Jan 20, 2016 News
– but measures to improve capacity apace
Although it was established with a keen focus on boosting HIV-related testing capabilities, the National Public Health Reference Laboratory has been seeking to expand its services. This, however, has not been without some challenges, ranging from a high staff turnover rate to non-functioning of some equipment.
This was related by Chief Medical Officer (CMO), Dr. Shamdeo Persaud, during an interview.
The challenges, according to him, have resulted in the diminished use of the laboratory, on occasions, since it opened its doors in July 2008. In fact the laboratory, during the course of last year, was forced to halt its viral load and CD4 count tests which are required to effectively assess and treat HIV patients. This was mostly due to the non-functioning of equipment in the laboratory because of lack of maintenance.
“A lot of these equipment are very sensitive, so we have to have the annual maintenance contract under review, because some of them have not received their regularly scheduled maintenance, and some of them are actually not functioning because of that,” Dr. Persaud related.
He disclosed, too, that even within the regular laboratory network, including regional hospitals “we have several labs with equipment that has not been serviced, or there is a part missing or reagent or kit not available that caused the equipment not to be used. That is a challenge. Our small standards unit has been struggling a bit, but they have been trying to prioritise first of all and deal with the areas that can be addressed.”
But according to Dr. Persaud, this situation is one that is sometimes caused by delays on the part of manufacturers and suppliers of biomedical services.
Nevertheless, Dr. Persaud said that deliberate efforts are being made to change the shortcomings faced by the national reference laboratory.
“From the start of this year we have started to see the laboratory doing more tests. They have re-commenced doing viral load and CD4 count testing,” said Dr. Persaud.
The laboratory, situated at the junction of Thomas and New Market Streets in Georgetown, was implemented with strong input from the US President’s Emergency Plan For AIDS Relief (PEPFAR). As such, the CMO noted that “although a priority area happens to still be HIV-related tests, we have also started to do some other general tests, and they can actually do some of the viral tests.”
At the moment, the laboratory has the capacity to test for viruses including the H1N1 virus, though to a limited extent. This translates to the ability to ascertain whether a tested blood sample contains influenza A or B viruses.
Influenza A viruses are known to cause influenza in birds and some mammals, and could be transmitted to humans, while Influenza B is a type of flu virus that can cause respiratory, fever and stomach symptoms.
“Right now our lab can only take us to the point of deciding whether it is influenza A or B. A is the one that causes H1N1, but the actual typing needs a further test which we will try to work on as time goes by,” related Dr. Persaud.
But efforts are currently being made to build capacity and improve the service at the national lab. “They are actually putting together a list of what can be done…there were some capacity built for (testing for) Chikungunya and we did receive the kits, but they were not compatible with some of the machines we had, and that was a setback for us,” the CMO admitted.
“Hopefully we will get that right and set things in motion,” he added.
In the meantime, the Caribbean Public Health Agency (CARPHA) in Trinidad has been helping Guyana with the majority of its testing needs. For instance, samples were tested there for the H1N1 virus, which recently claimed the life of a businessman, and the Zika virus, which was also recently detected in a female patient.
Testing for the Zika virus and a few others, according to Dr. Persaud, is particularly challenging for the national laboratory, since “these require a little bit more advanced testing with Polymerase Chain Reaction (PCR) methodology.
Although PCR testing capabilities are available at the national laboratory, Dr. Persaud disclosed that the expertise is not. This is in part due to the staff turnover, he noted.
But the Public Health Ministry will always be eligible to take advantage of the CARPHA laboratory. This is in light of the fact, Dr. Persaud said, that Guyana is a contributor to the CARPHA laboratory.
Based on an inter-governmental agreement signed by the Caribbean Community (CARICOM) member states, the CARPHA laboratory was established in 2011 and became operational in 2013. Its establishment, in essence, combined the functions of five Caribbean Regional Health Institutes into a single agency. Those agencies are: the Caribbean Environmental Health Institute, the Caribbean Epidemiology Centre, the Caribbean Food and Nutrition Institute, the Caribbean Health Research Council and the Caribbean Regional Drug Testing Laboratory.
As party to the laboratory, Guyana, like other member states, makes annual subscription contributions.
“So under that (inter-governmental) agreement that’s (CARPHA) our lab too, and even when we get our lab really going, it will still serve as our reference lab to double check things, to do tests that we are unable to do, and to provide support,” Dr. Persaud informed.
As part of the agreement Guyana has with CARPHA, the national reference lab will be able to shortly gain technical support through a consultant who is expected to operate out of the local lab for a stint. The consultant, according to Dr. Persaud, will help to develop the laboratory system here.
In addition to working towards providing training for those already on staff and recruiting other qualified persons, Dr. Persaud disclosed that the Ministry is also looking to soon fill the vacant position of Director of the National Reference Laboratory. And according to him, already a number of well qualified persons have expressed their interest to fill the post.
“We are trying to get that post filled through the Public Service, and I am confident that very shortly we will have someone sit there.”
Dr. Persaud continued that “there is always a need for more people. We are inviting qualified people, even from within the Diaspora. This is an opportunity to contribute to the health and wellbeing in Guyana.”
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