controls
impressions and reports (bench sheets, reports, statistics, epidemiology)
queries, consultation of patient histories
various settings
data backup.

This software was originally designed for, and in partnership with, RESAOLAB (West African Network of Biological Analysis Laboratories). It represents the first regional programme in West Africa which aims to strengthen the field of biomedical analyses. Building on the success of RESAOLAB, the Foundation is supporting the establishment of a network of laboratories in Madagascar: RESAMAD. From 2015 to 2017, an improved version of the software, LabBook 2.0, was deployed in 9 laboratories in Madagascar, destined for Madagascar’s network of RESAMAD laboratories. Thanks to the laboratories’ monitoring and their use of the CLMS, user comments made it possible to improve the software with the implementation of LabBook 2.0. LabBook simplifies and facilitates the reading, management and consultation of laboratory data, compared to more complicated paper management, which explains why the percentage of laboratories submitting their activity reports (statistics) and epidemiological reports is so low. LabBook therefore makes it possible to strengthen epidemiological surveillance, through the regular collection and transmission of laboratory analysis data to the National Laboratory Bureau. The software enables the production of a weekly surveillance report for priority diseases (malaria, tuberculosis, diarrhoea, respiratory infections, malnutrition). In addition, it is configurable to allow optimal adaptation to the operation of each laboratory.

LabBook is implemented in Madagascar by providing technical support for laboratory technicians to learn how to use the software. They also benefit from IT support, and learn how to use a computer. In addition, LabBook has the advantage of having a focal point in Madagascar, which can link the RESAMAD and Mérieux Foundation laboratories.