(lab module) TRANSPORT MEDIUM FOR CSF normal 2019

Suspicion of meningitis epidemics in the African Meningitis belt^[i].

Trans Isolate (TI) medium supports the growth and survival of Neisseria meningitidis, Streptococcus pneumoniae and Haemophilus influenza. MSF has an agreement with the Norwegian Public Health Institute in Oslo, WHO Collaborating Centre for Reference and Research on Meningococci, to support its role in the surveillance of the evolution of meningitis strains. As part of this agreement, the Norwegian Public Health Institute is providing the TI medium free of charge to MSF for strain identification alone.

In 2023, MSF is only getting 120 bottles of the TI transport medium
from the supplier, the Norwegian Public Health Institute (Oslo).

As communicated internally previously (LWG, December 2018), the TI transport medium coming from Oslo has always been meant to be used ONLY for the purpose of global surveillance, and not for any other purpose. For any other testing purpose, TI transport medium needs to be requested at country level from the national referral laboratory/public health institute or regional WHO representative. Realizing the complexity of this supply, the MSF laboratory working group is investigating possible alternative supply sources, but this has proven complicated in the past and is unlikely to provide solutions in near future.

The pragmatic decision was made that the 120 TI bottles will be distributed equally to 12 different missions within the African meningitis belt , and that in each country they will be prepositioned in 1 coordination office, available for all sections to use for the specific purpose of sending CSF samples to Oslo only.

The TI is no longer part of this module.

[i] The 14 countries in the African Meningitis Belt with enhanced surveillance for meningococcal disease include Benin, Burkina Faso, Cameroon, the Central African Republic, Chad, Ivory Coast, the Democratic Republic of the Congo, Ethiopia, Ghana, Mali, Niger, Nigeria, Sudan and Togo.

This module contains all the packaging material (except the Trans Isolate!) needed for transporting CSF samples to the reference laboratory in Oslo.

• The CSF must be transported in a biphasic medium "Trans-Isolate" which is placed in a protection container
• The protection container containing the "Trans-Isolate" must be transported in a triple packaging box for diagnostic specimen UN 3373
• Do not put the "Trans-Isolate" in the refrigerator after seeding. See instructions for use in the video contained in the‌ meningitis guide