HIV Laboratory (from previous work as National Reference Center for HIV Testing)
- Fem Julia E. Paladin, MSc, PhD (Head, Virology Department)
Referral for HIV Testing and Confirmation
1997
1998
n = 627
n = 1846
Pos Neg Ind Pos Neg Ind Patients referred for possible HIV infection
27 8 0 5 42 0 Patients/specimen referred for follow-up
6 15 15 23 8 0 Serum/plasma referred for confirmation
133 88 19 87 100 26 Blood units/donors
316 0 0 0 1555 0 Total
482 111 34 115 1705 26
Evaluation of HIV Test Kits as Requirement for BFAD Registration
Total number of kits evaluated
7 No. of kits approved for renewal of registration
2 No. of kits approved for initial registration
5
RITM as National Reference Center for Polioviruses
- Fem Julia E. Paladin, MSc, PhD (Head, Virology Department)
1997 1998 n = n = Total number of stool samples received
620 596 Total number of suspected AFP cases (with stool samples)
127 292 Number of non-AFP cases (with stool samples)
11 15
Results of Virus Isolation:
1998 n = Mixed polio 1 and 2 (Sabin type)
2 Polio 3 (Sabin) + Enterovirus
1 Non-polio enterovirus and/or adenovirus
120
National Reference Laboratory for Measles Surveillance
- Fem Julia E. Paladin, MSc, PhD (Head, Virology Department)
Total number of blood samples received - 430
Results of measles and rubella IgM antibody testing:
Rubella
Pos Equi Neg Total Positive
11 10 325 346 (80.5%) Equivocal
1 2 32 35 (8.1%) Negative
4 2 43 49 (11.4%) Total
16 14 400 430
National Reference Laboratory for Dengue Viruses
- Fem Julia E. Paladin, MSc, PhD (Head, Virology Department)
Confirmation of dengue infection:
1997 1998 n = n = 384 Number of specimen evaluable for HI test (Paired)
30 104 Number of specimen - unpaired/not tested
42 Number of specimen for JE virus isolation
10
Results from serology:
RESULTS
1997 1998 n = 30 n = 104 Definite dengue infection
13 (43.3%) 45 (43.3%) Presumptive secondary dengue infection
10 (33.3%) 43 (41.3%) Not dengue
6 (20.0%) 10 (9.6%) Uninterpretable
1 (3.3%) 6 (5.8%)
Influenza Virus Surveillance
- Fem Julia E. Paladin, MSc, PhD (Head, Virology Department)
RESULTS
Number
Influenzae A
12 Rhinovirus
4 Adenovirus
2 Parainfluenzae 3
2 Negative
173 Pending
58
ANTIBIOTIC RESISTANCE
SURVEILLANCE REPORT
Celia C. Carlos, M.D.
(Unit Head and Chairperson, Committee on Antimicrobial Resistance Surveillance, DOH)
The Philippine National Drug Policy (PNDP) has set as one of its four pillars the promotion of the rational use of drugs, to include the class of antimicrobial agents. This will rest on 3 main elements: setting up of standards for rational drug use, monitoring of usage through surveillance data and performance of remedial action where flaws are identified. The Research Institute for Tropical Medicine (RITM) has participated in the program by providing quality antimicrobial resistance surveillance data collated and analyzed from sentinel regional and central laboratories. The project's general objective was to determine the current status and developing trends of bacterial resistance to antimicrobial agents in the country. By doing so, the institute hopes to provide accurate and reliable data for use by national policy makers and clinicians in making decisions on optimal antibiotic usage. The antimicrobial resistance surveillance projects (ARSP) specific objectives are: 1) To identify and strengthen regional laboratories which will participate in the program, 2) To improve the mechanism for data collection, reporting, collation, analysis and timely feedback, 3) To perform special studies like determination of minimal inhibitory concentrations among bacterial isolates with unusual susceptibility patterns, 4) To ensure the implementation of quality control procedures and to improve the quality assurance program in microbiology among member laboratories, 5) To monitor and evaluate the operations of the program, and 6) To disseminate the results of surveillance to appropriate groups.
The ARSP had thus been undertaking surveillance activities for the last ten years as of 1998 and had achieved the following: 1) providing important susceptibility data at the hospital level and, more importantly, at the national level for some control programs of the Department of Health, 2) introducing an updated computer program for data entry and analysis by the Data Management Unit of RITM, (although currently, the program utilizes the WHONET computer program of the WHO) 3) disseminating generated data through publications and lectures, 4) piloting an external quality assessment scheme since 1992 by sending "unknowns" on agar slants to participating laboratories to assess the performance of these laboratories and ensure that data submitted are accurate and reliable, 5) inclusion of more sentinel sites outside of Metro Manila to include the Celestino Gallares Memorial Hospital (CGMH) in Bohol (as of 1994), Zamboanga Medical Center (ZMC) in Zamboanga City (as of 1994), the Eastern Visayas Regional Medical Center in Tacloban City (as of October 1998), and the Corazon Locsin Montelibano Memorial Medical Center in Bacolod City (as of October 1998), 6) initiation of a gonococcal surveillance program in 1995, 7) performance of confirmatory tests on bacterial isolates with "unusual" susceptibility patterns using minimum inhibitory concentrations (MICs), confirming for instance the first proven methicillin-resistant Staphylococcus aureus isolates in the Philippines, 8) implementation of measures to upgrade laboratory performance like holding a three week laboratory workshop among medical technologists of sentinel sites, carrying out follow-up visits including distribution of supplies and ATCC reference strains to almost all ARSP sentinel sites, distribution of reference materials like guidelines of the National Committee for Clinical Laboratory Standards (NCCLS), undergoing a two month in-house training in microbiology at RITM by four medical technologists to further improve their skills, 9) initiation of policy initiatives by providing significant inputs on a position paper on the rationale of an educational strategy addressing the rational use of antibiotics, 10) undertaking research projects on specific organisms known to be causing significant problems of antibiotic resistance like Neisseria gonorrhoeae and Streptococcus pneumoniae, and nosocomial pathogens, 11) initiation of collaborative research and surveillance with organizations like the World Health Organization, Centers for Disease Control (CDC), Atlanta, U.S.A. and Asian Network for Surveillance of Resistant Pathogens (ANSORP), 12) improvement of technical skills of RITM staff through overseas training and participation in external quality assurance programs such as the WHO Quality Control and Proficiency Testing, WHONET Quality Control Program (c/o the CDC), and the WHO Gonococcal Antimicrobial Surveillance Quality Assurance Program, 13) development of standard operating procedures to be used when monitoring ARSP laboratories including a standard form, 14) provision of laboratory supplies to sentinel sites. and 15) provision of expert opinion on anti-infectives for the National Drug Committee and Bureau of Food and Drug.
Specific examples of activities of the ARSP from 1997-98 include publications, training, lectures, and other activities for advocacy related to rational antibiotic use.
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2001 Research Institute for Tropical Medicine |
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