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					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 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     Microbiolog    Name of District      Microbiologi Equip proc Reporting of  Tests      Status
             ist posted      Priority Lab         st posted                weekly L reported in
                                                                                      L form
               at SSU                                                    form to CSU
Andaman         No        G B Pant Hospital,         No          No          No          NA
& Nicobar                     Port Blair
  Island
Andhra         Yes        District hospital         Yes         Yes         Yes        Malaria     Estb
Pradesh                   lab, Mahbubnagar
                          District hospital         Yes         Yes          No          NA       Estb /
                          lab, Ongole
Arunachal       No         General Hospital ,       Yes         Yes          No          NA       Estb /
 Pradesh                       Naharlgun
  Assam        Yes        K.K. Civil Hospital,      Yes         Yes         Yes        Widal       Estb
                               Golaghat
  Bihar         No         Medical College,          No          No          No          NA
                                 Patna
Chandiga       Yes           Civil Hospital,        Yes         Yes         Yes        Widal       Estb
   rh                          Manimajra
                         Current status of District priority labs

 State     Microbiolo    Name of        Microbiolo     Equip      Reporting of    Tests         Status
              gist    District Priority gist posted    proc         weekly L   reported in
                                                                                 L form
           posted at        Lab                                   form to CSU
              SSU

Chattisg       No         JLN Medical       No           No           No            NA
  arh                   College, Raipur
Dadar          No     District Hospital,   Yes           No           Yes          ELISA-      Functional
Nager &               Silvassa.                       requireme                   Dengue &
Haveli                                                   nts                    leptospirosis,
                                                                               Culture-stool &
                                                                                    blood
Daman         Yes     District hospital,   Yes          Yes           No             NA          Estb /
& Diu                 Daman.

Delhi          No     Pt. Madan. Mohan      No           No           No            No
                      .Malviya Hospital,
                      Delhi
                      Current status of District priority labs

 State     Microbiol Name of District Microbiolo Equip proc Reporting    Tests             Status
             ogist     Priority Lab   gist posted           of weekly reported in
                                                                        L form
           posted at                                        L form to
             SSU                                               CSU

Goa           No    Goa Medical              No            No        No         NA
                    College, Bambolin,                requirements
                    Hospicio Hospital        Yes       Incomplete    No         NA            Estb /
                    ,Margao
Gujarat      No     General Hospital    No (posted by     Yes        Yes   Widal, Dengue **
                    Mehsana              state govt)                       ELISA
                    General Hospital,        No           Yes        Yes   Widal
                    Sabarkantha
Haryana      Yes    Govt. Public Health      Yes          Yes        Yes   Stool Culture, Functional
                    lab, Karnal                                            Widal, Dengue
                                                                              ELISA
                    DPHL, Hissar            No            Yes        No         NA
Himachal      No    DPHL, Bilaspur          No            No         No          No
Pradesh             DPHL, Mandi             No            No         No         No
                       Current status of District priority labs
   State    Microbio     Name of       Microbiolo    Equip   Reportin   Tests reported in     Status
              logist      District     gist posted   Proc      g of          L form
             posted     Priority Lab                         weekly L
             at SSU                                          form to
                                                               CSU
Jammu &       No         Provincial       Yes         Yes      No               NA             Estb /
Kashmir                Lab, Srinagar
Jharkhand     No          District         No         No       No               NA
                          Hospital
                        Laboratory,
                          Ranchi
Karnataka     Yes        District         Yes        Yes       Yes          Widal, Cholera   Functional
                          public                                           culture, Dengue,
                       health lab,                                      Chikengunya & Lepto
                       Chitradurga                                      ELISA, Blood culture
                          District        Yes         Yes      Yes          Widal, Cholera   Functional
                       hospital Lab,                                      culture, Dengue &
                           Udupi                                         Lepto ELISA, Blood
                                                                                culture
                         Current status of District priority labs
  State    Microbiol Name of District Microbiolo      Equip       Reportin   Tests reported in       Status
             ogist     Priority Lab   gist posted     Proc          g of          L form
           posted at                                              weekly L
             SSU                                                  form to
                                                                    CSU
Kerala       Yes      Regional Public     No        No(1 deep       No               NA
                       Health Lab,                   freezer)
                        Kozhikode
                      Regional Public     Yes           No          Yes      ELISA for dengue,      Functional
                       Health Lab,                  requirement                  Hepatitis A,
                        Ernakulam                                            leptospirosis, stool
                                                                             culture for cholera,
                                                                               blood culture for
                                                                                   typhoid
Lakshad       No       Indira Gandhi      No            No          No                NA
weep                      Hospital,
                          Kavaratti
Madhya       Yes        JP Hospital,      Yes          Yes          Yes            Widal              Estb
Pradesh                    Bhopal
Maharash      No      District hospital   Yes          Yes          Yes            Widal              Estb
tra                      Lab, Beed
                      District hospital   Yes          Yes          Yes            Widal              Estb
                         Lab, Nasik
                           Current status of District priority labs
  State     Microbiolog    Name of District      Microbiolo Equipment Reporting        Tests      Status
             ist posted      Priority Lab        gist posted procured of weekly L   reported in
               at SSU                                                   form to       L form
                                                                          CSU
Manipur         No          District-Hospital,      No        Yes         No            NA
                            Churachandpur
Meghalaya      Yes        Tura Civil Hospital,      Yes       Yes         No            NA        Estb /
                                   Tura.
Mizoram         No          District Hospital       Yes       Yes         No            NA        Estb /
                              Lab, Lunglei
                           Civil Hospital Lab,       Yes      Yes         No            NA        Estb /
                                 Aizawal          (trained)
Nagaland       Yes        Dimapur District           Yes      No          No            NA
                          Hospital
                          State IDSP                Yes       No          No            NA
                          laboratory, Kohima
Orissa          No        District                  No        No          No            NA
                          Headquarters
                          Hospital, Koraput
                             Current status of District priority labs
             Microbiol     Name of District       Microbiolog   Equipment    Reporting      Tests       Status
               ogist         Priority Lab          ist posted    procured   of weekly L   reported
  State
             posted at                                                        form to     in L form
               SSU                                                              CSU
Puducherry     Yes       Indira Gandhi Govt.         Yes           Yes          No           NA          Estb /
                          General Hospital,
                             Pondicherry
Punjab         Yes          Civil Hospital,          Yes           Yes         Yes          Widal,     *Functional
                                Mohali                                                     Dengue
                                                                                           ELISA
Rajasthan      Yes       District hospital Lab,      Yes           Yes         Yes           NA          Estb /
                                  Ajmer
                         District hospital Lab,      Yes           Yes         Yes          Widal,     *Functional
                                  Sikar                                                    Dengue
                                                                                           ELISA
Sikkim          No         STNM Hospital,            Yes           Yes          No           NA          Estb /
                                Gangtok
Tamil Nadu      No       District hospital Lab,      Yes           Yes         Yes          Widal,    * Functional
                         Cuddalore                                                         Dengue
                                                                                           ELISA
                         District hospital Lab,      Yes           Yes         Yes         Widal         Estb
                         Ramanathapuram
                           Current status of District priority labs
  State    Microbiolo     Name of District    Microbiologis   Equip   Reporting      Tests        Status
           gist posted      Priority Lab        t posted      proc    of weekly   reported in
              at SSU                                                  L form to     L form
                                                                         CSU
Tripura        No               RGM-               No          Yes       Yes          Widal         Estb
                           Hospital,North
                               Tripura,
                            Kailashahar
Uttarakh      Yes        District hospital,       Yes         Yes       Yes       Widal, stool   Functional
and                      Pauri                                                    culture,
                                                                                  Dengue ELISA
                         District hospital,       Yes          Yes       Yes      Widal, stool   Functional
                         Almora                                                   culture, blood
                                                                                  culture
Uttar          No          Regional Lab,           No          No        No              NA
Pradesh                       Swasthya
                         Bhawan, Lucknow
                          Disrict hospital,        No          No        No            No
                             Ghaziabad
West          Yes        District Hospital        Yes          No        Yes          Widal
Bengal                   Laboratory, Malda
                         District Hospital        Yes          No        No            NA
                         Laboratory,
                         Murshidabad
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)
                  Current status of referral lab network
State            Microbiolog Referral        Lab          Funds Functional       Quarterly
                 ist posted  lab plan    certificatio   disburse     ity of      report of
                 at SSU      finalised   n and MoU         d to   referral lab    referral
                             and           signing       referral network in        labs
                             endorsed     complete         labs      state       received
                             plan                                                 by CSU
                             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
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     Remarks
                       proposed by the
                       state in 2011-12
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      NIL
Island
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     Remarks
                       proposed by the
                       state in 2011-12


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      Number of labs     Remarks
state            proposed by the
                 state in 2011-12
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     Remarks
                     proposed by the
                     state in 2011-12
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

				
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