The Department of Epidemiological Surveillance and Prevention carries out the following work in connection with its responsibilities.
Epidemiological investigation of the infection
For this purpose, a repeat blood sample of the patient is taken by the epidemiologist for further examination, and if a positive result is obtained, this gives grounds to consider the possibility of a higher risk of HIV infection. In another test system, a blood sample is tested for the third time and a positive result is taken for the fourth or final time to confirm the presence of antibodies to HIV by immunoblotting.
Confirmation of HIV infection is made by the decision of the Expert Council on the basis of laboratory, epidemiological and clinical data on the basis of the presentation of the relevant structures of the Center.
Conducting epidemiological research (preparation of research document)
When the second examination of a citizen gives a positive result, an epidemiologist conducts an epidemiological investigation of the infection. The source of infection is sought, and if the result is another individual, an epidural is performed around him. In some cases, more than one source can be identified as a result of research.
Obtaining a warning letter from an HIV-infected person (preparation of a document)
In addition to the drafting of the epidemiological investigation document, the citizen is issued a warrant of criminal liability for knowingly infecting others with HIV, and both documents are kept in his medical records and at the same time separately.
Obtaining informed consent for examination and treatment
Antiretroviral therapy is initiated with the informed consent of the patient in order to involve him in the treatment program as soon as possible. After receiving the decision of the Citizen Expert Council and the registration code based on it, the Department of Epidemiological Surveillance and Prevention submits the patient’s medical records to the Department of Dispensary Surveillance and Outpatient Treatment. It should be noted that during all examinations, surveys and future treatment procedures, the citizen participates only voluntarily. It is inadmissible to involve him in the medical process by any force.
Search for evaders
From the process of detecting HIV patients to confirming their diagnosis and providing medical care, along with escort and research activities, epidemiologists are working to find those who have stopped the procedure and spread it consciously, to treat them at any stage, and to strengthen their commitment to it.
Incorrect diagnosis, examination of incorrectly recorded blood samples
In practice, the epidemiologist investigates the cases that have occurred and may occur as a result of incorrect marking of blood samples for any reason, identifies the culprits, determines the degree of responsibility and monitors the mandatory measurement.
Conducting exploratory epidemiological surveillance research
The Department of Epidemiological Surveillance and Prevention conducts periodic (usually every 2 years) reconnaissance epidemiological surveillance surveys to verify the accuracy of the indicators and the effectiveness of the control methods used, and the results are evaluated as leading criteria in choosing the right control areas. Although these studies have a huge work potential and time, they play an invaluable role in planning and forecasting.
Awareness in the field of prevention
The Department of Epidemiological Surveillance and Prevention organizes mass awareness and examination campaigns. Dissemination of comprehensive knowledge on HIV control among educational institutions and senior students, preparation of propaganda and advocacy materials are also included in the activities of this department.
Areas of activity of the department include scientific-practical conferences, training courses, maintaining contacts with the media, watching meetings organized by other countries to participate, sending scientific articles and theses to them.
Establishing and maintaining business relationships
International organizations, non-governmental organizations operating in the country, coordination of their activities related to HIV and participation in joint activities are in the field of prevention activities of the department.
Organizational and methodological work
The department of organizational and methodical work operates in the following areas of work:
Organizes the activities of structural units.
Monitors compliance with the rules adopted in the performance of activities and duties.
Participates in the analysis of key performance indicators and makes recommendations as a result.
Makes proposals on the organization of research and implementation of ways to increase the level of activity of structural units.
Provides methodological assistance to medical institutions in the fight against HIV.
The center’s laboratory is located on the third floor of the main building of the enterprise and consists of 7 examination boxes:
Box for registration of prepared blood samples and preparation for examinations;
Serological boxing – boxing where serological tests are performed (HIV screening, arbitration and immunoblot testing);
Hepatitis and opportunistic infections screening box;
Box of biochemical and general clinical examinations (general, biochemical, morphology of blood and urine and feces);
Bacteriology box;
Immunology box;
The box, which consists of 4 rooms, is divided into 2 parts for molecular genetic tests and determination of resistance.
Box for registration and preparation of samples for examination
All blood samples are entered into the laboratory and registered after registration in the reception department of the Center. According to the order of the Ministry of Health No. 29 of 2011, blood samples are sent to the Center for screening from medical institutions located in 5 districts of Baku (Garadagh, Binagadi, Yasamal, Sabail, Nasimi). Blood samples from regional laboratories and a number of other authorized laboratories are also included to confirm a positive result. In the laboratory’s admission box, blood samples are separated into components and sent to the appropriate boxes.
Serological examination box
Serological tests are performed in accordance with WHO recommendations. Since 2011, HIV screening and arbitration tests have been performed on Abbott’s Architect device. The tests performed on this device are based on the chemoluminescent method.
Hemoluminescent examination has a higher sensitivity and specificity. Sensitivity – 100 percent, Specificity -> 99.5 percent and a small number of “false positive” results.
Screening examinations are also performed by IFA method. In order to meet the needs of citizens for the first time, conducting tests with test systems of two companies (Biorad and Russia’s DS-IFA-HIV) ensures the accuracy of the results.
During the screening test, blood samples that test positive by IFA are tested in Phase II in 2-3 other different test systems. If the result is negative, the sample is considered negative. Samples with a positive result are tested in Phase 3 using a confirmatory Immunobloting (PU) method. HIV antigens (proteins) are determined by immunoblotting (PU), which is essentially a type of IFA. In conducting these examinations, the Central Laboratory develops two types of test systems (INNO-LIA HIV1 / 2 Score and BioRad New LAV Blot produced by FUJIREBIG). Based on the positive results of these examinations, individuals are permanently registered in the Council of Experts. During 9 months of 2021, 61,592 examinations were conducted, of which 522 people were registered on the basis of positive results.
Hepatitis and opportunistic infections screening box
Blood samples of persons registered at the dispensary in accordance with the rules and requirements of the national protocol are tested for the presence of HbsAg, anti-HCV, Lues, CMV, HSV, Toxoplasma.
These tests are performed serologically with IFA test systems. 870 Hbsag for 9 months of 2021 (23 positive); HCV 869 (123 positive); opportunistic infections 1484 (395 positive).
Box of biochemical and general clinical examinations
Blood samples sent from the dispensary and inpatient departments of the Center are examined in the biochemical and general clinical box. General clinical examination of blood samples entering the laboratory is carried out on a hematological analyzer “Sysmex XP-300”. During the first 5 months of 2021, 3,093 such examinations were conducted.
All biochemical tests are performed on the Cormay MULTI PLUS analyzer. (ALAT, ASAT, Creatinine, Bilirubin, Amylase, Cholesterol, Triglycerides, LDH, Glucose, ALP indicators). The device works in a semi-automatic and open system mode. During the first 9 months of 2021, 10077 examinations were conducted.
Immunology box
In immunological boxing, the immune status of HIV-infected patients is checked on 2 BD Fax Calibur Axis cytometers. As a result of this examination, patients are identified for ARV therapy. During 5 months of 2021, 3244 examinations were conducted.
Molecular – genetic testing and determination of resistance box
The viral load of patients registered in molecular genetic boxes is determined by PCR. Examinations are performed on a fully automatic Abbott 2000 sp. The device can perform 24, 48 or 96 examinations at a time. In addition, in December 2019, the Global Fund provided a GENE X-Pert device for PCR testing. This device has the ability to perform 16 tests at a time and get results in 90 minutes. In general, 4080 PCR examinations were conducted during 9 months of 2021.
PCR box uses Applied Biosystems genetic analyzer / sequencer 3500 (USA). Classical sequencers use a homogeneous probe for examination. Prior to sequencing, DNA fields are amplified by PCR. As a result, fragments of the same DNA are obtained.