Decentralized Laboratory Network Improves Detection of Viral Hemorrhagic Fevers in Guinea

The 2014–2016 Ebola epidemic underscored the need for local laboratory capacity to confirm infections rapidly, while limited testing in Forest Guinea had also constrained surveillance for Lassa fever, yellow fever, and dengue. Against this background, new findings show how strengthening and sustaining regional laboratory capacity has expanded detection and surveillance of viral hemorrhagic fever cases in the region.

Researchers at the Bernhard Nocht Institute for Tropical Medicine (BNITM; Hamburg, Germany) described a decentralized laboratory partnership centered on the Laboratory for Viral Haemorrhagic Fevers in Guéckédou and the regional hospital laboratory in N'Zérékoré. The Guéckédou laboratory began operating in 2017 after setup started in late 2016, while the N'Zérékoré laboratory was strengthened in 2021.

Both facilities are integrated into Guinea’s national viral hemorrhagic fever surveillance system. Operating under a mandate from the Guinean Ministry of Health, with support from the National Reference Laboratory in Conakry, they provide free molecular testing for Ebola, Marburg, and Lassa viruses, as well as yellow fever and dengue viruses.

The study analyzed surveillance data collected from 2017 to 2024, during which the two laboratories tested 4,683 samples from suspected viral hemorrhagic fever cases. Results were available within one day on average, enabling detection of infections including Ebola, Marburg, and Lassa viruses. In 2021, the laboratories rapidly identified both the resurgence of Ebola and the emergence of Marburg virus disease, supporting timely case confirmation and outbreak response.

Between 2020 and 2024, the laboratories also confirmed 30 cases of Lassa fever, primarily in the Guéckédou and N'Zérékoré prefectures. Among patients with known outcomes, approximately two-thirds died, corresponding to a case fatality rate of 67.9%. Published on September 16, 2026, in npj Viruses, the findings show how sustained diagnostic capacity in high-risk areas can support earlier case detection, more targeted outbreak control, and improved surveillance data for public health decision-making.

“Our study highlights the progress made in case detection and epidemiological surveillance in Forest Guinea, underscoring the importance of strengthening our laboratories' capacity to prepare for and respond to emerging diseases,” said Fara Raymond Koundouno, head of LFHV-GKD and lead author of the study. 

“This program shows what health-system resilience really looks like: diagnostic capacity built to last, not just deployed temporarily during an emergency. The open question is sustainability. Funding for this kind of work is still mostly tied to specific programs, and shifting that is one of our biggest challenges going forward,” said Dr. Sophie Duraffour, head of the "Outbreak Preparedness and Response" laboratory group at BNITM.

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Bernhard Nocht Institute for Tropical Medicine