Laboratory Strengthening under IDSP

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Laboratory Strengthening under IDSP
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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)

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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

4
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
Andhra Pradesh Yes 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
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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
Chattisgarh No JLN Medical College, Raipur No No No NA
Dadar Nager Haveli No District Hospital, Silvassa. Yes No requirements 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
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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
Goa No Hospicio Hospital ,Margao Yes Incomplete No NA Estb /
Gujarat No General Hospital Mehsana No (posted by state govt) Yes Yes Widal, Dengue ELISA
Gujarat No General Hospital, Sabarkantha No Yes Yes Widal
Haryana Yes Govt. Public Health lab, Karnal Yes Yes Yes Stool Culture, Widal, Dengue ELISA Functional
Haryana Yes DPHL, Hissar No Yes No NA
Himachal Pradesh No DPHL, Bilaspur No No No No
Himachal Pradesh No DPHL, Mandi No No No No
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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
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
Karnataka Yes District hospital Lab, Udupi Yes Yes Yes Widal, Cholera culture, Dengue Lepto ELISA, Blood culture Functional
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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
Kerala Yes Regional Public Health Lab, Kozhikode No No(1 deep freezer) No NA
Kerala Yes 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
Maharashtra No District hospital Lab, Nasik Yes Yes Yes Widal Estb
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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 /
Mizoram No Civil Hospital Lab, Aizawal Yes (trained) Yes No NA Estb /
Nagaland Yes Dimapur District Hospital Yes No No NA
Nagaland Yes State IDSP laboratory, Kohima Yes No No NA
Orissa No District Headquarters Hospital, Koraput No No No NA
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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 /
Rajasthan Yes 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
Tamil Nadu No District hospital Lab, Ramanathapuram Yes Yes Yes Widal Estb
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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
Uttarakhand Yes District hospital, Almora Yes Yes Yes Widal, stool culture, blood culture Functional
Uttar Pradesh No Regional Lab, Swasthya Bhawan, Lucknow No No No NA
Uttar Pradesh No Disrict hospital, Ghaziabad No No No No
West Bengal Yes District Hospital Laboratory, Malda Yes No Yes Widal
West Bengal Yes District Hospital Laboratory, Murshidabad Yes No No NA
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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

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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)

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Tests 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)

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Current status of referral lab network
State Microbiologist posted at SSU Referral lab plan finalised and endorsed plan received by CSU Lab certification and MoU signing complete Funds disbursed 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
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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

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Public health laboratories being developed under
NRHM for diagnosis of epidemic prone diseases
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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
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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
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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)
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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)
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Thank you
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Weekly L form reporting by district priority labs
to CSU
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Format for quarterly reporting by referral labs
to CSU, copy to SSU