In another three months tests for the H1N1 (swine flu) virus will be done at the National Public Health Institute laboratory through a collaborative effort with the Ministry of Health and the Pan American Health Organisation (PAHO).
According to Dr Colin Roach, Director of the institute, most popularly known as the reference lab, officials from the lab are now working with PAHO and it is expected that tests for the much talked about flu virus which has affected many countries and caused hundreds of deaths will be done locally.
As it is right now Guyana takes the samples and sends them to the Caribbean Epide-miology Centre (CAREC) in Trinidad and the results are received about two weeks later.
Since the outbreak of the flu, which started in Mexico and spread globally, Guyana has had eight confirmed cases with some sixty samples being taken and results for six are still outstanding.
Minister of Health Dr Leslie Ramsammy recently told Stabroek News that all the affected persons have been treated but they along with their families are being monitored.
DNA suite
The lab still has to procure kits and some other equipment so the test could be done but Dr Roach said the advantage is that they already have a DNA suite in which the tests will be done.
“The suite is there… and it is just to get the other things and we are working with PAHO right now to get the other things that we need to conduct the H1N1 test…,” Dr Roach said.
However, when testing begins they would need to have a certain amount of samples before any testing process can start as they would not want to waste the kits. But he said the process would be shorter than having to ship the samples to another country.
Should the H1N1 testing become a reality it would probably be one of the more significant achievements of the year-old lab which, according to its director, is now functioning at 75% but there is still a lot more to be done.
The US$4.4 million lab is located in the compound of the Georgetown Public Hos-pital Corporation at Thomas and New Market streets. It was built with major assistance from the US President’s Emergency Response for AIDS Relief (PEPFAR) and was commissioned on July 3 last year but became operational last September.
‘Mother of all labs’
Referring to the lab as ‘the mother of all labs in the country’, Dr Roach told Stabroek News that the lab now has seven departments, including the surveillance and bacteriology departments, and is staffed by 29 persons.
Staff members include both technical and non-technical personnel and they have been trained to ensure that the lab is functional.
The lab has since been able to acquire DNA and RNA PCR technology with the DNA PCR utilising the pulmonary strain reaction technique which involves checking for the HIV virus in infants under the age of 18 months who were born to infected mothers.
Babies carry their mother’s antibodies up to 18 months so before officials here were unable to determine whether the child was HIV-infected until they would have passed that age. The test can be done as early as six weeks with a follow-up test later.
The RNA PCR would be used to check viral load of HIV-infected persons so as to monitor them on how they are responding to the drug therapy.
Green light
from CDC
The equipment to conduct the tests, Dr Roach said, has already been procured and installed and training for staff has also been done. The lab has been given the green light for the DNA PCR testing from the Centers for Disease Control (CDC) in Atlanta and Dr Roach said it means that they are satisfied with the quality of work coming out of the lab and so this test would be done as early as next week.
This would be a big step locally as before such samples were taken and sent all the way to South Africa to be tested.
As for the viral load testing the lab is awaiting the green light from a Canadian laboratory before this commences.
The lab had commenced doing microbiology and tests for tuberculosis and drug sensitivity, the testing of persons who may be developing resistance to drugs but had stopped following a few glitches. They have now restarted, Dr Roach said.
“There were a few glitches in terms of the structure and that has since been corrected and we had resumed TB culture,” Dr Roach said.
And soon CD4 count tests for HIV infected persons would be conducted at the New Amsterdam Hospital as Dr Roach said they are attempting to de-centralise this to other regions. The equipment has already been installed and as soon as the new Linden hospital is completed equipment, which has already been procured, will be installed. Dr Roach said that the two areas were selected because of the volume of samples that originate there.
The lab is also expected to conduct the complete blood count tests for HIV infected persons as before they were done at the GPHC laboratory but now it will be done at the new lab.
Lepto and
dengue tests
Further, according to Dr Roach, they are conducting tests for dengue and leptospirosis.
“We are doing the basic testing and now what we are hoping to do as a reference lab is to take the level of testing to another level where we can do more specific confirmatory type of tests… for both lepto and dengue,” Dr Roach said. While the tests for those diseases are done locally if there are complicated samples then those would have to be sent overseas.
Meanwhile, Dr Roach feels that the lab in terms of “basic things” is 100% functional but “it hasn’t reach its full potential, this lab has huge potential.”
He said they hope to one day conduct virology surveillance and this will be done through close work with PAHO and they would also want research to be done.
“In terms of full capacity… if we are to think about all the things I would say we still have a very far way to go,” Dr Roach acknowledged, adding that “we are talking about doing research and all the different antenatal screening and all these things… Some of these things we would have to look at whether they would be cost-effective,” Dr Roach said.
Dr Roach feels that the US$4.4 million spent to make the lab a reality was money well spent and he said they are making full use of it even although more needs to be done.
“It was money well spent…” he stressed.
“We have satisfied 75% of our mandate for a lab of this magnitude in a situation in which we are right now. If we want to take it to another level… then it is another story altogether.”
