Laboratory Strengthening under IDSP. Current Strategy Strengthening of 50 district priority labs Establishing state referral lab network for etiological

Laboratory StrengtheningLaboratory Strengthening under under IDSPIDSP

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


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


State Microbiologist

posted at SSU

Name of District Priority

Lab


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.


Delhi No Pt. Madan. Mohan .Malviya Hospital, Delhi

No No No No



posted at SSU



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



posted at SSU

Name of District

Priority Lab


EquipProc

Reporting of

weekly L form to

CSU

Tests reported in L form

Status

Jammu & Kashmir

No Provincial Lab, Srinagar


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



posted at SSU



EquipProc

Reporting of

weekly L form to

CSU


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


Maharashtra

No District hospital Lab, Beed


District hospital Lab, Nasik




at SSU


Microbiologist

posted

Equipment procured


form to CSU

Tests reported in

L form

Status

Manipur No District-Hospital, Churachandpur

No Yes No NA

Meghalaya

Yes Tura Civil Hospital, Tura.


Mizoram No District Hospital Lab, Lunglei


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


State

Microbiologist

posted at SSU



Equipment procured


form to CSU


Status

Puducherry Yes Indira Gandhi Govt. General Hospital,

Pondicherry


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


*Functional

Sikkim

No STNM Hospital, Gangtok


Tamil Nadu No District hospital Lab, Cuddalore


* Functional

District hospital Lab, Ramanathapuram




at SSU



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


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

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

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


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


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)



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)


Weekly L form reporting by district priority labs to CSU

Format for quarterly reporting by referral labs to CSU, copy to SSU

Documents

Laboratory Strengthening under IDSP. Current Strategy Strengthening of 50 district priority labs Establishing state referral lab network for etiological