The Disease Division is responsible for providing the analytical and laboratory diagnostic services in the prevention of communicable and non-communicable diseases as well as outbreak control in the Ministry of Health, Malaysia.
The Disease Division also actively involved in screening and surveillance programs to support the programs conducted by the Ministry of Health, Malaysia.
In addition, the Disease Division also serves as a training center for laboratory personals throughout Malaysia, a method development center, involved in laboratory quality assurance and research.
The Disease Division consists of 6 sections, which are:
- Virology Section
- Bacteriology Section
- TB & Leprosy Section
- Parasitology & Mycology Section
- Biochemistry Section
- Entomology Section
1. Virology Section
The Virology Section is divided into four units based on their test methodologies, which are:
- Virus Isolation Unit
- Molecular Unit
- Serology Unit
- Electron Microscopy Unit
The Virology Section is equipped with an Enhanced Biosafety Level 3 Laboratory.
The functions of the Virology Section include:
1.To provide laboratory services for pathogen identification and characterization for outbreak investigation and control activities.
2.To provide laboratory services for the identification and characterization of pathogens to support laboratory surveillance programs as follows:
- Measles Elimination Program (MEP)
- Influenza Like Illness Surveillance (ILI)
- Dengue Virus Serotype Surveillance (DVSS)
- Hand, Foot & Mouth Disease Surveillance (HFMD)
- National Japanese Encephalitis Surveillance (JE)
- Flavivirus Surveillance
3. To provide laboratory services for the identification and characterization of high-end pathogens.
4. To provide reference reagents and to set standards for accurate and cost effective laboratory tests.
5. To develop and provide services related to quality assurance activities.
6. To develop diagnostic methods for detection and characterization of pathogens.
7. To implement a quality management system to fulfill the requirements of MS ISO 15189.
8. To act as WHO reference laboratory for Measles & Rubella and Japanese Encephalitis.
9. To act as a National Reference Laboratory for Measles & Rubella, Japanese Encephalitis, Dengue and Influenza.
On Site Review of WHO for National Elimination Measles/Rubella Programme
2. Bacteriology Section
The Bacteriology Section is divided into three units based on the syndromic approach, namely
i. Food and Water Borne Diseases Unit
ii. Respiratory Unit
iii. Zoonotic and Environment Unit
The functions of the Bacteriology Unit include:
i. To provide laboratory services for pathogen identification (enteric, respiratory, blood etc.) from clinical and environmental samples for outbreak investigation and control activities.
ii. To design and carry out laboratory surveillance programs for certain pathogens, for example, Leptospira surveillance.
iii. To conduct genotyping, Multilocus Sequence Typing (MLST) and other appropriate tests for the use of molecular epidemiology such as Vibrio cholerae and Corynebacterium diphteriae.
iv. To develop and carry out quality assurance services for certain pathogens such as EQA Syphilis.
v. To design and provide technical trainings to strengthen the competency of the laboratory personals from the Public Health Laboratories, Ministry of Health or other agencies.
3. TB and Leprosy Section
The TB and Leprosy Section was established in the year 2011. This section is divided into two units, namely the National TB Reference Laboratory and the Leprosy Unit.
A. National TB Reference Laboratory
The National TB Reference Laboratory started its services since the year 2000 and was known as the Tropical Laboratory, NPHL. In April 2003, NPHL officially took over the role of the National TB Reference Laboratory from the Institute for Medical Research (IMR). With this development, the National TB Reference Laboratory experience a revolution in its laboratory services. Until now, this laboratory has developed in par with the needs and improved laboratory services to strengthen the role of the laboratory in the control and prevention of tuberculosis in Malaysia. This development is also in line with the development of the latest diagnostic tests as recommended by the WHO such as MDR-TB.
The functions of the National TB Reference Laboratory include:
i. To provide laboratory services for TB, non-tuberculous mycobacterium (NTM) for case investigation activities and surveillance programs.
ii. To provide TB and NTM Reference Laboratory services.
iii. To develop TB and NTM diagnostic methods according to current development.
iv. To develop and implement EQA services as an EQA Provider.
v. To provide comprehensive training to strengthen the competency of the technical officers and monitor the effectiveness of the training.
vi. To organize a visit to the facilities of Ministry of Health for laboratory quality monitoring under the TB Program. vii. To monitor the laboratory quality implementation based on the established standards.
viii. To compile and analyze laboratory data for the National TB Reference Laboratory and Non-Tuberculosis Laboratory. ix. To conduct the vaccine potency test.
x. To implement a quality management system to meet the MS ISO 15189, ISO 17043, National Reference Laboratory and WHO accreditation requirements.
B. Leprosy Unit
The National Public Health Laboratory took over the activities of the Leprosy Laboratory from the National Leprosy Control Center (NLCC) in the year 2008. However, the operational location of this laboratory is still maintained at the original site which is at NLCC.
Among the main functions of this unit are:
i. To provide laboratory diagnostic services for confirmation and detection of leprosy.
ii. To conduct skin-slit smear slide quality control program.
iii.To conduct national surveillance for antibiotic resistance in leprosy treatment.
iv. To provide comprehensive training to strengthen the competency of the technical officers and monitor the effectiveness of the training.
4. Parasitology and Mycology Section
The Parasitology Laboratory started its service in NPHL in the year 2008. Initially, this service was carried out by the Vector Borne Disease Branch Headquarters in Putrajaya which was later taken over by NPHL due to the need for complete resources.
NPHL was directed by the Director of the Disease Control Division to take over the tasks of the Malaria Laboratory and directed it to become Malaria Reference Laboratory and also to prepare before the Malaria Elimination Program which started in 2009. The Parasitology Section consists of three units namely, EQA & Panel Testing Unit, Special Diagnostic Unit and Microscopic Training Unit. Among the functions and services offered in the Parasitology and Mycology Section are:
EQA & PANEL TESTING UNIT
- Prepare EQA user guide manual and create slide bank for EQA-Panel Testing at national level.
- Supply EQA-Panel Testing Slides for malaria to the State Vector Laboratory and Public Health Laboratory at the national level.
- Monitor the quality and competency of malaria microscopist at the Ministry of Health.
SPECIAL DIAGNOSTIC UNIT
- Provide advisory services and act as a reference laboratory for related outbreaks.
- Prepare and offer relevant screening tests for controlling outbreaks and surveillance activities.
- Develop relevant tests including molecular tests to assist outbreak control activities and surveillance programs.
- Provide competent human resources in preparation for the field trip to help relevant outbreak cases.
- Planning and providing inputs to create Public Health Programs, such as Anti-Malaria Drug Resistance Surveillance, P. knowlesi surveillance among PATI or foreign workers in rubber or palm oil plantations and intestinal parasite surveillance among psychiatric patients in government hospitals.
MICROSCOPY TRAINING UNIT
- Coordinate malaria microscopic training organized by WHO or other agencies.
- Coordinate and provide microscopy training modules for malaria at the Ministry of Health.
- Coordinate and provide training for trainers for malaria at the Public Health Laboratories
- Offer short-term courses and attachment in malaria microscopy at local and international level.
Field Trip to Tawau for blood sample collection to prepare BFMP for malaria microscopic training and EQA PT slide preparation.
EQA PT Malaria slide preparation
Malaria microscopy revision training at Pahang in 2022
Malaria microscopy revision training at JKWPKL in 2022
WHO External Competency Assessment (September 2022) at Kompleks Kesihatan Bandar Botanik, Klang
Gambar:WHO External Competency Assessment (12 - 16 Feb 2018) at Makmal Botanik, Klang
5. Biochemistry Section
The biochemistry section provides tests for outbreaks, surveillance and specialized diagnostics for non-communicable diseases. There are three laboratories under the Biochemistry Section, namely Tar and Nicotine Laboratory, Biochemistry Laboratory and Heavy Metal Laboratory.
The services offered in the Biochemistry Section include:
i. The cigar monitoring program under the Control of Tobacco Product Regulations 2004, Food Act 1983.
ii. Congenital Hypothyroidism Screening Program
iii. Iodine Deficiency Disorder Monitoring Program
iv. Occupational Health and Screening Program
v. Coordinator for the EQAS Clinical Chemistry program in Health Clinics throughout Malaysia.
The tests offered in the Biochemistry Section are:
- Thyroid Function Test (TSH/FT4)
- Clinical Chemistry Test (Glucose, Liver Function, Renal Function, Lipid Profile, Cholinesterase, ISE, Calcium and Phosphate)
- Iodine Urine Test
- Heavy Metal Test (Mercury)
- Full Blood Count (FBC) Test
- Tar, Nicotine and Carbon monoxide content test in cigarettes
6. Entomology Section
The Entomology Section began operating in 2012 at the NPHL for the purpose of surveillance of mosquito resistance to insecticide (IR). Monitoring or surveillance of vector resistance to insecticides is one of the basic tasks in vector surveillance activities.
There are total of four staffs in this section, that is, two Scientific Officers (Entomology) and two Medical Laboratory Technologists. The Entomology Laboratory and Insectarium operates from two cabins that are equipped with various laboratory equipment, taking into consideration the safety features.
The functions of The Entomology Section include:
- To produce and supply various insect colonies in the insectarium for laboratory testing and diagnostics.
- To supply specimens or insects to outside agencies for laboratory study and research purposes for a fee.
- To colonize the susceptible insects for the purpose of insecticide base line testing and insecticide testing.
- To carry out resistance tests to insects and pests.
- To create an archive on various species of insects of public health interest for local and international reference.
- To conduct molecular testing for virus/ parasite/ filaria on mosquitoes.
- To monitor and update information related to vectors and pathogens at national and regional levels.
- To create a network and information sharing related to critical vector borne disease outbreaks in the national and regional levels.