28/01/2022
KNH Laboratories: A critical look at what is on offer By Kilivwa Mukaya Transplant Immunology Laboratory This is the ‘new kid on the block’. The establishment of this laboratory has been received with jubilation from our clients who no longer depend on foreign laboratories for HLA tissue typing services. The laboratory opened its door to patients on December 14, 2021. Among the tests that are readily available includes; HLA-A, B, C, DR, DQ, DP, Class I&II Antibody, Class I ID Antibody Detection, Class II IDv2 Antibody Detection, Donor Specific Antibody Detection, Single Antigen Class I Detection, Single Antigen Class II Detection, Single Antigen MIC Antibody Detection, and Complement Dependent Cytotoxicity. We aim to play among the best as we continue to offer efficient and effective histocompatibility and Immunogenetics services. Of utmost importance is the intended plan to enroll the laboratory in the American Society of Histocompatibility and Immunogenetics (ASHI) accreditation program to maintain high standards of operation. Clinical Chemistry Laboratory It is also known as chemical pathology, clinical biochemistry or medical biochemistry Lab is generally
PHOTO | COURTESY LUMINEX fluoroanalyzer machine for HLA tissue typing Olympus microscope for Complement Dependent Cytotoxicity
concerned with the analysis of body fluids for diagnostic and therapeutic purposes. Our clinical Chemistry laboratory is highly automated to accommodate the high workload typical of a level 6 hospital laboratory. Tests performed are closely monitored and quality controlled. Like all our other laboratories, we participate in the External Quality Control program. We handle a large array of tests which can be categorized into sub-specialties of: General chemistry tests are commonly ordered blood chemistries such as liver and kidney function tests. Immunochemistry tests encompass clinical endocrinology, such as; Fertility hormones, Thyroid function tests, and tumor markers (EG CA 125, CEA, AFP) Vitamins and anemia testing (vitamin D, Vitamin B12 Ferritin). Clinical Toxicology assays involve studies of drugs-of-abuse screening such as; marijuana, cocaine, methaphetamines, tricyclic antidepressants(TCA), among others. Therapeutic involves measurement of therapeutic medication levels to optimize dosage (Tacrolimus, Sirolimus, Cyclosporine). Urine and body fluids chemistry involves chemical analysis of urine, body fluids such as CSF, and effusions. Dynamic tests include body challenge tests such as glucose
PHOTO | COURTESY Olympus microscope for Complement Dependent Cytotoxicity
ISSUE 1 | Kenyatta National Hospital Newsline
tolerance testing. The laboratory can handle further, special immunology tests such as; TORCHES (Toxoplasmosis IgG/IgM, Rubella virus IgG/IgM, Cytomegalovirus IgG/IgM, Herpes simplex I$II virus IgG/IgM, Epstein barr virus IgG/IgM, Syphilis) Procalcitonin, Anti-nuclear antibodies, Anti-CCP. The laboratory is set to expand the test menu in line with demand and technological advancement. Newly installed state-of-the-art clinical Chemistry machine that is proving to be a game-changer in a service delivery machine installed in a clinical chemistry laboratory. Microbiology Laboratory This is the laboratory where isolation and characterization of microorganisms causing infections are performed. This has two important functions. The first is clinical - everyday management of infections. The second is epidemiological - knowledge of an infective microbe in a patient which can lead to finding its source and route of transmission. This allows staff to stop infections from spreading. Furthermore, the microbiology laboratory interprets microbiology data for clinicians and Infection Prevention and Control professionals, thus participating in Health Care Workers education. The microbiology laboratory also participates in the development of an institution’s antibiotic policy. Most Hospital Acquired Infections (HAIs) are caused by bacteria and fungi that can be more antibioticresistant than community-acquired pathogens or their susceptibility to antibiotics is less predictable. Etiological diagnosis of HAIs is therefore exceptionally important for targeted antimicrobial chemotherapy. Our microbiology laboratory has become more important in clinical medicine and the prevention of HAIs, especially as new or antibioticresistant pathogens emerge and new diagnostic technologies are developed.
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