laboratory strengthening under idsp. current strategy strengthening of 50 district priority labs...
TRANSCRIPT
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 labsStrengthening of district priority labsExpected 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
Current status of District priority labs
State Microbiologist posted
at SSU
Name of District Priority Lab
Microbiologist posted
Equip proc Reporting of weekly L
form to CSU
Tests reported in
L form
Status
Andaman & Nicobar
Island
No G B Pant Hospital, Port Blair
No No No NA
Andhra Pradesh
Yes District hospital lab, Mahbubnagar
Yes Yes Yes Malaria Estb
District hospital lab, Ongole
Yes Yes No NA Estb /
Arunachal Pradesh
No General Hospital , Naharlgun
Yes Yes No NA Estb /
Assam Yes K.K. Civil Hospital, Golaghat
Yes Yes Yes Widal Estb
Bihar No Medical College, Patna
No No No NA
Chandigarh
Yes Civil Hospital, Manimajra
Yes Yes Yes Widal Estb
State Microbiologist
posted at SSU
Name of District Priority
Lab
Microbiologist posted
Equip proc
Reporting of weekly L
form to CSU
Tests reported in
L form
Status
Chattisgarh
No JLN Medical College, Raipur
No No No NA
Dadar Nager & Haveli
No District Hospital, Silvassa.
Yes No requireme
nts
Yes ELISA- Dengue &
leptospirosis, Culture-stool &
blood
Functional
Daman & Diu
Yes District hospital, Daman.
Yes Yes No NA Estb /
Delhi No Pt. Madan. Mohan .Malviya Hospital, Delhi
No No No No
Current status of District priority labs
State Microbiologist
posted at SSU
Name of District Priority Lab
Microbiologist posted
Equip proc Reporting of weekly L form to
CSU
Tests reported in
L form
Status
Goa No Goa Medical College, Bambolin,
No No requirements
No NA
Hospicio Hospital ,Margao
Yes Incomplete No NA Estb /
Gujarat No General Hospital Mehsana
No (posted by state govt)
Yes Yes Widal, Dengue ELISA
**
General Hospital, Sabarkantha
No Yes Yes Widal
Haryana Yes Govt. Public Health lab, Karnal
Yes Yes Yes Stool Culture, Widal, Dengue
ELISA
Functional
DPHL, Hissar No Yes No NAHimachal Pradesh
No DPHL, Bilaspur No No No NoDPHL, Mandi No No No No
Current status of District priority labs
State Microbiologist
posted at SSU
Name of District
Priority Lab
Microbiologist posted
EquipProc
Reporting of
weekly L form to
CSU
Tests reported in L form
Status
Jammu & Kashmir
No Provincial Lab, Srinagar
Yes Yes No NA Estb /
Jharkhand No District Hospital
Laboratory, Ranchi
No No No NA
Karnataka Yes District public
health lab, Chitradurga
Yes Yes Yes Widal, Cholera culture, Dengue,
Chikengunya & Lepto ELISA, Blood culture
Functional
District hospital Lab,
Udupi
Yes Yes Yes Widal, Cholera culture, Dengue &
Lepto ELISA, Blood culture
Functional
Current status of District priority labs
State Microbiologist
posted at SSU
Name of District Priority Lab
Microbiologist posted
EquipProc
Reporting of
weekly L form to
CSU
Tests reported in L form
Status
Kerala Yes Regional Public Health Lab, Kozhikode
No No(1 deep freezer)
No NA
Regional Public Health Lab, Ernakulam
Yes No requirement
Yes ELISA for dengue, Hepatitis A,
leptospirosis, stool culture for cholera, blood culture for
typhoid
Functional
Lakshadweep
No Indira Gandhi Hospital, Kavaratti
No No No NA
Madhya Pradesh
Yes JP Hospital, Bhopal
Yes Yes Yes Widal Estb
Maharashtra
No District hospital Lab, Beed
Yes Yes Yes Widal Estb
District hospital Lab, Nasik
Yes Yes Yes Widal Estb
Current status of District priority labs
State Microbiologist posted
at SSU
Name of District Priority Lab
Microbiologist
posted
Equipment procured
Reporting of weekly L
form to CSU
Tests reported in
L form
Status
Manipur No District-Hospital, Churachandpur
No Yes No NA
Meghalaya
Yes Tura Civil Hospital, Tura.
Yes Yes No NA Estb /
Mizoram No District Hospital Lab, Lunglei
Yes Yes No NA Estb /
Civil Hospital Lab, Aizawal
Yes (trained)
Yes No NA Estb /
Nagaland Yes Dimapur District Hospital
Yes No No NA
State IDSP laboratory, Kohima
Yes No No NA
Orissa
No District Headquarters Hospital, Koraput
No No No NA
Current status of District priority labs
State
Microbiologist
posted at SSU
Name of District Priority Lab
Microbiologist posted
Equipment procured
Reporting of weekly L
form to CSU
Tests reported in L form
Status
Puducherry Yes Indira Gandhi Govt. General Hospital,
Pondicherry
Yes Yes No NA Estb /
Punjab Yes Civil Hospital, Mohali
Yes Yes Yes Widal, Dengue ELISA
*Functional
Rajasthan Yes District hospital Lab, Ajmer
Yes Yes Yes NA Estb /
District hospital Lab, Sikar
Yes Yes Yes Widal, Dengue ELISA
*Functional
Sikkim
No STNM Hospital, Gangtok
Yes Yes No NA Estb /
Tamil Nadu No District hospital Lab, Cuddalore
Yes Yes Yes Widal, Dengue ELISA
* Functional
District hospital Lab, Ramanathapuram
Yes Yes Yes Widal Estb
Current status of District priority labs
State Microbiologist posted
at SSU
Name of District Priority Lab
Microbiologist posted
Equip proc
Reporting of weekly L form to
CSU
Tests reported in
L form
Status
Tripura No RGM-Hospital,North
Tripura, Kailashahar
No Yes Yes Widal Estb
Uttarakhand
Yes District hospital, Pauri
Yes Yes Yes Widal, stool culture, Dengue ELISA
Functional
District hospital, Almora
Yes Yes Yes Widal, stool culture, blood culture
Functional
Uttar Pradesh
No Regional Lab, Swasthya
Bhawan, Lucknow
No No No NA
Disrict hospital, Ghaziabad
No No No No
West Bengal
Yes District Hospital Laboratory, Malda
Yes No Yes Widal
District Hospital Laboratory, Murshidabad
Yes No No NA
Current status of District priority labs
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 NetworkState 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 performedTests to be performed
1. Cholera and other enteropathogens : culture and sensitivity and serotyping
2. Typhoid: Serological tests (TyphiDot) and Culture & antimicrobial sensitivity (including isolate confirmation with specific antisera)
3. Bacterial meningitis-rapid latex agglutination test, CSF examination-wet mount, gram stain and culture & antimicrobial sensitivity.
4. Hepatitis A-IgM µ capture ELISA
5. Hepatitis E- IgM µ capture ELISA
6. Measles- IgM µ capture ELISA
7. Dengue- IgM µ capture ELISA
8. Diphtheria-Smear examination, culture, toxigenecity testing
9. Leptospirosis-ELISA/Rapid test
10. Any other tests for locally prevalent epidemic prone disease (to be identified by the state)
State Microbiologist posted at SSU
Referral lab plan finalised and endorsed plan received by CSU
Lab certification and MoU
signing complete
Funds disburse
d to referral
labs
Functionality of
referral lab network in
state
Quarterly report of referral
labs received by CSU
Andhra Pradesh Yes Yes Partial Partial Partial No
Gujarat No Yes Yes Yes Yes Yes
Karnataka Yes Yes Yes Yes Yes Yes
Maharashtra No Yes Yes Yes Yes No
Punjab Yes Yes Yes Yes Yes No
Rajasthan Yes Yes Yes Yes Yes Yes
Tamil Nadu No Yes Yes Yes Yes No
West Bengal Yes Yes No NA No NA
Uttarakhand Yes Yes Yes Yes Yes No
Current status of referral lab network
Important issues related to functionality Important issues related to functionality of referral lab network 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
Name of the state Number of labs proposed by the state in 2011-12
Remarks
Andhra Pradesh 21 State had proposed Rs 728.81 lakhs for strengthening of 21 district public health labs, advised to take up in phases and propose under NRHM Flexipool. No budget allocation in flexipool section of RoP
Andaman & Nicobar Island
NIL
Arunachal Pradesh NIL
Assam NIL
Bihar NIL
Chandigarh NIL
Chattisgarh NIL
Dadar Nager & Haveli 1 UT had proposed Rs 17.9 lakhs for strengthening of District public health Laboratory, No budget allocation in flexipool section of RoP
Public health laboratories being developed under NRHM for diagnosis of epidemic prone diseases
Name of the state Number of labs proposed by the state in 2011-12
Remarks
Daman & Diu NIL
Delhi NIL
Goa NIL
Gujarat 10 The State has proposed Rs 224.89 lakhs for strengthening district public health labs; No budget allocation in flexipool section of RoP
Haryana NIL
Himachal Pradesh 2 Two labs (IGMC Shimla & RPGMC Tanda) have been identified by the State for strengthening as district public health lab with the total budget of 1.02 crores. No budget allocation in flexipool section of RoP
Jammu & Kashmir NIL
Jharkhand NIL
Kerala NIL
Public health laboratories being developed under NRHM for diagnosis of epidemic prone diseases
Name of the state
Number of labs proposed by the state in 2011-12
Remarks
Karnataka NIL
Lakshadweep NIL
Madhya Pradesh NIL
Maharashtra 30 Under the head of strengthening of public health labs, allocation of Rs. 273 lakhs for 30 labs of Water Supply and Sanitation Department (budget allocation under flexipool)
This fund is not allocated for public health labs for diagnosis of epidemic prone diseases
Manipur 8 Rs. 2.77 lakhs has been allocated to the State for strengthening of 8 district labs (budget allocation under flexipool)
In such small budget the labs may not be able to perform the tests required
Meghlaya 1 Rs. 28.23 lakhs proposed by the State to strengthening of district labs at Civil hospital Shillong; No budget allocation in flexipool section of RoP
Mizoram NIL
Nagaland NIL
Orissa 2 Rs. 74.80 lakhs has been allocated to the State for strengthening of 2 district labs (Kalahandi & Sundergarh) (budget allocation under flexipool)
Public health laboratories being developed under NRHM for diagnosis of epidemic prone diseases
Name of the state Number of labs proposed by the state in 2011-12
Remarks
Puducherry 1 Allocation of Rs 34.71 lakhs for one model district public health lab (budget allocation under flexipool)
Punjab NIL
Rajasthan 6 PFA labs Allocation of Rs 31.5 lakhs for PFA labs at 6 districts; Ajmer, Jaipur, Udaipur, Jodhpur, Kota, Alwar (budget allocation under flexipool)
This fund is not allocated for public health labs for diagnosis of epidemic prone diseases
Sikkim NIL
Tripura NIL
Tamil Nadu 6 Allocation of Rs. 208.20 lakhs for one Public health laboratory in each 6 districts; Thiruvannamalai, Erode, Tiruchi, Nagapatnam, Kanyakumari, Dindigul (budget allocation under flexipool)
Uttar Pradesh NIL
Uttarakhand NIL
West Bengal 4 Allocation of Rs. 138.82 lakhs for one Public health laboratory in 4 districts (budget allocation under flexipool)
Public health laboratories being developed under NRHM for diagnosis of epidemic prone diseases