Technical Guidelines for Integrated Disease Surveillance ... - PHRplus

Suspected disease orconditionDiagnostic test Specimen When to collect How to prepare, storeand transportOnchocerciasis Routine laboratory confirmation for surveillance is not required.Schistosomiasis Prescence of S.haematobium eggs in urine.ORUrineCollect sample whendiagnosis required forclinical and epidemiologicalpurposesCollect sample into cleanbottle.Should be transported atroom temperature to the labwithin 2 hoursPrescence of S. mansonistool.StoolSexually transmittedinfections (STIs)Routine laboratory confirmation for surveillance is not required.Trypanosomiasis Routine laboratory confirmation for surveillance is not required.Tuberculosis(Smear positive pulmonarytuberculosis)REFERENCE:Laboratory Services inTuberculosis Control, Parts I,II and III. WHO publicationsWHO/TB/98.258.Presence of acid fastbacillus (AFB) in ZiehlNeelsen stained smearsDeep-chest sputum Collect sputum (not saliva)for direct smear microscopyand examine at least twostained specimens taken ondifferent days.Smear should be examinedat health facility where thespecimen is taken.Viral hemorrhagic fevers(VHF)REFERENCES:Infection Control for ViralHemorrhagic Fevers in theAfrican Health Care SettingWHO/EMC/ESR/98.2Viral Infections of Humans;Epidemiology and Control.1989. Evans, A.S. (ed).Plenum Medical BookCompany, New YorkPresence of IgM antibodiesagainst Ebola, Marburg,CCHF, Lassa or DenguefeverORPresence of Ebola in postmortumskin necropsyFor ELISA:Whole blood, serum orplasmaFor PCR:Whole blood or blood clot,serum/plasma or tissueFor Immunohisto-chemistry:Skin or tissue specimensfrom fatal casesCollect specimen from thefirst suspected case.If more than one suspectedcase, collect until specimenshave been collectedfrom 5 to 10 suspectedcases.Handle and transportspecimens from suspectedVHF patients withextreme caution. Wearprotective clothing anduse barrier precautions.For ELISA or PCR: Refrigerate serum orclot. Freeze (-20C or colder)tissue specimens forvirus isolation.For Immunohistochemistry: Fix skin snip specimenin formalin. Specimencan be stored up to 6weeks. The specimenis not infectious once itis in formalin. Store at room temperature.Formalin-fixedspecimens may beshipped at roomtemperature.ResultsResults should be readywithin 24 hours.TB microscopy resultsshould be ready within aday.Quantification of observedmycobacteria arereported using variousreporting methods. Referto the criteria used by theexamining laboratory.Diagnostic services forVHF are not routinelyavailable. Advancearrangements are usuallyrequired for VHF diagnosticservices. Contact theNational Surveillance Unitor WHO.136Technical Guidelines for Integrated Disease Surveillance and Response in Ghana