Laboratory Of Khrc

November 02, 2020 | Department | Reading time: 3 min

Bacteriology Unit: The unit is equipped with a class II biosafety cabinet which is the main work station, a carbon dioxide (CO2) incubator, two BACTEC machines for blood cultures and an autoclave. Samples processed include blood, CSF, urine, nasopharyngeal swab, ear swab and stool. Culturing, identification and antimicrobial susceptibility testing are performed according to Good Clinical Laboratory Practice and Clinical Laboratory Standard Institute guidelines.The KHRC Clinical Laboratory consists of units for the following: Bacteriology, Clinical Chemistry, Entomology, Haematology, Immunology, Micronutrients, Molecular Biology, and Parasitology. To ensure that results generated from this unit are of high quality and reliable, the unit was enrolled in External Quality Assessment (EQA) schemes. These include WHO/NICD proficiency testing (supported by the World Health Organisation) and THISTLE QA. Excellent results have been obtained from these schemes in both the identification of microorganisms and antimicrobial susceptibility testing. In addition to the participation in EQAs, daily, weekly and monthly internal quality controls on both equipment and reagents are performed to ensure they are all working effectively. The unit supports the children’s ward of the Kintampo Municipal Hospital by processing patient samples. Also, during outbreaks such as meningitis and cholera, samples such as cerebrospinal fluid (CSF), nasopharyngeal swabs and stool are brought from within the Brong Ahafo Region for analysis.

Clinical Unit:This unit is equipped with two VitaLab Flexor E Clinical Chemistry analysers for carrying out analyses such as liver function tests, kidney function tests, lipid profile, glucose and uric acid. These analyzers are “open system” and thus, can be programmed to perform additional tests. The EasyLyte Electrolyte analyser is also available for the determination of sodium and potassium levels. In addition to internal quality control systems, the unit also participates in External Quality Assessment (EQA) schemes organised by the College of American Pathologist (CAP) and the International External Quality Assessment Scheme (IEQAS) from the United Kingdom.

Entomology:The unit has one Entomologist and 2 Research Officers. Major equipment in the unit include:

An ELISA plate reader (DYNEX) with Revelation 4.2 software
1.An automated ASYS Atlantis plate washer
2.CDC light traps and accessories
3.WHO vertical test tubes for susceptibility bioassays
4.Mosquitoes rearing cages
5.Stereo Dissecting Microscope

Haemotology
The unit is equipped with an ABX Pentra 60 C+ (5-part differential) Haematology analyzer, two ABX Micros 60 (3-part differential) analyzers, electrophoresis equipment for haemoglobin genotyping, and two photometers for quantitative determination of Glucose-6-phosphate dehydrogenase (G6PD). The unit participated in external quality assessment schemes organised by the United Kingdom National External Quality Assessment Scheme (UK NEQAS) and the College of American Pathologists (CAP). One staff of the unit is currently pursuing a Masters programme in Haematology at the University of Ghana.

Immunology Unit
The unit has separate sections for cellular and humoral assays, with equipment such as a class II biosafety cabinet, refrigerated centrifuge, microplate washer and pipetting accessories. The unit is also equipped with a laminar flow cabinet, a carbon dioxide incubator, -80oC and -150oC freezers and liquid nitrogen tanks. Currently, isolation and cryopreservation of peripheral blood mononuclear cells (PBMCs) is being done at the unit. The unit has 3 staff (one with a Masters in Clinical Immunology, and 2 pursuing PhDs in Immunology).

Molecular Biology
The unit has C1000 Thermal Cycler with 96-well Fast Reaction. The following are among tests the unit is capable of carrying out:
1.Plasmodium species identification
2.Merozoite Surface Protein-2 (MSP-2) genotyping
3.Glucose-6-phosphate dehydrogenase (G6PD) genotyping
4.Haemoglobin genotyping
5.Knock-down-resistance (kdr)
6.Anti-malarial drug resistance

Micro-Nutrient
A High Performance Liquid Chromatography (HPLC) machine with auto-sampling, UV Scanning Spectrophotometer and a Zinc Protoporphyrin (ZPP) analyzer are the major equipment at the Unit. Following the support of Novartis to develop capacity on the development and validation of an HPLC method for the determination of efavirenz concentrations in plasma, the unit is now ready to perform bio-equivalence studies for both local and international pharmaceutical companies prior to registration of the drugs locally. The unit also has the capacity to determine vitamin concentrations in blood (especially serum retinol), ELISA assays (e.g. for ferritin, transferrin, etc) and C-Reactive Protein (CRP), and is manned by 2 staff (one with a Masters in Analytical Chemistry, and another is pursuing a PhD in Biochemistry.

Parasitology
This unit is one of the most active ones in the Clinical Laboratory as most studies require malaria microscopy results. For quality purposes, each malaria blood smear is examined by two independent certified microscopists. Discordant slides are examined by a third microscopist. Staff of the unit are also actively involved in facilitation of Malaria Microscopy Trainings organised by the Malaria Diagnostic Centre. For external quality assurance, the unit participates in the following malaria External Quality Assessment Schemes: College of American Pathologists (CAP), National Institute for Communicable Diseases, South Africa/World Health Organization (NICD/WHO), and UK National External Quality Assessment Scheme. Examination of stool samples for parasites is also being performed in the unit. Wet-mounts, formol-ether concentration, and the Kato-Katz techniques are used for the examination of the stool samples.

Malaria Slide Bank
The Clinical Laboratory manages the Malaria Slide Bank (MSB), which was developed by KHRC in collaboration with Improving Malaria Diagnosis (IMaD), Centres for Disease Control and Prevention (CDC), PATH MalariaCare, and partners. These slides are used by the Clinical Laboratory Unit, Institutional Care Division of the Ghana Health Service for training and competency assessment of malaria microscopists nationally. The slides (over 6,000) have been validated by both microscopy and molecular methods and contains slides of different malaria species and different levels of parasitaemia. The laboratory also has the capacity of supporting the development of malaria slide banks in other countries.