Laboratory Strengthening under IDSP Current Strategy Strengthening of
Laboratory Strengthening under IDSP
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 Ig. M 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 Andam an & Nicobar Island Andhra Pradesh Microbiol Name of Microbiolo ogist District Priority gist posted at Lab posted SSU Equip proc Tests Status Reporting of weekly reported in L form to CSU No G B Pant Hospital, Port Blair No No No NA Yes District hospital lab, Mahbubnagar District hospital lab, Ongole General Hospital , Naharlgun K. K. Civil Hospital, Golaghat Medical College, Patna Yes Yes Malaria Estb Yes Yes No NA Estb / Yes Yes Widal Estb No No No NA Arunac hal Pradesh Assam No Yes Bihar No
Current status of District priority labs Tests State Microbio Name of Microbiol Equip Reporting logist District ogist proc of weekly reported in L form posted Priority Lab posted L form to at SSU Chattis garh Dadar Nager & Haveli No Daman & Diu Yes Delhi No No JLN Medical College, Raipur District Hospital, Silvassa. District hospital, Daman. Pt. Madan. Mohan. Malviya Hospital, Delhi No No No Yes No requirem ents Yes Yes No No Status NA ELISAFunction Dengue & al leptospirosis, Culturestool & blood NA Estb / No
Current status of District priority labs State Microbi Name of Microbiol ologist District ogist posted Priority Lab posted at SSU Goa Gujarat Haryan a No No Yes Goa Medical College, Bambolin, Hospicio Hospital , Margao General Hospital Mehsana General Hospital, Sabarkantha Govt. Public Health lab, Karnal No Equip proc Tests Reporti reported ng of in L form weekly L form to CSU No requiremen ts Incomplete No NA No (posted by state govt) No Yes Yes Widal, Dengue ELISA Widal Yes Yes Stool Culture, Widal, Status Estb / ** Functiona l
Current status of District priority labs State Microbio Name of Microbiol logist District ogist posted at Priority Lab posted SSU Jammu & Kashmir No Jharkhand No Karnataka Yes Equip Proc Reportin g of weekly L form to CSU Tests reported Status in L form Provincial Lab, Srinagar District Hospital Laboratory, Ranchi District public health lab, Chitradurga Yes No NA No No No NA Yes Yes District hospital Lab, Udupi Yes Yes Estb / Widal, Cholera Function culture, Dengue, al Chikengunya & Lepto ELISA, Blood culture Widal, Cholera Function culture, Dengue al & Lepto ELISA, Blood culture
Current status of District priority labs State Kerala Tests reported Status in L form Microbiol ogist posted at SSU Name of District Priority Lab Microbiol ogist posted Equip Proc Reportin g of weekly L form to CSU Yes Regional Public Health Lab, Kozhikode Regional Public Health Lab, Ernakulam No No(1 deep freezer) No Yes No requireme nt Yes No No No Yes Yes Yes Widal Estb Laksha dweep No Madhya Pradesh Mahara shtra Yes No Indira Gandhi Hospital, Kavaratti JP Hospital, Bhopal District hospital Lab, Beed NA ELISA for Function dengue, Hepatitis al A, leptospirosis, stool culture for cholera, blood culture for typhoid NA
Current status of District priority labs State Microbiolog Name of Microbio ist posted at District Priority logist SSU Lab posted Manipur No Meghala ya Mizoram Yes Nagaland Orissa No Yes No District. No Hospital, Churachandpur Tura Civil Yes Hospital, Tura. District Hospital Yes Lab, Lunglei Civil Hospital Yes Lab, Aizawal (trained) Dimapur Yes District Hospital State IDSP Yes laboratory, Kohima District No Headquarters Hospital, Equipment Reporting procured of weekly L form to CSU Tests Status reported in L form Yes No NA Estb / No No NA
Current status of District priority labs State Microbiol Name of District Microbiol ogist Priority Lab ogist posted at posted SSU Puducher ry Yes Punjab Yes Rajastha n Yes Sikkim No Tamil Nadu No Equipment procured Reporting of weekly L form to CSU Tests reporte d in L form Status Indira Gandhi Govt. General Hospital, Pondicherry Civil Hospital, Mohali Yes No NA Estb / Yes Yes *Functional District hospital Lab, Ajmer District hospital Lab, Sikar Yes Yes Widal, Dengue ELISA NA Yes Yes *Functional STNM Hospital, Gangtok District hospital Lab, Cuddalore Yes No Widal, Dengue ELISA NA Yes Yes District hospital Lab, Yes Yes Estb / Widal, * Functional Dengue ELISA Widal Estb
Current status of District priority labs State Microbiolo gist posted at SSU Name of District Priority Lab Microbiolo gist posted Equip proc Reporting of weekly L form to CSU Tests reported in L form Status Tripura No No Yes Widal Estb Uttarak hand Yes RGMHospital, North Tripura, Kailashahar District hospital, Pauri Yes Yes District hospital, Almora Yes Yes Regional Lab, Swasthya Bhawan, Lucknow Disrict hospital, Ghaziabad No No No Uttar Prades h No Widal, stool Functional culture, Dengue ELISA Widal, stool Functional culture, blood culture NA No
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 1. Cholera and other enteropathogens : culture and sensitivity and serotyping 2. Typhoid: Serological tests (Typhi. Dot) 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-Ig. M µ capture ELISA 5. Hepatitis E- Ig. M µ capture ELISA 6. Measles- Ig. M µ capture ELISA 7. Dengue- Ig. M 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)
Current status of referral lab network State Microbiol ogist posted at SSU Referral lab plan finalised and endorse d plan received by CSU Lab Funds Function Quarterl certificati disburs ality of y report on and ed to referral of Mo. U referral lab referral signing labs network labs complete in state received by CSU Andhra Pradesh Yes Partial No Gujarat No Yes Yes Yes Karnataka Yes Yes Yes Maharashtra No Yes Yes No Punjab Yes Yes Yes No Rajasthan Yes Yes Yes Tamil Nadu No Yes Yes No West Bengal Yes No NA Uttarakhand Yes Yes Yes No
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 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 Ro. P 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 Ro. P
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 Daman & Diu NIL Delhi NIL Goa NIL Gujarat 10 Haryana NIL Himachal Pradesh 2 Jammu & Kashmir NIL Jharkhand NIL Kerala NIL Remarks The State has proposed Rs 224. 89 lakhs for strengthening district public health labs; No budget allocation in flexipool section of Ro. P 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 Ro. P
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 Ro. P 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 Sikkim NIL Tripura NIL Tamil Nadu 6 Uttar Pradesh NIL Uttarakhand NIL West Bengal 4 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 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) 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
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