X
GO

Laboratory Services

 
Petri Dish

The Laboratory Services and Networks Department contributes to improving the health status of Caribbean people by working with and advancing the capability of CARPHA Member States in laboratory technology and related public health disciplines through the state-of-the-art validated laboratory provision of methods, technical cooperation, service, advice, expertise, training, technology transfer and research.

Quality Policy

CARPHA Medical Microbiology Laboratory (CMML) is committed to providing accurate and reliable services for surveillance and control of disease in CARPHA Member Countries. This is accomplished through ensuring compliance with the quality policy of the organization, rigorous training of all personnel, strict adherence to protocols defined in standard operating procedures, timely review of the Quality Management System and implementation of those changes that will improve and enhance performance.

Core Functions
 
Laboratory Technician

Public health laboratories (PHLs) provide vital services to public health systems which are geared towards the prevention and control of diseases and the improvement of the health of populations.  Surveillance is therefore a key function of public health laboratories and for an effective laboratory surveillance system, good communication between the laboratories and epidemiologists is required.

The key core functions of public health laboratories are:

  1. Identification of disease outbreaks and related pathogens through the examination of specimen; identification and location of source(s) of infection detection of new pathogens which have the potential to spread;
  2. Provision of reference services, which includes the identification of unusual pathogens;
  3. Testing for emerging and re-emerging diseases which are of public health importance;
  4. Chemical and microbiological testing of environmental samples such as food, air, water and soil to assess quality;
  5. Research, including discovery of new and emerging pathogens, development of new test methodologies, population studies such as screening for chronic diseases like diabetes, neonatal screening for microcephaly;
  6. Data gathering and rapid dissemination to epidemiologists and other decision makers;
  7. Training of laboratory and technical personnel

Through these core functions, the general public is protected from disease outbreaks through the early identification of pathogens accompanied by appropriate treatment and preventive measures to prevent disease spread and identify at-risk populations.

CARPHA Medical Microbiology Laboratory (CMML), Port-of-Spain
 

CMML operates under an accredited quality management system (QMS) in accordance with the international requirements of ISO/IEC 15189: 2012 through the Jamaica National Agency for Accreditation (JANAAC). 

Laboratory testing services are provided to Member States through the designated national public health laboratories for human infectious diseases under surveillance (Vaccine Preventable, Respiratory, Vector borne and Foodborne Diseases), as well as outbreak support and reference level genetic characterization for pathogens of public health importance. 

Capacity building initiatives to enhance national and regional resilience are available for specialized laboratory techniques e.g. molecular and serology platforms; and laboratory operations training including laboratory biosafety and biosecurity practices, infectious substances shipping and implementing laboratory quality management systems.

The Caribbean Public Health Laboratory Network (CariPHLN) is the platform for all laboratories across the Caribbean to actively engage with sister laboratories on issues of quality, advances in technology and leveraging available resources among members.

(Click here for more - goes to CMML specific page)


Environmental Health and Sustainable Development (EHSD) Department, Castries
 

The Environmental Health Laboratory (EHL) located within the EHSD is accredited to ISO 17025 by the Canadian Association for Laboratory Accreditation (CALA). The full-service microbiological and analytical laboratory provides environmental analyses, including water quality monitoring, plant, soil and tissue analyses, food microbiological testing, indoor environmental quality monitoring and noise testing.

These services are widely available to private enterprises, government agencies and statutory bodies on a “fee for service” basis.

Click here for more

Medicines Quality Control and Surveillance Department (MQCSD), Kingston
 

The Medicines Quality Control and Surveillance Department (MQCSD) includes the only ISO/IEC 17025 accredited pharmaceutical quality control laboratory in the English-speaking Caribbean Region, which serves CARPHA Member States (CMS). The laboratory plays a vital role in testing and verifying that finished pharmaceutical products circulating in the Region continue to meet international standards of quality and safety.

The testing services complement the Post Market Surveillance Programme in partnership with National Regulatory Authorities/ Ministries of Health and CARPHA’s regulatory unit, the Caribbean Regulatory System (CRS). The laboratory evaluates the continual quality of medicines after approval for sale in the region. CMS can report suspected substandard, falsified medicines and/or adverse medicine reactions to a regional platform called VigiCarib for analysis and action, including testing by the laboratory on an emergent basis.


Click here for more

CARPHA Medical Microbiology Laboratory (CMML)
 

 

CMML
Alerts
 

COVID-19

While there have been no confirmed cases of COVID-19 in the Caribbean thus far, transmission of the virus has been reported in territories with direct flights to Caribbean States.  Therefore, due to the current increased risk of importation of COVID-19 to the Region, the Caribbean Public Health Agency (CARPHA) has upgraded the risk of coronavirus disease transmission from low, to “moderate to high.”  

 

The CARPHA Medical Microbiology Laboratory (CMML) has been actively responding to requests from Member States since 11th February 2020 when we announced our capacity to detect SARS-CoV-2, for the disease known as COVID-19.

 
Resources
 

Laboratory Update 1

Laboratory Update 2

PAHO/WHO Laboratory Recommendations

PAHO/WHO Laboratory Biosafety Recommendations

Click here for more



Quality Management System
 

Role of the Laboratory

The main function of the laboratory based in Trinidad is to provide reference and referral services, training, technology transfer, monitoring and research of public health importance.

Our staff is committed to providing the highest quality service to our member states and as such we have instituted and continually upgraded our systems to ensure that the quality of our services is assured at all times.

Quality Policy

  • Senior management will provide the resources necessary to maintain the Laboratory quality management system.
  • The laboratory is committed to ensuring:

- that internal and external customer requirements are met 

- continual improvement of the quality of the laboratory services provided to its customers.

- that examinations are suitable for their intended use

- the continuing suitability of the quality management system

  • The laboratory will provide a system for the establishment and review of the quality objectives. 
  • Quality practices are communicated within the organization, understood and adhered to by all employees. 
  • The laboratory ensures a competent workforce that adheres to good professional practices and delivers quality results in a timely manner according to the ISO 15189.




Accreditation
 

In November 2018, CMML was awarded accreditation through the Jamaica National Agency for Accreditation (JANAAC) to the international standard ISO/IEC 15189: 2012 “Medical laboratories — Requirements for quality and competence” (see Accreditation Certificate and Scope).

The current scope of accreditation:

Respiratory Diseases – Influenza A and B**, Non-influenza Panel (Adenovirus, Respiratory Syncytial Virus, Rhinovirus, Human Metapneumovirus, Para Influenza 1 – 3) **, Mycobacterium tuberculosis**

Vaccine Preventable Diseases - Measles*, Rubella*

Vector Borne Diseases – Chikungunya, Dengue, Zika**, Chikungunya*

 Note. * serology (ELISA), ** molecular (PCR) technique




Testing Services & Outbreak Support
 

Accessing Our Services

All requests for laboratory tests and outbreak support must be channelled through the designated National Reference/ Public Health Laboratory or the Ministry of Health.

The following minimum information must accompany each specimen

1. A labelled specimen container with the following information:

- National Patient ID/Laboratory Number

- Date of collection

- Specimen type

2.Completed CARPHA Laboratory Investigation form Click here to download

The Laboratory has a web-based Laboratory Information Management System (LIMS). Countries will be trained in its use. Once fully implemented the method of submission of information will change.

For more information refer to the Laboratory User Manual

3. Notification of Incoming Shipments of Specimens

Referred specimens must always be prepared, packaged and transported in accordance with current international shipping guidelines and IATA regulations.

1.     Send an email to customerservice@carpha.org with the following information –

  • Test/s being requested
  • Number of samples per test requested
  • Completed Air Way Bill (AWB) and CARICOM Invoice

2.     Await feedback on completeness of documents and confirmation to proceed with shipment.

3.     Ensure accuracy, legibility and completeness of shipment documents then proceed with shipment.

4.     Send an email to customerservice@carpha.org with a notification that the shipment is en-route.

5.   Address all packages as follows:

            Executive Director of CARPHA

            Dr. Joy St. John

            The Caribbean Public Health Agency (CARPHA)

            16-18 Jamaica Boulevard

            Federation Park

            PORT of SPAIN

            TRINIDAD, W.I.

 Accessing our 24/7 Emergency Service
 
CMML Lab

CARPHA’s Medical Microbiology Laboratory (CMML) based in Port-of-Spain operates routinely every Monday to Friday 8:30 a.m. to 4:30 p.m.

However, we understand that events may occur which requires laboratory diagnosis or confirmation outside of this routine e.g. weekends, public holidays and emergency situations.

In order to provide accurate and timely laboratory results for your decision making please use the following steps.

1. Contact the Head, Laboratory Services and Networks directly at 1-868-324-0869 (C) or escobaga@carpha.org, to conduct a rapid risk assessment for the submission of laboratory samples under emergency conditions.

Examples include:

  • Suspected acute case(s) of Measles or Rubella (imported and/or indigenous),
  • Cases of severe acute respiratory illness (SARI) associated with Middle East Respiratory Syndrome (MERS-CoV) or fatal cases where Influenza virus is suspected,
  • An emerging event of public health importance e.g. suspected case of an exotic disease,
  • Unknown, epidemic-prone fatal diseases

2. Once there is agreement to submit specimens, proceed with the shipment. Ensure compliance with proper packaging and completion of required documentation e.g. CARICOM Invoice.

3. The Head, Laboratory Services and Networks will activate the internal response to ensure the specimens are processed promptly on arrival at CMML

 
 
Capacity Building
 
Capacity building

CMML assists national laboratories with the implementation of sustainable quality management systems through assessments and targeted training programmes to improve the quality, efficiency and timeliness of national laboratory services for the detection, containment and response as part of infectious disease surveillance.

Programmes include:

  • Laboratory assessments using the Laboratory Quality Management System Stepwise Improvement Process (LQMS-SIP)
  • Laboratory Biosafety and Biosecurity Practices and Infectious Substances Shipping Training Click here for more (Training materials)
  • Technology transfer: Molecular Detection of Arboviruses and Respiratory Diseases e.g. Influenza, Tuberculosis; Immunofluorescence Assays for the Detection of Respiratory Viruses; Serology Methods for the Detection of Arboviruses; etc.

 

 

Advisory Services
 

Queries relating to service provision or the User Manual should be directed to the Laboratory Management Team (Head of Laboratory Services, Biorisk Manager and Quality Manager).

Email: LMT@carpha.org.

Requests for advice regarding technical aspects of the service must be directed to the Head of Laboratory Services, Dr. Gabriel Gonzalez-Escobar.

Email: escobaga@carpha.org  


Projects
 

Mosquito-Based Arbovirus Surveillance (MoBAS): Detection of DEN, CHIK, ZIK, YF, WN, WEE, MAY, ILH, BUSS, USU, SPO, ONY, EEE, SFV, ROC viruses in mosquitoes conducted in the BSL3 laboratory.


CariPHLN (to be further developed)
 

Link to Forum documents

Laboratory Technician
Laboratory Services

We serve as the Caribbean Reference Laboratory in the disciplines of Medical Bacteriology, Virology, Parasitology and Entomology. These operational areas which provide direct support for surveillance and disease prevention and control activities are supported by a laboratory management system which includes key aspects of quality assurance, laboratory safety and information systems.

 
Program Areas
 
Laboratory Technician

Activities at a Glance 2018-2019

  • Processed more than 18,000 test requests (95% primary diagnostic, 5% confirmation and reference)
  • CARPHA Medical Microbiology Laboratory (CMML) was accredited under ISO 15189:2012 by the Jamaican National Agency for Accreditation (JANAAC)
  • New tests developed and available for the Member States: Leptospirosis PCR, Mayaro virus PCR, Measles and Rubella PCR, Antimicrobial Susceptibility Test (AST). Malaria PCR test is being developed and will be available by March 2020
  • Continue technical assistance in vaccine-preventable diseases, vector-borne diseases, food-borne diseases, epidemic-prone, and respiratory diseases.
  • Special research projects on the Mayaro virus, Hantaviruses, and Mosquito-based arbovirus surveillance (MoBAS Project).
  • Biosafety Level 3 (BSL3) laboratory utilised to respond to epidemic threats and MoBAS Project.
  • More efficient and rapid-response technology: Respiratory, Gastrointestinal and Meningitis/Encephalitis Panels for the rapid detection of more than 50 infectious agents.
  • Development of CMML strategy for the CARPHA Member States  (ongoing).
  • Development of CMML business plan (ongoing).
  • The Emergency Action Mechanism (TEAM) developed and activated for 24/7 testing support to the CMS during special situations like natural disasters and epidemics/pandemics.
  •  
  •