Strengthening and Sustaining a Network of Public and Animal Health Clinical Laboratories in Pakistan Proceedings of a Joint Workshop (2023) / Chapter Skim
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4 Effective Use of Clinical Laboratory Data
4 Effective Use of Clinical Laboratory Data
Pages 43-58
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From page 43... ...
Agency for International Development assistance, is intended as a central health information portal with links to provincial health departments and other health information systems throughout Pakistan. It is a useful repository of information, but it is not intended to be a real-time disease surveillance tool.
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A Joint Pakistan-U.S. Workshop on Strengthening and Sustaining a Network of Public and Animal Health Clinical Laboratories in Pakistan.
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In addition, each district of Pakistan reports monthly on specific diseases and about 10,000 community-based centers also submit data, all of which are available via the dashboard. Pakistan has a successful Lady Health Worker program, which employs female health workers at the community level in the areas of disease prevention, diagnoses, treatment, and data submission.2 Beyond geographically-collected data, the dashboard contains information on a disease-specific basis, especially for malaria, tuberculosis, and hepatitis.
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From page 46... ...
Pakistan, as a Global Health Security Agenda signatory,4 is working toward integrated disease surveillance mechanisms. Pakistani experts are also working to link the dashboard to the relevant systems under the One Health concept, such as those related to biosafety and biosecurity.
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HARNESSING MODERN COMMUNICATION FOR IMPROVED DISEASE SURVEILLANCE Affan Shaikh began by discussing opportunities to use new technology to improve public health communication. He described these as "disruptive innovations," the concept of transforming products and services using information technology innovations to make existing services and industries more affordable and accessible.
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Mobile phone networks allow for electronic surveillance to empower and enable efficient and effective public health workflow processes designed to prevent, predict, detect, and respond to infectious diseases. Public health informatics is a growing field leveraging public health surveil lance (PHS)
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Complacency, inaction, limited infra structure, poor healthcare systems and health surveillance, and limited health education contributed to the spread. WHO declared Ebola a public health emergency of international concern in August 2014.8 There were 28,657 clinically compatible cases and 11,325 confirmed deaths.9 It served as a grim reminder that novel, zoonotic viruses cause human disease and remain a persistent threat to global health security.10 During the outbreak, mHero, a two-way mobile phone–based communication system using basic text messages to connect ministries of health and health workers was used as an information transmission mechanism.
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In 2007, 26 percent of the population was infected.13 There were 3,000 requests for CD4 tests per month coming from about 40 different clinics.14 The tests require nurses to draw blood, which is then transported to the central lab via bicycle for analysis. However, the lab tests take two days, and the full TAT for the results to reach the health workers and patients is fairly long and unpredict able.
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First, PHS must be developed, and electronic surveillance can be a way to accomplish it. PHS strengthening involves strategies to thoughtfully adopt policies that allow for: • Reportable disease lists and frequencies, case definitions based on global best practices, for example • A harmonized, synergized, and integrated local, district, provincial and national PHS workflow process • Standardized reporting instruments • Workforce training The goal is to leverage advancements and opportunities to empower, enable, and enhance core functions that allow public health workers to do their jobs better, faster, and cheaper.
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WHO categorizes health information systems under five interrelated subsystems, one of which relates to routine service reporting.17 Laboratory forms and service delivery records are important data collection instruments for patient/client management. The ultimate objectives of any health information system are not only to gain information, but also to ensure that the information collected is used to increase efficiency of health services.
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This network includes the Aga Khan University Hospital and Shaukat Khanum Clinical Laboratory Service, which have networks consisting of multiple collection facilities and main clinical lab oratories in Karachi and Lahore, respectively. This network of laboratory services provides same-day and real-time reporting of many test results.
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, and facilitated appropriate control strategies. Clinical laboratories are increasingly tasked with emergency preparedness and response, environment health, food safety, global health, infectious diseases, informatics, laboratory systems and standards, genetic and newborn screening, and research.
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During the discussion period, greater efforts to connect the clinical labs, particularly provincial-level labs, with universities for statistical analysis and data management were proposed as having significant potential.
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In the United States, labs participate in several disease surveillance programs, including the National Outbreak Reporting System, which collects data on reportable diseases; the C aliciNet, which uses that information to link outbreaks to common sources; and NoroSTAT, in which seven state labs and the U.S. Centers for Disease Control and Prevention work together to establish and maintain standard practices for norovirus outbreaks to allow for rapid reporting to quickly link epidemiology with lab data.
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and 100% (96%–100%) for combination electronic health record data."21 Disease surveillance is a critical concern among professionals in all countries.
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She stated that those who conduct assessments receive specific training to conduct the associated audits. Finally, while registration of labs is an important first step, accreditation should follow.
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