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Ministry of Health and Quality of Life

Overview

             OVERVIEW
 
ROLES & FUNCTIONS OF HLS
 
Functions of HLS
Ø  Help clinicians in the screening & diagnosis of diseases
Ø  Monitor individual patients & provide lab. Control on therapy wherever appropriate
Ø  Develop & implement new methods of diagnosis
Ø  Participate in research projects (Biomedical, HSR, epidemiological etc)
 
 
WORKLOAD STATISTICS
Annual laboratory workload is 14.5 Million tests carried out in 2017 compared to 10.1 Million in 2012.Range of tests have increased from 246 different laboratory tests in 2005 to 264 tests in 2011 with the introduction of tests such as Testosterone, Legionellosis, Filariasis and Cancer Markers like Ca 19.9 and Ca 125. In 2016, the latest figures reveal that the range of tests has increased to 287 with the introduction of Free T4/Free T3 for thyroid function, GAD65/IA2 for Diabetes type I, FIT test for Occult blood for colorectal cancer, ENA profile testing for auto-immune diseases, ZIKA PCR and second-line antibiotic sensitivity testing for TB.  In 2018 the total number of laboratory tests is 299
Laboratory manpower comprises of medical, scientific, technical and allied grades amounting to 395 officers.
Grades
Number
Medical (Pathologists/Microbiologists)
13
Scientific (Clinical Scientists in Biochem & Virology)
12
Medical Laboratory Technologists
219
Laboratory Attendants
73
Pathology Laboratory Assistants
15
Nursing staff (BBO, BBA & HCA)
38
Allied (Adminstrative,IT,Stores)
25
TOTAL
395
 
SERVICES
The services provided which are based on solid scientific foundation helps health authorities concerned for
• Diagnosis and follow up of treatments
• Deciding on optimum utilization of available resources.
 The laboratory service network consists of the following:
• Central Health Laboratory
• Four regional laboratories at Dr A. G. Jeetoo Hospital, SSRNH, Flacq Hospital, Jawaharlal Nehru Hospital.
• Four peripheral laboratories at Souillac Hospital, Mahebourg Hospital, ENT Hospital and Yves Cantin AHC.
Services provided
Central Health Lab
Regional lab
Peripheral Lab
Bacteriology
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Biochemistry
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Blood Transfusion Service
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Cytology
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Haematology
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Histology
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Malaria
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Parasitology
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Virology.
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Figure: Services provided by respective departments
RECENT ACHIEVEMENTS
(i)                 New laboratory tests made available in 2017-2018 are as follows: -
 
Departments
Tests
 
Biochemistry
Free T4, Free T3 for thyroid function tests
GAD65/IA2 screen for diabetes type I testing
FIT test for Occult blood for colorectal cancer screening
Haematology
ENA profile testing successfully introduced for diagnosis of auto-immune diaseases
Molecular Biology
ZIKA PCR testing started on the occasion of Olympic games in Brazil
Bacteriology
At SEL TB Lab, introduction of second-line antibiotic sensitivity testing for TB to detect antibiotic resistance (Multi-resistant TB)
 
(ii)               Purchase of new major Laboratory Equipment in 2016-2018: -
 
1)      Random Access Chemistry Analyzer (Konelab Prime 60) for New Souillac Hospital (Ebola funds)
2)      New Chemistry analyzers for CHL (Biochemistry and Jeetoo Hospital labs)
3)      Commissioning of automated Micro Scan equipment for identification and sensitivity of bacteria
4)      Installation of second GeneXpert in TB lab (purchased by Sir Edgar Laurent Trust following request by CHL)
5)      HighThroughput Fully Automated Blood count Analyzers (2 for CHL and 1 for each regional hospitals)
6)      Beta thalassaemia screening equipment
7)      Immunohisto Chemistry Analyzer
8)      Ergonomic Microscopes for pathologists
9)      NAT Testing (2 units)
10)  Semi-automated ImmunoHistochemistry equipment for tissue cancer markers
 
 
(iii)             Infrastructural work 2016-2017: -
Departments
Works
 
Biochemistry
Phase 2 at SSRNH laboratory completed
Renovation of building to relocate QEH lab
Haematology
One room allotted by Pharmacy for diagnosis and monitoring of Lupus and other auto-immune diseases
 
Bacteriology
Major renovation of bacteriology department at CHL completed
Anteroom created at SEL TB Lab (ECSA project)
 
(iv)             Research/Surveys completed in 2016-2017: -
Departments
Research / Surveys
 
 
Biochemistry
NCD survey Rodrigues (April 2016)
Mauritius type 2 Diabetes prevention Study (May 2016)
IAEA project RAF 6042 (Childhood Obesity) Ongoing
IAEA project MAR6012 (Obesity, Insulin Resistance and Cancer in women) ongoing
Bacteriology
Many improvements at SEL TB lab following support from ECSA/Uganda SRL/Global Fund and improvement from 0 to 2 star in SLIPTA check-list
Virology
Surveillance on Measles and Rubella being carried out since Aug 2016
 
Molecular Biology
Zika virus testing among RIO Athletes in Jul-Aug 2016
MERS-CoV testing among Hadjis from Saudi-Arabia in October 2016
 
(v)               EQAS /  Proficiency testing
CHL departments are enrolled with various international External Quality Assurance Schemes. Some of them are listed below and several of our departments achieved 100% score across the board.
 
 
Department
Test/s
Names of Schemes
Source of Funds
Feedback
 
 
Biochemistry
General Biochemistry
ASQUA Lab (Biolabo) 2010 UK, EQAS since 1984
WHO
Excellent
Clinical Biochemistry
Hormone, Tumour Marker, TDM, Biorad since 2010
 
 
Excellent
HbA1c
EQAcom, Switzerland since 2007
WHO
Excellent
 
Haematology
Hb, WBC & Film Report
 
 
 
Blood parasites
UK, EQAS
WHO
 
Virology
HIV testing
NICD, South Africa
 
Excellent
Microbiology & Parasitology
Salmonella Stereotyping
WHO collaboration centre, Denmark since 1999, Malaria
WHO
 
 
Bacteriology
Meningitis, TB, Microscopy & GE Pathogens
Enrolment with WHO/NICD (South Africa) under discussion
 
Excellent
NBTS
General
SANBS (HIV, Hep C, B, Syp) identification, TTI, Immunohaematology Cross-Matching
 
Excellent
 
(i)                 EQAS Participation 2017-2018
The following table contains details for CHL participation in EQAS for the year 2016.
Departments
Participation in EQAS
 
Biochemistry
EQAS ongoing for all regional labs for clinical chemistry
EQAS for Hormones, tumour markers and TDM from BIORAD (CHL funds)
Bacteriology
Proficiency testing (External Quality Assessment)
2015-2016 PT scheme organized by WHO /  National Institute of Communicable Diseases of South Africa (funded by WHO AFRO)
TB microscopy PT scheme organized by WHO and by ECSA
Water PT scheme organized by National Lab Association of South Africa (funded by MoHQL)
First participation in TB sensitivity testing (funded by ECSA)
Virology
Surveillance on Measles and Rubella being carried out since Aug 2016
 
Molecular Biology
Zika virus testing among RIO Athletes in Jul-Aug 2016
MERS-CoV testing among Hadjis from Saudi-Arabia in October 2016
 
FORTHCOMING PROJECTS
Over the past years, health authorities have felt the need for a new state-of-the-art facility to meet present ISO accreditation requirements, infrastructural and safety standards and future needs.  Government of Mauritius is committed to the setting-up of a new state-of-the-art National Health Laboratory Services (NHLS) Centre which will host the National Reference Lab, the National Blood Service and a Public Health Lab with Biosafety Level 3+ facilities.  Although we are still in the inception stage of setting up of this new Centre, the success of this project will be a new milestone in the lifecycle of the HLS and in the medical landscape of Mauritius itself. As of now, Technical Committees under Director, Laboratory Services have submitted their respective reports as regards proceedings and requirements.
Moreover, over the years, we have felt the need to upgrade our existing legacy computer system. We require a modern, comprehensive, internationally recognized medical Laboratory software to replace the current software and address the new exigencies of Health Laboratory Services (HLS) in terms of increasing workload.  The proposed Laboratory Information Management System (LIMS) shall be connected to peripheral and regional laboratories and shall also be interfaced with automated laboratory analyzers. The new LIMS will employ bar code technology integrated stores, personnel management, a billing module for private requests, a statistics module and a robust reporting tool compliant with ISO standards as laid down for accreditation purposes.   

 

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