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Introduction. Strengthening Laboratory and Epidemiology Collaboration. May 2007. Learning objectives. At the end of this presentation, participants should know: The goal of this course The specific objectives of the course The methods used during the course. Why this course?.

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Strengthening Laboratory and Epidemiology Collaboration

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Strengthening laboratory and epidemiology collaboration

Introduction

Strengthening Laboratory and Epidemiology Collaboration

May 2007


Learning objectives

Learning objectives

At the end of this presentation, participants should know:

  • The goal of this course

  • The specific objectives of the course

  • The methods used during the course


Why this course

Why this course?

Public health is multidisciplinary

  • Epidemiologists, clinicians, laboratory specialists, environmental specialists, entomologists, veterinarians, nurses

    Specialists may have different

  • Skills, knowledge, working habits, perspectives

    Specialists need to collaborate often on

  • Surveillance, outbreak investigations, studies

    Activities must be coordinated to reach common goals


Conditions for successful collaboration

Conditions for successful collaboration

Identify common goals

  • Applied public health (action)

  • Research

    Understand that there are different perspectives

    Recognize different skill sets

    Respect different working cultures

    Communicate effectively


Module objectives

Module Objectives

To facilitate communication and collaboration between epidemiologists and the laboratory by:

  • Providing epidemiologists with basic training in microbiology techniques and analysis

  • Providing epidemiologists with the laboratory perspectives of public health investigations


Specific objectives

Specific objectives

  • Develop field epidemiologists’ knowledge of basic laboratory sciences

  • Identify ways to have better collaboration between the laboratory specialists and the epidemiologists

  • Prepare the epidemiologist to ask the right questions when collaborating with laboratory specialists


Field epidemiologists should be able to

Field epidemiologists should be able to:

  • Engage in positive interactions with laboratory specialists

  • Identify appropriate samples to collect

  • Appropriately collect, label, package and transport specimens

  • Identify key laboratory investigations for selected syndromes and/or suspected pathogens

  • Identify when and which typing methods should be used


Field epidemiologists should be able to1

Field epidemiologists should be able to:

  • Identify the need for and use of antimicrobial susceptibility testing

  • Identify the role of the laboratory in public health surveillance

  • Understand the role of laboratory quality assurance

  • Interpret laboratory test results: sensitivity, specificity and causality criteria


1 engage in positive interactions with the laboratory

1. Engage in positive interactions with the laboratory

  • Understand why and when to engage the laboratory

  • Learn how to communicate with the laboratory by learning their language

  • Take into account the needs, objectives and perspectives of the team:

    • Laboratory specialists, clinicians, veterinarians, environmental specialists, entomologists


2 identify appropriate samples to collect

2. Identify appropriate samples to collect

  • Think critically while working with laboratory specialists

  • Identify surveillance, clinical, laboratory needs

  • Estimate the number of samples needed to confirm the cause of the outbreak

  • Define sampling strategy - mode of transmission, syndrome

  • Seek external advice for atypical scenarios

  • Collect samples ethically


3 appropriately collect label package and transport samples

3. Appropriately collect, label, package and transport samples

Identify criteria to select an appropriate laboratory

  • virulence, type of testing, location, time, needs (diagnostic vs specialised testing)

    For each type of sample, know:

  • Collection protocol

  • Documentation, labeling requirements l

  • What to include (patient, outbreak information, tracking system)

  • Appropriate bio-safety packaging and transportation requirements (UN)


4 identify key laboratory investigations for selected syndromes and or suspected pathogens

4. Identify key laboratory investigations for selected syndromes and/or suspected pathogens

  • Understand advantages and disadvantages of key microbiological methods

  • Understand basic immunology principles

  • Understand use of microbiological techniques as epidemiologic tools :

    • Time frame for antigen/pathogen detection

    • Windows for antibody detection

    • Time required to obtain results

    • Cost, sensitivity, specificity and limitations


5 identify when and which typing methods should be used

5. Identify when and which typing methods should be used

  • Identify typing methods that can:

    • Confirm the existence of an outbreak (e.g. when epidemiological methods are insufficient)

    • Identify the cause of disease (e.g. environmental reservoir)

    • Describe the phylogeny of pathogen


6 identify the need for and use of antimicrobial susceptibility testing

6. Identify the need for, and use of, antimicrobial susceptibility testing

  • Understand anti-microbial resistance and implications for antibiotic use

  • Understand when to ask for antibiotic resistance patterns

  • Understand the need for laboratory-based surveillance for antibiotic resistance

  • Interpret antimicrobial resistance results in a public health context


7 identify the role of the laboratory for public health surveillance

7. Identify the role of the laboratory for public health surveillance

  • Understand the principles of laboratory-based surveillance

  • Understand how the laboratory contributes to surveillance


8 understand the role of laboratory quality assurance

8. Understand the role of laboratory quality assurance

  • Think critically about laboratory quality assurance

  • Think critically about laboratory methods

    • Ensure that the corresponding laboratory has the highest possible level of quality assurance


9 interpret laboratory test results sensitivity specificity and causality criteria

9. Interpret laboratory test results: sensitivity, specificity and causality criteria

  • Understand sensitivity, specificity and causality criteria

  • Interpret laboratory results according to:

    • Sensitivity and specificity

    • Context

    • Incidence/prevalence of the disease

    • Host-pathogen relationship


Content of the module

Content of the Module

  • Lectures

  • Case studies

  • Communication exercise


Lectures

Lectures

  • Sampling strategies

  • Specimen management

  • Laboratory techniques

  • Microbiology

  • Immunology

  • Quality assurance

  • Interpretation


Facilitated case studies

Facilitated case studies

  • General aspects of collaboration with the laboratory

    • Communication

    • Sampling strategy

    • Specimen management

    • Interpretation of the results

  • Management of an outbreak where the pathogen may be unknown


Communication exercise

Communication exercise

  • Johari windows technique

    • Understand each other’s perspective when epidemiologists work with laboratory specialists


Strengthening laboratory and epidemiology collaboration

Developed by the Department of Epidemic and Pandemic Alert and Response of the World Health Organization with the assistance from:European Programme for Intervention Epidemiology Training Canadian Field Epidemiology Program Thailand Ministry of Health Institut Pasteur

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