TB Infection Control
request for assistance
Dear all
It's Lesley Odendal, the MSF IC coordinator at the community based DR TB
Project. I forward this email of behalf of my colleagues.
MSF-Belgium wants to go for TLA in Malawi (a faster and cheaper technique
for TB culture) and we have a new building that we can use as the lab. I
just would like to ask you from your point of view what would be the minimal
requirements for a TB culture lab in terms of feasibility.
Minimally, we would install Biosafety cabinets for smear preparation and
culture and we have big windows that will be sealed but there will be a lot
of light. SAS also is important for the flow of the lab.
I am not sure about the following:
UV lights can be an option but I am not sure if this is feasible (costs,
maintenance). I also think that the height of the ceiling is an issue, I am
not quite sure but there must be certain height?
Negative pressure is to fancy and costly but maybe we can use instead a fan
extractor? Or whirlybirds? Do they work?
I would appreciate a lot your help on this!
Best regards,
Emmanuel
Grace Egos, MSPH
Dear Lesley,
I'd like to ask a few more questions :
1. What is the budget? Is it enough to build a BSL3 facility and save for a maintenance? Putting up a BSL3 in my experience does not need to be that sophisticated. We can work for an improvised one. It does not have to be the whole lab. Extractor fans may work but this will not be the first choice and provided it is in the right location (and should be away from the populated area )
2. What is the area of the laboratory in square meters?
3. What methods are being used for culture? Is it the simple technique or do you plan to use liquid culture?
4. What is the anticipated workload? How many sputum samples will be processed in this lab?
5. Do you have a floor plan? Normally we wanted the arrangement to be from clean to dirty (unidirectional). Not all rooms have to be negative pressure, etc.
Thanks, Grace
*Grace E. Egos, MSPH*
*Laboratory Manager*
*Tropical Disease Foundation*
*Phil. Institute of Tuberculosis*
*Amorsolo cor Urban Avenue*
*Legaspi Village Makati City*
*Philippines, 1229*
10:39 AM, 5 Apr 2009 | Permalink
Paul A. Jensen, PhD, PE, CIH
Dear Lesley:
I have a comment and few questions to add to Grace's!
Laboratory biosafety level (facility, equipment/primary barriers, and work practices/procedures) are based on risk, both the microorganism and the process(es) conducted.
5. What other procedures will be performed in this lab? What other lab facilities are co-located?
6. TLA has a few different preparation procedures. Will you follow the same procedures MSF used in Kenya? Treat and concentrate sputa in the lab? Provide sputum cups with decontamination solution? How will sputum specimens be handled & stored before they get to the lab?
7. Based on the above, you will determine which aspects of BSL2 and BSL3 will be needed. Note that some items (e.g., autoclave) required for BSL2 and BSL3 may be shared.
After reviewing all this new information, we can start making some recommendations!
References:
WHO 2004 Laboratory Safety Manual (http://www.who.int/csr/resources/publications/biosafety/Biosafety7.pdf). Of particular interest, see Table 3. Summary of biosafety level requirements.
CDC/NIH 2007 Biosafety in Microbiological and Biomedical Laboratories (http://www.cdc.gov/OD/ohs/biosfty/bmbl5/BMBL_5th_Edition.pdf). Of particular interest, see Table I. Summary of recommended biosafety levels for infectious ...
4:52 PM, 5 Apr 2009 | Permalink
Lesley Odendal
Dear Paul and everyone
thanks so much for all the input. As I am not working on this project directly, I am ccing in my colleague Emmanuel who sent me the request. I trust he will be in touch later today
many thanks
Lesley
1:09 AM, 6 Apr 2009 | Permalink