Fractionation method adaptation for methylene diphosphonate (MDP) radiopharmaceutical kit used in the diagnosis of infectious diseases Lusaka, Zambia.

The global emergence of antimicrobial resistance (AMR) highlights the urgent need for accurate diagnostic tools to combat infectious diseases effectively. Radiopharmaceuticals, such as the metastable state of Technetium-99m Methylene Diphosphonate (99mTc-MDP), are recognized as reliable diagnostic methods; however, challenges related to their storage persist especially in developing countries like Zambia because storage facilities are quite costly and maintenance is challenging particularly during power outages. While the literature has revealed that MDP aliquots kept at frozen and refrigerated conditions remain of good quality, this research explored the viability of MDP aliquots made from four different kinds of normal saline. The research enquired into the potential of ambientstored MDP radiopharmaceuticals to overcome the hurdles associated with cold-chain maintenance and storage infrastructure limitations. By addressing these challenges, the study aimed to contribute valuable insights that could pave way to a more sustainable and accessible deployment of nuclear medicine technologies, thereby improving diagnostic capabilities and patient outcomes in resource-challenged environments. The research was conducted at the University Teaching Adult Hospital (Nuclear Hot Laboratory) in Lusaka, Zambia from October 2022 to February 2023. A mixed methodology design was applied and data was collected from both the laboratory and biodistribution tests. In all, 80 MDP aliquots made with different types of normal saline were tested and biodistribution studies were done on staphylococcus aureus infected rat models. Data analysis using Stata 14 revealed that the Radiochemical Purity (RCP) for ambiently-stored MDP aliquots ranged from 98 to 99%, exceeding the World Health Organization’s expected required minimum of 90%. Furthermore, the efficacy of the radiolabeled MDP fractions using biodistribution animal models demonstrated accurate localization. The study concluded that MDP aliquots stored at ambient temperature demonstrated exceptional RCP and favorable biodistribution patterns, effectively localizing in regions of interest in infected rat models. This suggests potential application for ambient-stored MDP in low-resource countries facing challenges in maintaining cold chain storage, particularly during power outages.