Clinical Laboratory Services

Clinical Laboratory Services is a multidisciplinary laboratory comprising: Clinical Pathology, Clinical Biochemistry, Clinical Microbiology, Molecular and Serodiagnostic laboratories, and out-patient service project in Dhaka, and the Matlab Clinical Laboratory. The laboratories cater to the need for diagnostic support to patient-care activities of the Clinical Research and Service Centre (CRSC) in Dhaka and Matlab and paying patients, including British Embassy medical unit, selected tests for American Embassy medical unit, and JICA medical unit. Laboratory diagnostic support is also provided to clinical, community and field studies undertaken by the Centre's scientists. The laboratory scientists carry out research and train national and international fellows, graduate and postgraduate students in laboratory research and laboratory diagnostic techniques. In total, 137,471 specimens and 386,030 tests were processed by the laboratory in 2003. The out-patient service project handled 52,932 patients.

Clinical Laboratory Services Staff

Clinical Biochemistry

The Laboratory processed blood, serum, plasma, stool, urine cerebrospinal fluid (CSF), intravenous fluid (IVF), oral rehydration, etc. and performed 132,266 tests/assays on 37,245 specimens. The paying-cases contributed most to the overall workload (66.77%). A number of new tests/assays were introduced with income-generating potential and research.

Clinical Biochemistry Staff

Clinical Microbiology

The Laboratory processed 33,534 specimens for culture, isolation, identification, and testing for antimicrobial susceptibility of clinical isolates from various clinical samples, such as blood, stool, rectal swab, urine, throat swab, sputum, CSF, pus, etc. Specimens from hospitalized patients at CRSC contributed most to its overall workload (52.11%). The common diarrhoeal pathogens isolated from 17,588 faecal samples were: Shigella1,560 (8.87%), V. cholerae O11,654 (9.40%), V. cholerae O13952 (0.30%), Salmonella spp.281 (1.60%), Aeromonas spp.429 (2.44%), and Plesiomonas184(1.05%); 125 (5.60%) C. jejuni were isolated from 2,244 faecal samples. The commonest blood isolates were S. Typhi (4.04%, 217 of 5,375) and N. meningitis (0.52%), and the most common urine isolate was E. coli (12.90%, 946 of 7,348). Among 278 rectal swabs collected by the epidemic control team of the Public Health Sciences Division of ICDDR,B, 58 were positive for V. cholerae O1 (20.86%), and no Vibrio cholerae O139 was isolated. The Laboratory worked for 28,591 man-hours producing 16,08,244 workload units (WLUs). The general index was 56.25 (optimum 42-45) WLUs per person per hour. The Laboratory continued its participation in the External Quality Assurance Scheme (EQAS) with the College of American Pathologists. The overall rated score was 99%.

Clinical Microbiology Staff

Clinical Pathology

The Clinical Pathology Laboratory, comprising haematology, serodiagnostic and microscopic units, performed 134,135 tests/assays on 66,693 specimens of blood, serum, plasma, stool, urine, cerebrospinal fluid, etc. Most (66.83%) of these specimens and tests were paying-cases. Of blood specimens of CRSC patients, 47.5% were collected by finger prick. The laboratory work produced 1341,358 work-load units (WLUs) in 23,077.5 man-hours. The general index of WLUs per person per hour was 58.12 (optimum 42-45), indicating an overload.

Mole & Serodiagnostic

This laboratory has recently been opened by incorporating serology which was a part of the Clinical Pathology Laboratory. The serodiagnostic activities have been merged with Clinical Pathology for the year 2003 as molecular part was yet under development. The activities of this unit will include routine serological diagnosis of different infectious and non-infectious diseases, such as typhoid, rheumatic fever, rheumatoid arthritis, dengue, syphilis; and various types of hepatitis and cancer markers. The Laboratory has already started setting up a multiplex PCR assay for the characterization of human diarrhoeagenic Escherichia coli. As part of the routine tests, it will start the qualitative and quantitative diagnosis of HBV and HCV and estimation of viral load from the blood specimen, genotyping of HCV and viral load monitoring of HIV. Very soon, the Laboratory will introduce serological diagnosis of more cancer markers, such as CA 19- 9, CA 125, CA 15-3. It may add diagnosis of tuberculosis from the sputum specimens in future.

Mole & Serodiagnostic Staff