INSIDE THIS ISSUE:

C ENTRAL PUBL I C

HEAL TH LABORATOR IE S M I N I S T R Y O F

H E A L T H

which a 5 year strategic

plan for implementation

shall soon be finalized. �� Establishing a credit

line for provision of essen-

tial laboratory supplies to

all health facilities �� Construction /

renovation and equipping of

laboratories in various

health facilities �� Establishment of exter-

nal quality assessment

schemes Putting in place a number of

in-service training pro-

grams.

Unfortunately, many labora-

tory personnel, clinicians

and the wider public remain

largely unaware of these

efforts and as such have not

played their part in contrib-

uting to the drive. It gives

me great gratitude therefore

that the Central Public

Health laboratories (CPHL),

the focal point for labora-

tory services in the Ministry

of health is launching the

Confirm bulletin to bridge

this gap. It is in line with

the Ministry’s strategy of

keeping all stakeholders

abreast with events at the

Ministry.

I hope you get informed as

you enjoy the reading.

Dr. Alex Opio Assistant Com-missioner National Disease Control, MOH

By Dr. Alex Opio (Assistant Commissioner National Disease Control, NDC)

It is difficult to imagine modern

clinical practice without support

from diagnostic services. Like

imaging techniques, laboratory

results often provide clinicians

with information that put diag-

noses beyond doubt. Indeed, for

the vast majority of conditions, it

is laboratory data that clinicians

rely on for pinpoint identification

of the etiologic agent.

In view of its importance in de-

ciding the course of patient man-

agement, users of laboratory

data ought to be sure of its au-

thenticity. Unfortunately many

clinicians in Uganda have such

little confidence in laboratories

that they often prefer to rely on

their clinical acumen alone. This

mistrust is the culmination of

years of perceived or actual in-

adequacy of Uganda’s laboratory

services. Issues like availability

of laboratories in lower level

health facilities have been major

causes of concern.

Even at the higher health facili-

ties where laboratories are al-

ways present, many of the essen-

tial tests have not been regularly

performed due to a lack of essen-

tial supplies like reagents and

specimen collection materials

like swabs and blood culture

bottles. Excessively long pro-

longed turnaround times have

also been a key concern for

laboratory users.

Quality management systems

such as external quality assess-

ment schemes and accredita-

tion of laboratories that would

promote user confidence were

virtually absent in the country

for a long time.

To compound it all, many clini-

cians have been trained in a

setting with limited functional

laboratory systems and have

not had an

adequate

opportunity

to interface

closely with

laboratories.

Fortunately, the Ministry of

Health is sparing no effort in

its drive to ameliorate the

situation. Working closely with

various development partners

and stakeholders, the ministry

has invested significantly in

revitalizing the national labo-

ratory network. Some of the

key developments to this end

include:

�� Development and launch-

ing of the National Health

Laboratory Services Policy for

The Assistant Commissioner Na-tional Disease Control, MOH & Chairman National Laboratory Technical Committee; Dr. Alex Opio

Foreword:

Foreword from the chairman National Health Laboratory Technical Commit-tee

1

The Central Public Health Laborato-ries and Coordina-tion of Laboratory Services in Uganda: Working Towards Better Diagnosis

2

The National Health Laborato-ries Services Policy: Providing Direction for improved labo-ratory services

2

Scientific article: External Quality Assessment in Uganda: Helping laboratories evalu-ate their levels of performance through proficiency testing

3

Key Events: 4

Upcoming events 5

Confirm J A N U A R Y 2 0 1 1

Clinical Laboratory News for Uganda

P A G E 2

the laboratory was

established in 1983 in

borrowed premises at

the Institute of Public

Health (IPH) with Mr.

Gaspard Guma and

Mrs. Scholastica Okui

as its first personnel.

The Central Public Health Laboratories Offices on Plot 7/11 Buganda road

The Central Public Health Laboratories: History, functions and future:

By Kajumbula Henry Coordinated health laboratory services in Uganda date back to the times of the British co-lonial administration. At that time, all laboratory services and functions were under the Chief Pathologist based at Wandegeya in the current Government Chemist and the National T.B reference labora-tory buildings. At independ-ence in 1962, the position of chief pathologist was dropped and the roles taken over by the Consultant pathologist at Mu-lago Hospital, assisted by 2 chief technologists (one in charge of the Mulago Hospital laboratories and the other in charge of upcountry laborato-ries). During the early post-independence era, the func-tions of disease surveillance and outbreak investigation were conducted by Mulago Hospital, the Makerere Medi-cal school laboratories and the East African Virus Research Institute (now UVRI). With time, however, these roles proved too demanding for these institutions, which were not directly under the Ministry of Health. As such, the idea of a Central Public Health Laboratory was conceived in 1975. Unfortunately, the nas-cent plans for a laboratory at the current Mbuya industrial area were nipped in the bud by the prevailing political insta-bility. Upon realizing that a CPHL building could not be attained in the short term, the labora-tory was established in 1983 in borrowed premises at the Institute of Public Health (IPH) with Mr. Gaspard Guma and Mrs. Scholastica Okui as its first personnel.

At inception, the laboratory was administratively under the office of the Chief Medical Laboratory Technologist for Upcountry laboratories, then Mr. Vincent Oyullu who was based in Wandegeya where the current National tuberculosis and leprosy program offices are housed. Upon retirement in 1985, Mr. Oyullu was re-placed by Mr. Gaspard Guma who was heading the CPHL. As a result, the 2 offices of head of CPHL and the chief laboratory technologist for upcountry labs were unified. CPHL therefore became more involved in the coordination of laboratory services in addition to its surveillance and out-break investigation role. In 1987, a laboratory division was formed under the office of the commissioner for curative services, requiring Mr. Guma to move from Wandegeya to the MoH headquarters in En-tebbe. Subsequent restructur-ing in 1999 placed all health laboratory institutions includ-ing CPHL under the Uganda National Health Research Or-ganization (UNHRO) and dropped the laboratory divi-sion at the ministry. However, this plan was never imple-mented as the Department of National Disease Control (NDC) felt that a UNHRO based CPHL would not ade-quately support disease sur-veillance and outbreak investi-gations. As such, CPHL was placed under the NDC. Increasing Ministry of Health and partner interest in reliable laboratory services in the country, together with finaliza-tion of the National Health Laboratory services policy and the near completion of a 5 year plan for implementation of the

policy are a prelude to a promis-ing future for CPHL. The United States Government (USG) through CDC-Uganda has gener-ously offered to construct the CPHL building at Butabika. The design has been finalized and USG is in the process of follow-ing up the construction. With ongoing restructuring at the MOH, a proposal to accord CPHL a semi-autonomous status has been approved by the Minis-try’s top management. If ac-corded, a semi-autonomous CPHL would have a highly fa-vorable staff establishment that would attract highly qualified and productive professionals. The new CPHL shall require a vividly articulated mandate, a key activity in the National labo-ratory services strategic plan. As contemporary practice is in-creasingly adopting molecular techniques in laboratory identifi-cation of infectious agents, CPHL plans to gradually intro-duce these methods in its routine procedures not only to keep up with the times but also to harness their potential cost saving bene-fits. Finally, CPHL shall have to har-ness its boundless research po-tential not only to inform policy and practice in the country but also to attract funding to sustain its activities. Simple but critically important topics such as antim-icrobials susceptibility profiles and distribution of various strains of infectious agents in the coun-try are already being developed for research. CPHL has coursed an undulating history, operating in the face of scarcity and promises of plenty. Current trends point to an in-creasingly bright future for a highly dynamic institution.

CPHL Laboratorians in practice

C L I N I C A L L A B O R A T O R Y N E W S F O R U G A N D A

P A G E 3 The keyplayers at the Central Public Health Laboratories

C L I N I C A L L A B O R A T O R Y N E W S F O R U G A N D A

Dr. Christina

Consultant Laboratory Services

Mr. Amato Menya Senior Advisor CPHL Mr. Gaspard Guma

Senior Advisor CPHL

Dr. Hakim Sendagire Program Officer Laboratory Services, MOH

Dr. Winifred Wafula Deputy Laboratory Chief CDC

Mr. Tom Tenywa National STD/I Lab

Coordinator

Mr. Wilson Nyegenye Mr. William Ziras

Lali

Lab Quality Officer

Mrs. Bakunda Kamaranzi

Program Officer Training

Mr. Charles Kiyaga National EID Coordinator

Mr. Sulaiman Ikoba Project Administrator

Atek Kagirita Lab Scientist

Mr. Michael Dfendu

Lab Scientist

Diana Kamusime Program Assistant

CPHL

Mary L. Nakitende Program Assistant HCT

Rita N. Eragu Project Secretary

Susan Nambozo Program Assistant

Penina Nalukenge Program Assistant,

HBC

Thomas Alinaitwe IT Systems

Daniel Kasule Data Officer

Rebecca Nakidde Program Assistant

EID

Bossa Khasim

Office Messenger

Susan Nandutu Janitor

Madinah Nakate Janitor

Paul Bwebale Driver

Fred Khauka Driver

Edward Rutatinisib

wa

Ibrahim Kasujja Driver

Boniface Bagonza Askari

Mrs. Okui Scholastica Senior Technologist CPHL

Dr. Henry Kajumbula Technical Advisor

Agnes Nabasirye Program Assistant CDC

Michael Nandala Lab Technologist

Nelson Ogwang Lab Technologist

Joseph Nkodyo Lab Technologist

Bernard Baitwababo

Data Analyst

Nicholas Isa

Janitor

Aggrey Ngobi Driver

District Laboratory Focal Persons; The Foot soldiers of laboratory services in Uganda The concept of District Laboratory Focal Persons (DLFP) was adopted in Uganda in 2002 as part of the Integrated Disease Surveil-lance Response (IDSR). According to IDSR guidelines, each district should have a laboratory professional on their rapid response team. All districts designated laboratory personnel from their existing staff to fulfill the role of DLFP. As various laboratory strengthening programs were rolled out throughout the country, the role of DLFPs expanded beyond surveillance and rapid response to include; coordination of logistics, quality assurance and training. activities Currently, DLFPs coordinate such activities as order-ing, receiving and storage of laboratory creditline items, they act as the first controllers in the AFB slide rechecking external quality assessment scheme, and are engaged in regular support supervision of laboratories in their districts. With these increasing tasks, DLFPs need to be appointed as full time coordinators of laboratory activities and relieved of their bench tasks as advocated for in the draft National Health Laboratory Strategic Plan for 2010—2015. Below is a list of current DLFPs and their contacts, save for a few new districts who are yet to assign the responsibility:

Kibaale Ondonga Jimmy 0772-366801 Kiboga Byakika Grace 0772-657002 Kiruhura Budaki Morris 0773-172325 Kisoro Bakunzi Deo 0703-270262 Kitgum Opoka G.Samson 0772-606641 Koboko Atiku Alex 0772-884681 Kotido Opio Francis 0772-549017 Kumi Oguma Geoffrey 0772-691119 Kyenjojo Mukokoma Erisa 0772-823873 Lira Amuge Bernard 0772-653231 Luwero Kalyesubula Edward 0712-567380 Lyantonde Ndawula Anthony 0782-319989 Manafa Opio Charles 0782-097688 Masaka Ahimbisibwe James 0712-936789 Masindi Tigambirwa Peter 0782-412447 Mayuge Byekwaso John Bosco 0782-534637 Mbale Ekeu Isaac 0772-850853 Mbarara Namono Norah 0782-320620 Mityana Mugwanya Adolph K. 0772-521441 Moroto Catherine Lorot 0775-242989 Moyo Asi Gaone Abraham 0782-498789 Mpigi Sonko Paul

District Name Tel. Contact Abim Omodo Christopher 0772-896592 Adjumani Peter Madra 0772918562 Amolatar Ongom Dizzozo Justine 0774-666322 Amuria Akol Peter 0774-934917 Amuru Okello Mark 0712-640493 Apac Okello Francis 0772-561147 Arua Lou Lou Louis 0772-683956 Budaka Tazenya 0782-310948 Bududa Nanfungo 0782-6503272 Bugiri Musobya Daniel 0772-433427 Bukedea Okwalinga Robert 0782-405232 Bukwo Kotti Julius 0753-900412 Buliisa Mvazomaniku 0772-688789 Bundibugyo Ejoku Emma 0782-807386 Bushenyi Lubega Dan 0782-411567 Busia Nafula Scovia, 0782-475399 Butaleja Owere Lawrence 0772-606585 Dokolo Ogwanga Lawrence 0752-418166 Gulu Muloya Felix 0773213866 Hoima Tibamwenda Anthony 0772-844100 Ibanda Kiiza Aloysius 0782-842624 Iganga Kirunda Menya Kakaire 0782-855255 Isingiro Ddumba John Rogers 0752-503493 Jinja Bikumbi Patrick 0772-832102 Kaabong Lonio Isaac 0782-968099 Kabale Kariisa Samson 0772-475455 Kabarole Bisogo Mughusu Ezekeil 0772-696390 Kaberamaido Epwonu James Frank 776521280 Kalangala Ssebulime Richard 0772-537772 Kaliro Acile Godrey 0782-636305 Kampala Mulindwa Francis 0772-414714 Kamuli Kintu Ali Ahmed 0712-353997 Kamwenge Byarugaba Didas 0772-612150 Kanungu Rwakoojo Anthony Blair 0752-618442 Kapchwora Kiisa Sylvia 0782-662347 Kasese Yet to assign 0772-959777 Katakwi Ekoluot Geoffrey 0782-681757 Kayunga Hibira Henry 0712696853

District Name Tel. Contact Mubende Kalema John 0772-935510 Mukono Mule William 0772-521928 Nakapiripirit Aboka Moses 0782-381099 Nakaseke Luzira Isaac 0772-480242 Nakasongola Okwir Alex 0774-970507 Namutumba Wandera Tom 0782315836 Nebbi Odokonyero Henry 0772-559000 Ntungamo Mugenda David 0752-976273 Nyaduri Louga Albino 0782-598944 Oyam Alinga John Bosco 0772-547613 Pader Ongom Patrick Sisto 0782-570377 Pallisa Emuduk John 0782-333747 Rakai Nambale John Bosco 0772-875133 Rukungiri Agaba K. John Paul 0772-468055 Sembabule Arinaitwe Francis 0782-310690 Sironko Okoboi Bosco 772692425 Soroti Obonyo Charles 0772-682699 Tororo Akol Beatrice 0782-070155 Wakiso Matovu Baker 0712-840174 Yumbe Dima A. Terence 0772-379248 Nwoya Okello Mark 0712640493 Amuru onen Alfred 0772921482 Otuke Modest Adaku 0782320482 Aleptong Alex Odyek 0782359093 Kole Aumaaa Jane 0772332598 Buyende Kisawuzi Christopher 0776444769 Agago Ayella George Oryem 0772999413 Kibuku Oryem John Bosco 0782859974 Buwuma Aisu Alfred 0775402866 Buikwe Nasuna Chritine 0753805831 Serere Kasim Kata 0772675203 Kiryandongo Opio Samuel 0392963765 Namayingo Partrick Otak 0772588183 Kyegegwa Lwanga Sam 0772533225 Zombo Mugasha Sam 0782598980 Luuka Samson Nkulega 0782107315 Butambala Muyingo James 0775753359 Mpigi Sonko Paul 0772601316 Gomba Kakooza 0774423005 Shema Abenaitwe Amon 0772870825 Mitooma Bakengama Sam 0782735293 Buhweju Bemera Amon 0772015988 Bushenyi Lubega Dan 0772305114 Kumi Ejoku Bernard 0772950207 Ngora Enguria Issac 0777773195 Lwengo Yet to assign Bukomansimbi Yet to assign Kalungu Yet to assign Amudat Daniell Kalepun 078260732 Napak Yet to assign Kween Selangat Jacob 0782712752

Some of the DLFPs attending a workshop in HIV rapid testing at Jinja.

Implementation of Integrated National Laboratory Quality Improvement in Uganda Authors: William LALI1, Gaspard GUMA1, Henry KAJUMBULA1, Peter NSUBUGA1, Zainab AKOL1, Peter AWONGO2, Prossy NAMPIJJA3, Nakitende Mary Lious1, ONOMA N Virgil4

P A G E 5 SS C I E N T I F A R T I C L E :

Affiliation: 1Central Public Health Laboratory, Ministry of Health, Kampala, Uganda. 2National Tuberculosis and Leprosy Program, Kampala, Uganda. 3Uganda Virus Research Institute, Entebbe, Uganda. 4School of Public Health, Makerere University; Location of Project/Program: Uganda Key Words: Quality Improvement, Quality Assurance Introduction: External quality assessment of laboratories involves the monitoring of the per-formance of a laboratory by an entity outside that laboratory. It may entail su-pervisory visits, retesting of a portion of the specimens tested by the laboratory or administering panels of specimens to the laboratory to check on its ability to test them correctly. A number of external quality assessment schemes have recently been set up in Uganda. These include the T.B slide rechecking by the Na-tional T.B Reference laboratory, the CD4 NEQAS where CDC in collaboration with CPHL distributes panels for CD4 lymphocyte counts, the EAREQAS, where AMREF distributes panels to 93 laboratories and the CPHL NEQAS where CPHL distributes pan-els for malaria parasites, HIV rapid testing and stool micros-copy. During 2009, CPHL reached a total of 214 laboratories with its CPHL NEQAS. In addition, quality audits were performed on the same 214 laboratories. Here we report on the findings. Methodology: Sets of panels for HIV screening, T.B microscopy and malaria microscopy were prepared and validated at the Uganda Virus Research Institute, The National T.B Reference Laboratory and the Central Public Health Laboratory respectively. The panel testing results were then scored at CPHL and laboratories adjudged to have posted satisfactory or unsatisfactory results based on a cutoff of 75% for each of the tests. The quality audit visits were performed by a central team of laboratory personnel who used a standard checklist and the key issues that could have compromised performance identified form the checklist. Results: A total of 214, approximately 14.3% of laboratories in the public network were reached in the assessment. Their distribution by level is summarized in figure 1. A total of 214 laboratories participated in the EQA program and assessment. These included 8 regional referral hospital laboratories (3.7%), 46 general hospital laboratories (21.4%), 49health center IV laboratories (22.8%), and 111health cen-ter III laboratories (51.8%). Lab Performance in the proficiency panel testing Overall, 180 (84%) of the laboratories scored satisfactory results, with 34 (16%) posting an unsatisfactory result in one or more of the test panels. Figure 2 summarizes the mean scores for each panel. The mean scores were 91% for HIV screening, 85% for malaria microscopy and 85 percent for T.B microscopy. sd at the bottom of the figure are the standard deviations. The laboratory audit data of the poorly performing laboratories was analyzed for findings of factors affecting quality of testing. The key findings were reagent stock out/expiries (32.4% of the failing labs), poor records management (29.4% of the failing labs), inadequate technician skills (20.5% of failing labs), lack of stan-dard operating procedures (11.7% of failing labs) and failure to follow standard procedures (5.8% of failing labs). Discussion: External quality assessment schemes in the country remain very limited in cover-age with CPHL reaching only 214 about 14% of laboratories in the public net-work. In 2009 however, CPHL NEQAS had only been in its second year of imple-

mentation and lessons for scaling up were still being learnt. The mean performance of the EQA was above the satisfactory score of 75% for each of the 3 panels. However, 14% of the laboratories returned unsatisfactory results. The unsatisfactory laborato-ries performed worst in the malaria tests particu-larly in the aspect of quantification of the para-sites. Supplies, poor records management and inade-quate personnel skills were key issues in the poorly performing laboratories Recommendations; There is a need to scale up the coverage and fre quency of the EQA schemes Poorly performing laboratories need closer follow

up to support their logistics management, data man agement. Their personnel need mentoring and training to augment their skills

Lab Performance in the proficiency panel testing

“A total of 214, approximately

14.3% of laboratories in

the public network were reached in the assessment.”

Distribution of participating laboratories by level

P A G E 6

“As a follow up to the

policy, a 5 year strategic

plan for its implementation

is being developed “

From left to right: Dr. Giorgio Roscigno, FIND CEO; Mr. James Kakooza, Hon. Minister of State for Health (primary health care); Dr. Joaquim Saweka, WHO Representative for Uganda; and Dr. Kevin Mills McNeill, Country Director of CDC/Uganda

E V E N T S : Uganda Launches a National Health Laboratory Policy

By Kajumbula Henry The 24th September 2009 ought to be highlighted as a major milestone to delivery of health laboratory services in Uganda. It was on this day at a colorful ceremony in the Imperial Royale Hotel that the Honorable James Kakooza, Minister of State for Primary Health launched the National Health Laboratory Services Policy. While not a panacea to the rig-ours of delivering quality labo-ratory services, the policy forms an all important framework. It elucidates the strategies and objectives relating to laboratory services in the National Health Policy and the Health Sector Strategic Plan II. The process to develop a Policy to guide laboratory services in Uganda dates back to the mid 1980s. At that time, the Ministry worked together with AMREF and developed policy guidelines for laboratory services. Unfortu-nately, the document was never launched or widely publicized. While they acted as reference material for many stakeholders, these guidelines were neither official nor binding. In 2005, the second Health Sec-tor Strategic Plan (HSSP-2) of 2005 – 2010 made development of a comprehensive National Health Laboratory Services Pol-

icy a key objective. The National Health Laboratories Technical and Advisory Committee rose to the challenge in 2007. Working with the Central Public Health Laboratories (CPHL) with support from the Centers for Dis-ease Control (CDC), a draft policy was developed. In 2008, the Foun-dation for Innovation in New Di-agnostics (FIND) established a program in Uganda. A key objec-tive of FIND’s Uganda Program was to support the Ministry in finalization of the Policy. This concerted effort from the Ministry in partnership with FIND and CDC led to its completion in early 2009. In general, the policy aims at pro-viding a framework for ensuring that the health laboratory services

in Uganda are strengthened so as to support effective and efficient delivery of the Uganda National Minimum Health Care Package (UNMHCP). It sets the strategic direction in 13 key areas that are fundamental to attaining available and sustainable quality laboratory services in the country. These key areas around which the objectives of the policy revolve are: �� Organization and manage-

ment �� Delivery of the services �� Laboratory facilities and

safety �� Laboratory equipment

and supplies �� Human resources �� Quality management

systems �� Information systems �� Research and develop-

ment �� Community involvement �� Partnerships �� Regulatory and legal

framework �� Monitoring and evalua-

tion �� Financing and account-

ability The policy gives a couple of strategies through which each of the 13 policy objec-tive, shall be achieved.

As a follow up to the policy, a 5 year strategic plan is be-ing developed. A draft of the plan was presented to stake-holders in September 2010. Once finalized the strategic plan shall guide all govern-ment and partner investment in health laboratory services for the period of 2010 – 2015. End

From left to right: Dr. Giorgio Roscigno, FIND CEO; Mr. James Kakooza, Hon. Minister of State for Health (primary health care); Dr. Joaqui saweka, WHO Representative for Uganda; & Dr. Kevin Mills McNeill, Country Director of CDC/Uganda .

C L I N I C A L L A B O R A T O R Y N E W S F O R

P A G E 7

By Hakim Sendagire On 27th and 28th of July, Uganda hosted a meeting to review the progress of East African Countries in implementing the World Health Organization (WHO)’s accreditation process that was launched in Kigali, Rwanda in July 2009. The meeting that attracted over 40 public health and laboratory systems experts from the Ministries of health of Uganda, Kenya, Tanzania, Rwanda and Ethiopia was organized by the Ministry of Health of Uganda in conjunction with WHO, CDC-Uganda and AFENET and was held at the Serena Resort in Kigo.

Opening the meeting, Uganda’s Minister of Health, Dr. Stephen Malinga underscored the central role played by laboratories in clinical management of patients, as well as the early detection and management of disease outbreaks.

Attending countries updated the meeting on their progress in implementation of the accreditation process. The countries shared their experiences in the implementation of the ‘Strengthening of laboratory management training towards accreditation (SLMTA).

SLMTA is essentially a training and mentoring tool developed by CDC-Atlanta to strengthen management of laboratories in order to attain immediate and measurable quality improvement.

At the end of the meeting, all countries committed to implementation of the WHO accreditation process and SLMTA. They resolved to explore mechanisms of setting up an East African Regional Accreditation Body while at the same time strengthening National Institutions. End

E V E N T S : Uganda hosts East African Regional meeting for laboratory accreditation

Dr. Alex Opio, MOH (top), Mr.

Lali Ziras William, CPHL

(centr), Dr. Winifred Wafula,

CDC, Ms Agnes Nabasirye,

CDC (bottom) and some of the

delegates (left), in a discus-

sions during the WHO Labora-

tory Accreditation workshop,

that was hosted in Uganda,

27th – 28th July 2010.

C L I N I C A L L A B O R A T O R Y N E W S F O R

By Eragu N. Rita The Ministry of Health recognizes the critical role played by various partners in the delivery of labo-ratory services in the country. To this effect, the Ministry teamed up with CDC-Uganda to host a 2 day meeting for laboratory services implement-ing partners. The event, held on 30th September and 1st October 2010 at Protea Hotel, Kampala sought stakeholder input to the draft National Health Laboratory Services Strategic Plan for 2010 - 2015 and the draft National Laboratory Quality Assurance Plan. The meeting was also used as an opportunity to collect Data on services offered by various implementing partners. End

CPHL and CDC-Uganda co-host a laboratory strengthening implementing partners’ meeting

Hon. Stephen Malinga

The Director General for Health Services, Dr Kenya Mugisha (standing) sounding the move from ministry of disease to ministry of health, MOH’s commitment to imple-ment the Laboratory Strategic Plan and the curb false diagnosis reports tagged to monetary values especially in the private sector. Next to him is the Assistant Com-missioner Clinical Services Dr. Jackson Amone and the WHO representative.

P A G E 8 E V E N T S :

By Guma Gaspard : Increasing migration of populations across East African borders either in search of economic opportunities or as a result of forced displacement is a potential fuel to outbreaks of communicable diseases like cholera, meningitis, drug resistant tuberculosis and newly emerging global epidemics like swine flu (H1N1 influenza). While laboratories form a central cog in efforts for early detection and control of such outbreaks, they remain the weakest link to such efforts. In recognition of this fact, the 4 East African Countries of Kenya, Rwanda, Tanzania and Uganda have secured World Bank Loans totaling to USD 66.7 million to strengthen the public health laboratory network in the region. The project entitled ‘The EAST AFRICAN PUBLIC HEALTH LABORATORY NETWORKING PROJECT (EAPHLNP)’ aims at establishing a network of high quality accessible public health laboratories for the diagnosis and surveillance of TB and other communicable diseases. It has 3 components namely; �� Strengthening of the regional capacity to diagnose diseases of public health

importance and to share information to mount an effective regional response. �� Joint training and capacity building to expand the pool of qualified

laboratory technicians �� Joint Operational Research, knowledge sharing/Regional Coordination and program management In total, 25 laboratories across the 4 countries shall be built or refurbished, equipped and supported to operate effectively. In addition, the disease surveillance capacity of the East African Community health desk and the East Central and Southern Africa Health Community (ECSA-HC) based in Arusha shall be supported to coordinate the regional efforts. In Uganda, a new National TB Reference Laboratory shall be constructed in Butabika at the proposed CPHL site. In addition 5 regional laboratories shall be constructed/refurbished, equipped and operationalized to enable them perform T.B cultures and molecular assays and bacteriological/mycological cultures. The 5 laboratories include Arua regional Hospital, Lacor Hospital, Mbale Regional Hospital, Mbarara Regional Hospital and Mulago National Referral Hospital. The first 4 hospitals were selected on the basis of their location near national borders and would therefore be able to serve neighboring countries. The project has gone through cabinet and parliamentary approvals and is expected to be effective by the end of January 2011. End

The Assistant Commissioner National Disease Control, Dr. Alex Opio (centre above) addressing stakeholders, in company of Dr. Mwangi Christina (L), Dr. Hakim Sendagire and Dr. Henry Kajumbula. Stakeholders included PEPFAR Team, Walter-Reed funded, USG funded partners, Acade-mia (National lab institutions), Civil Society Organiza-tions, Private Not for Profit, Medical Superintendents and District Health Officers. ↑

East Africa launches a project to harmonize laboratory efforts towards disease surveillance

→CPHL Senior Advisors Mr. Amato Ojwiya (centre) and Mr. Guma Gaspard (front), Atek Kagirita, (L), Peter Awongo (R), Pendun Martha, (far right), Dr. Robert Downing, CDC and Bernard Baitwababo, CPHL. →

..more on lab strengthening implementing partners’ meeting

↑ Some of the lab implementing partners’ representatives in the meeting.

Association of Pathologists of Uganda hosts the 20th Association of Pathologist of East Central and Southern Africa Congress.

P A G E 9 E V E N T S :

Below: Some of the posters showing findings displayed.

Above and below: A cross-section of delegates during a session.

By Susan Gathoni On the 15th to 17th of September 2010, the Association of Pathologists of Uganda (APU) hosted the 10th biennial Conference of Association of Pathologists of East Central and Southern Africa (APECSA) at Hotel Africa in Kampala. APU brings together specialists in the various fields of pathology in Uganda while APECSA is the umbrella for all pathologists associations in the regions of East, Cen-tral and Southern Africa. These associations aim at promoting quality teaching and practice of all the fields of pathology including histology, cytology, microbiology, hematology, chemistry and immunology. The conference’s theme was ‘Repositioning Pathology Practice in sub-Sahara Africa: opportunities and Chal-lenges. It drew a record attendance of 130 delegates from 16 countries , and 41 papers were presented. The Ministry of Health was represented by Dr. Asumani Lukwago, the Permanent Secretary. Other prominent speakers included Dr. Stephen Kijjambu, Dean of the School of Medicine at the Makerere University College of Health Sciences and Professor Sebastian Lucas of King’s College London. Many speakers emphasized the need of laboratory services and all disciplines of pathology to dem-onstrate their relevance and become more visible in order to attract adequate support. One of the key events of the conference was launching of the College of Patholo-gists of East Central and Southern Africa (COPECSA), whose aim is the promotion of excellence in the practice of pathology through training, examination and profes-sional development. Dr. Ranjiv Erasmus of South Africa was elected as its president. Dr. Henry Kajumbula and Dr. Othieno Emmanuel from Uganda were elected onto its 25 member council. End

“APU brings together specialists in the various fields of

pathology in Uganda while APECSA is the

umbrella for all pathologists

associations in the regions of East,

Central and Southern Africa. “

Upcoming Events:

�� Uganda AIDS Indicat or Survey—February

2011

�� Pilot ing PIM A ( Point of Care) CD4 M a-

chine in Uganda — January 2011

�� St rengthening Laborat ories Towards Ac-

creditat ion ( SLM TA) TOT-M arch 2011- Johannesburg—South Afr ica

← more labo-

ratory imple-

menting part-

ners’ represen-

tatives who

attended the

meeting co-

hosted by

CPHL-MOH

and CDC

Uganda.. ↓

Plot 7/11 Buganda Road, Kampala

Phone: +256-414-230-265

Email: cphlug@gmail.com

Central Public Health Laboratories, Uganda

Ministry of Health

Social Corner CPHL says bye 2010 in style: For the first time in its history, CPHL hosted an end of year party. The event was hosted on 22nd December 2010 at the CPHL gardens. Patrons were treated to mouth-watering muchomo, a special treat by Mrs. Ikoba. Chief guest Dr. Zainabu Akol, Manager AIDS Control Pro-gram, Ministry of Health, thanked everyone for their efforts during 2010, and appealed to them to remember thanking God for the lives in 2010, and to be more conscientious in

their work during 2011.

Right: The beautiful Mastula Ikoba; the hands behind the special nyama choma. She left her office in time to make CPHL’s day. With her are their lovely children Ryan and Anah, plus husband Ikoba Sulaiman (CPHL Administrator)

Above: Dr. & Mrs. Sebulime, Sharon and Lydia arriving at the venue.

Left: The master of ceremony could not hide his excitement. Right: Delicious nyama choma

Right: Mr. Guma sharing his new year resolutions; as usual members had to hold their tummies to control stomachache caused by his hu-morous characteris-tic.

Above: A few of the honorable guests who blessed the function.

It was all about lab technologists...

Nandala Michael and Joseph Nkondyo, two of CPHL’s lab technologists were introduced to their in-laws in breath-taking functions.

↑ Micheal Nandala (left) with collegues on the d-day.

Joseph Nkodyo (left) with collegues on his day→ ↑ Smartness was the word as the CPHL family posed

for the introduction functions.

Wat

ch o

ut fo

r the

nex

t iss

ue!