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Enhancing capabilities of district labs for epidemic diseases confirmation & establishing state referral lab network. Outcome-focused approach. Upgrading microbiology services and fostering lab-to-lab communication for timely response.
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Current Strategy • Strengthening of 50 district priority labs • Establishing state referral lab network for etiological diagnosis of outbreaks of epidemic prone diseases in the districts (in 9 states)
Strengthening of district priority labs Expected outcomes: • Undertake laboratory confirmation of epidemic prone diseases on a routine basis • Tests to be performed • Blood culture for typhoid • Serological test for typhoid • Stool Culture for Cholera • Dengue IgM ELISA • ELISA/Rapid test for Leptospirosis (in endemic areas) • Other tests for diagnosis of epidemic prone diseases • Support outbreak investigations in the district • Participate in EQAS • Report weekly data in L form to CSU for monitoring
Important issues related to functionality of district priority labs • State and District IDSP officers to facilitate generation of lab based surveillance data of epidemic prone diseases from district hospitals • Integration of IDSP lab, including the microbiologist, as a part of the main laboratory of the district hospital • Routine referral of specimens for testing of epidemic prone diseases • Upgrading the microbiology component of the district labs and ensure availability of resources in terms of manpower and consumables
State Referral Lab Network Functional laboratories of states, primarily in medical colleges linked to adjoining districts for etiological diagnosis of outbreaks of epidemic prone diseases Annual grant of Rs. 2 lakhs to maintain performance standards, subsequent reimbursement based on tests performed (ceiling of 3 lakhs per annum/lab)
Tests to be performed Cholera and other enteropathogens : culture and sensitivity and serotyping Typhoid: Serological tests (TyphiDot) and Culture & antimicrobial sensitivity (including isolate confirmation with specific antisera) Bacterial meningitis-rapid latex agglutination test, CSF examination-wet mount, gram stain and culture & antimicrobial sensitivity. Hepatitis A-IgM µ capture ELISA Hepatitis E- IgM µ capture ELISA Measles- IgM µ capture ELISA Dengue- IgM µ capture ELISA Diphtheria-Smear examination, culture, toxigenecity testing Leptospirosis-ELISA/Rapid test Any other tests for locally prevalent epidemic prone disease (to be identified by the state)
Important issues related to functionality of referral lab network • State epidemiologist and state microbiologist to ensure all outbreaks in the state undergo lab investigation • Regular district level meetings conducted by District surveillance officers and epidemiologists for streamlining the bottle necks for optimum utilization of referral lab network • Good communication between DSOs of linked districts and nodal microbiologists from referral labs • State microbiologist to ensure timely reporting of • lab results of outbreak samples by referral labs, • submission of quarterly reports by referral labs to CSU
Public health laboratories being developed under NRHM for diagnosis of epidemic prone diseases
Public health laboratories being developed under NRHM for diagnosis of epidemic prone diseases
Public health laboratories being developed under NRHM for diagnosis of epidemic prone diseases
Public health laboratories being developed under NRHM for diagnosis of epidemic prone diseases
Public health laboratories being developed under NRHM for diagnosis of epidemic prone diseases
Format for quarterly reporting by referral labs to CSU, copy to SSU