The Laboratory Research Division drives RITM’s excellence in the laboratory research and development, training and reference laboratory services for infectious diseases. The RITM Laboratory Research Division (LRD) boasts of technical expertise in the laboratory diagnosis and characterization of infectious agents in the country. Competent lead researchers, well-equipped facilities and highly-proficient laboratory staff ably support the Division. The LRD houses several National Reference laboratories and World Health Organization (WHO) recognized laboratories. These lead centers are tasked with performing laboratory research, surveillance and reference laboratory confirmatory testing to monitor for disease occurrence and spread, and responding rapidly to outbreaks and pandemics. Furthermore, LRD shares these technologies and expertise by conducting training workshops and providing technical assistance to other laboratories. LRD also provide quality assurance programs to help ensure the quality of testing for laboratories.
The Microbiology Department is divided into 3 components namely: laboratory services, training, and research. The laboratory is composed of trained and highly capable staff to perform bacteriological examinations such as culture isolation and identification of bacterial pathogens including serotyping and antimicrobial susceptibility test and molecular assays as well. The Department also houses the 3 National Reference Laboratories (NRL) as per Department Order No. 393 namely: Bacterial Enteric Diseases, Emerging and Reemerging Bacterial Diseases, and Mycology. The function of these laboratories is to provide referral services such as confirmatory testing, surveillance, training and research, and evaluation of test kits and reagents.
Through the Department of Health Administrative Order 2007-0027: Revised Rules and Regulations Governing the Licensure and Regulation of Clinical Laboratories in the Philippines and Department Memorandum No. 2009-0086: Implementation of External Quality Assessment Program as a Regulatory Requirement for Licensing of Clinical Laboratories, the Department of Microbiology is conducting the National External Quality Assessment Scheme for Bacteriology, Parasitology, and Mycobacteriology which caters to all tertiary laboratories nationwide. The Scheme or Program was created to monitor and evaluate laboratory capabilities in identification and susceptibility testing of clinically important pathogens through proficiency testing; ensure that the quality of microbiological examination is improved and maintained; identify frequent laboratory errors guiding laboratories in corrective action to remedy identified deficiencies; update laboratory staff on the microbiological advancements and good laboratory practices; create inter-laboratory standardization and supporting accreditation; and provide health administrators and regulatory agencies insights on the status of the bacteriology, parasitology and mycobacteriology laboratories nationwide.
The Pathology Department is composed of four sections: the Clinical Laboratory, Histopathology, Electronmicroscopy, and the Transfusion Transmissible Infections-NRL (TTI-NRL). The Clinical Laboratory is the central clearing section where all the specimens from within and outside RITM are received. These specimens are then brought to the different laboratories for testing. Laboratory results from these laboratories are then forwarded to the Clinical Laboratory for release. The four sections function independently and simultaneously, each with its own laboratory facility and personnel. The department collaborates and provides support services to other departments and study groups of the Institution in their research activities. The TTI-NRL is the confirmatory laboratory for the National Voluntary Blood Services Program (NVBSP) of the Department of Health (DOH) that provides confirmatory testing of reactive blood donor samples and blood units/products for transfusion transmitted infections. As the National Reference Laboratory, it performs the following functions: confirms blood donors and blood units reactive for Hepatitis B surface Antigen (HbsAg), Hepatitis C virus (HCV), Human Immuno Deficiency Virus 1 and 2 (HIV 1&2), syphilis and Malaria among Blood Service Facilities (BSFs); provide Quality Assurance by conducting External Quality Assurance Schemes (EQAS) to BSFs and identify areas for improvement on technical procedures and kit performance; provide recommendations and strategies to ensure safety of blood supply; provide technical training to NVBSP-BSFs Medical Technologists on testing for TTIs; evaluate test performance primarily for kits used among NVBSP-BSFs; and conduct research to provide data to refine or improve the quality testing among NVBSP-BSFs.
The Department of Parasitology provides routine and confirmatory diagnostic services in medical parasitology to the Institute’s in- and out-patients, and to referred patients from both public and private hospitals and clinics. It handles the parasitology training for the Institute’s clinician-fellows on infectious diseases and medical technologist-externs. It also regularly offers short intensive training courses on diagnostic parasitology and malaria for medical technologists. Current research activities of the Department include diagnostic, epidemiological and clinical studies on malaria, paragonimiasis, and filariasis. The Department is a designated National Reference Laboratory for Malaria and Other Parasites and a World Health Organization (WHO) Collaborating Centre for Malaria Diagnosis.
The Department of Virology of the Research Institute of Tropical Medicine (RITM) serves as the National Reference Laboratory for Poliomyelitis and other Enteroviruses, Measles and other Exanthems, Dengue, Japanese Encephalitis and other Arboviruses, and Influenza and other Respiratory Viruses, as mandated by the Department of Health. It is in charge of laboratory surveillance and routine diagnostics of viral diseases of significant public health importance. The Department collaborates with local, regional and international organizations such as the Department of Health, National Epidemiology Center, National Center for Disease Control and Prevention-Expanded Programme on Immunization, World Health Organization and US Centers for Disease Control in terms of service, training, and research.
Antimicrobial Resistance Surveillance Reference Laboratory
The Antimicrobial Resistance Surveillance Reference Laboratory (ARSRL) is the coordinating laboratory for DOH Antimicrobial Resistance Surveillance Program (ARSP). ARSP is a laboratory-based surveillance program established in 1988 currently with 24 sentinel hospitals nationwide with the objective of providing critical inputs to DOH’s effort to promote rational antibiotic use by determining the current status, and developing trends of antimicrobial resistance of selected bacteria to specific antimicrobials.
As the coordinating laboratory for ARSP, ARSRL utilizes standard methods for culture and antimicrobial susceptibility testing, as well as phenotypic and genotypic subtyping methods to detect presence of antimicrobial resistance among aerobic bacteria. Surveillance data is managed through WHONET and summary reports generated annually are provided to stakeholders.
The Immunology Department performs following functions: conduct collaborative researches utilizing tools in immunology, molecular biology and epidemiology; provide expertise and technical assistance in basic immunological and molecular procedures; and provide diagnostic services for schistosomiasis and hepatitis and other services utilizing immunological procedures. The hybridoma and general immunology laboratory functions as a core research and development facility for the production of monoclonal antibodies for the development of immune-diagnostic assays and vaccine development for infectious diseases.
National TB Reference Laboratory (NTRL)
NTRL is one of the reference laboratories of the RITM and at the same time, serves as the laboratory arm of the National TB Program (NTP).
Basically, the principal role of NTRL is embodied into administrative orders (AO) issued by DOH. Both of these AOs provide among others that NTRL shall lead in the implementation of the quality assurance system on direct sputum smear microscopy (DSSM) and the Programmatic Management of Drug Resistant TB (PMDT), and overall management of the TB Laboratory Network in the country.
The following are the functions of NTRL: develop policies, technical guidelines and standards that are in consonance with existing NTP policies; provide technical assistance and supervision to all TB laboratories in the network; perform diagnostic tests such as Acid Fast Bacilli (AFB) sputum microscopy examination, cultures and drug susceptibility test, rapid diagnostic tests such as GenXpert and LPA; conduct training on quality assurance, and all TB diagnostic tests; monitor, supervise and evaluate the nation-wide implementation of Quality Assurance System, and all PMDT culture and Drug Susceptibility Testing (DST) centers; conduct operational research related to TB laboratory service; and ensure biosafety of TB laboratories in the network.
The department is primarily involved in the conduct of basic and applied researches on vectors of mosquito-borne infectious diseases such as malaria, dengue, filariasis, and Japanese encephalitis. This includes field and laboratory studies on vector mosquito biodiversity and density, as well as insecticide resistance monitoring activities for the assessment of implemented vector control measures. It also conducts entomological investigations in relation to outbreak of mosquito-borne diseases.
Molecular Biology Department
The Molecular Biology Laboratory (MBL) is a core facility under the Laboratory Research Division which provides expertise on the use of molecular biology tools for research on and diagnosis of pathogens of public health importance. The main functions of MBL include research and surveillance, development of molecular diagnostics, rapid outbreak response, and training and proficiency testing.
Veterinary Research Department
The Veterinary Research Department (VRD) was established in 1985. It has been engaged in the conduct of diagnostic and research involving zoonotic diseases like rabies and ebola. Much of what has been achieved in rabies research in the country can be attributed to the effort of the department (Special Pathogens Laboratory Section) and rabies research group.
Aside from the conduct of research, the department has an animal facility, and its annex at Bay Laguna continues to breed and maintain pathogen-free laboratory animals for the different diagnostic and biological product evaluation requirements such as pyrogen, safety, potency, skin reactivity tests, and blood collection. The annex facility maintains horses and serpentarium currently used in antivenom production.
In addition, the department initialized the physical identification of snakes that have bitten patients, either seen at RITM or at the nearby health clinics. Intensive training for taxonomic identification of snakes is currently done to fully equip the VRD staff for accurate and rapid identification of venomous and non-venomous shakes.