Turnaround time in the surgical pathology laboratory

One measure of the efficiency of a surgical pathology service is the rapidity of reporting the diagnosis to clinicians. The turnaround time (TAT) has been used for this purpose. This study showed that the TAT for 66 percent of specimens submitted to the surgical pathology laboratory in the University Hospital of the West Indies was within 3 days and for 89 percent within 6 days. The TAT within 7 days was considered acceptable, but it was shown that it was more than 7 days for 9 percent, of the specimens submitted. The importance of this information is discussed and recommendations made for identifying more accurately the source of delays in those cases in which the TAT was considered to be unusually prolonged.(AU)

Laboratory services: new roles, new demands, new opportunities

Laboratories are rising to the challenge of better and cheaper care in the wake of exponential increasing in cost and variation in patterns of care that have spawned capitation and managed care. There is an increasing body of evidence that 30 to 50 percent of all tests done are unnecessary. In the current environment, we must argue against doing any test that does not demonstrably add value to care. Laboratorians are now equal partners in delivery of healthcare services and are at the table to discuss new programmes services, even new drugs; everything impacts on the laboratory! Laboratory services are being redefined by epidemiologists, cost accountants and professional managers.(AU)

Re-emergence of tuberculosis in the Caribbean: how ready are the Caribbean laboratories in 1997?

The incidence of tuberculosis is increasing in the English speaking Caribbean and multiple drug resistant M. tuberculosis has been reported. Twenty-one laboratories in the Caribbean were surveyed to assess their current practices and capabilities for the detection, isolation and drug susceptibility testing of M. tuberculosis. Sixteen laboratories perform laboratory diagnosis of tuberculosis, most commonly by the Kinyoun technique (10/16). Microscopic examination of sputum for acid fast bacilli (AFB) was being performed in 12 laboratories by the direct method. Only one laboratory used fluorochrome methods for the rapid detection of AFB in sputum and other clinical specimens. Only five laboratories culture for mycobacteria. None of the laboratories perform either nucleic acid probes of BACTEC NAP for the identification of mycobacteria other than tuberculosis (MOTT). Only three laboratories performed antimicrobial susceptibility testing in the Caribbean. Centrifuges with safety carriers were being used in only 13 percent of laboratories. Eight laboratories (50 percent) used level 2 containment biological safety cabinets while processing all specimens for mycobacterial infections. Reporting of smear results to hospital, physician or the ministry of health/public health department was mainly done by telephone. The time taken to report AFB smear microscopy results averaged over 48 hrs in 75 percent of laboratories. Implementation of CDC recommendations and laboratory quality standards for the control of tuberculosis are urgently needed in the Caribbean.(AU)

Knowledge, attitudes and practices of Caribbean laboratory workers: adoption of bio-safety guidelines - abstract

Biomedical laboratories are work environments which pose special infectious disease risks to personnel who work in them. With the advent of the AIDS pandemic, emphasis has been placed on adoption of Universal Precautions Policy by all health care workers. In order to assess the extent of safety management, knowledge of, and compliance with established safety standards, laboratory workers in the English-speaking Caribbean were surveyed via an anonymous, self-administered, pre-coded questionnaire. One hundred and thirty-one questionnaires were returned from 16 laboratories in 13 countries (50 percent response rate). Responses indicated that there were universal deficiencies in safety management. Only 38 percent of respondents indicated that a safety manual was readily available. Most staff indicated some familiarity with Universal Precautions but there was inadequate awareness (60 percent affirmative responses) regarding the possibility of contracting infections in the laboratory. There were instances of eating, drinking, smoking, mouth pipetting and recapping of needles. The preliminary survey indicates that there is inadequate compliance with safety standards among laboratory workers in the English-speaking Caribbean. Safety management needs to be improved with intervention strategies designed to heighten laboratory workers' perception of the real risk of infection, in order to accomplish the neccessary behaviour modification. (AU)

Monitoring for activity of arboviruses in Trinidad and Tobago

Paper covers the history and some of the operations of the Trinidad Regional Virus Laboratory

Some aspects of solid wastes management in health care and related support service facilities in Kingston and Spanish Town, Jamaica

The proper management of solid wastes is critical to the prevention of disease and the maintenance of the integrity of the environment. Indiscriminate disposal of hazardous wastes and the dire effects of this on human health causes much concern to health authorities worldwide. Inspite of the foregoing however, scant attention is apparently being paid to the management of solid wastes generated from care of the sick. This solid waste, which has immediate potential for disease transmission is not even mentioned among those categorized as hazardous. It is estimated that thirty-three percent of the waste from health care delivery operations is infectious and is therefore hazardous to health. This waste is poorly managed at best, and indiscriminately disposed of at the worst. This study examines the management of solid wastes at health care and related support service facilities in Kingston and in Spanish Town, Jamaica. The findings reveal a high potential for disease transmission from this waste to the general public, through those persons who scavenge at landfill sites where it is finally deposited (AU)

Activities of the Trinidad regional virus laboratory in 1953 and 1954 with special reference to yellow fever outbreak in Trinidad, B.W.I

Serological surveys of Trinidad residents by the Trinidad Regional Laboratory demonstrated yellow fever immunes in eight individuals 15-19 years of age, and in a high proportion of older individuals. Yellow fever virus was isolated from a human case in April 1954. Subsequently virus isolations have been made from 13 other human cases, 7 red howler (Alouatta) monkeys which were brought in dead, 21 pools of Haemogogus mosquitoes, and 1 pool of mixed mosquitos -a total of 43 virus isolations. Yellow fever virus was repeatedly recovered from Haemogogus mosquitoes captured at ground level. (Summary)