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The National

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The National
HIV and AIDS Registry

Manual of Operations

National Epidemiology Center


Department of Health

DOH Central Library

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11111111 [III [1111111111

01321
H7.45 N385 2006/ The National HIV and AIDS registry

Republic of the Philippines


Department of Health
OFFICE OF THE SECRETARY
2" Floor Bldg. 1 San Lazaro Compound, Rizal Ave., Sta Cruz,
Manila

Foreword
The Department of Health established the National HIV and AIDS Registry in
1987. Since then reported HIV positive cases surged to more than 2,000.
Through all these years, the National Epidemiology Center has been steadfast in
monitoring the country's HIV cases. Reports published every month serve as a
guide in designing effective interventions by program managers.
Submission of reports entails an organized process which involves key players in
HIV and AIDS: the NEC, SACCL, San Lazaro Hospital, RITM, the NVBSP, the
Philippine National Red Cross, Philippine Blood Center, HIV testing laboratories,
NASPCP, DOLE, POEA, OWWA and even the HIV and AIDS Core Team in the
hospitals. This Manual of Operations for the National HIV and AIDS Registry is
carefully written and intended for all health workers dedicated to controlling and
conquering HIV and AIDS. This also contains all the legal mandates related to
the HIV and AIDS Registry.
I wish to acknowledge the committed efforts of the National Epidemiology Center
in bringing quality data necessary for action. I thank all the contributors in this
Manual who helped in identifying gaps in the reporting system and provided
recommendations for improvement. I am also grateful to our International
Partners: the WHO, UNICEF and UNAIDS, who have constantly shared the
vision of the Department of Health.
The Philippines still enjoys a low-level prevalence of HIV and AIDS. But we
should not remain complacent. This Manual of Operations features a detailed
process to follow from the time a client comes in a clinic for testing, the need for
pre- and post-test counseling and the apt referral to a treatment center or
physician for treatment, care and support. With this Manual we aim to set the
standards in bringing an effective continuum of services for all HIV and AIDS
patients.

ACKNOWLEDGEMENT
The Technical Working Group
Aura C. Corpuz, MD, PHSAE, MPH
Dorothy May Agdamag, MD, MSc
Rontgene Solante, MD, FPCP, FPSMID
Rosario Jessica Tactacan-Abrenica, MD, MPH, FPSVI
Rossana Ditangco, MD, FPCP, FPSMID
Jose Gerard Belimac, MD

Danilo Eustaquio, RMT

NHSSS, National Epidemiology Center


SACCl, San Lazaro Hospital
San Lazaro Hospital
AIDS Pavillion, San Lazaro Hospital
Research Inslilute for Tropical Medicine
NASPCP, National Center for Disease
Prevention and Control
Department of labor and Employment
Philippine National Red Cross
Bureau of Health Facilities and Services
Philippine Blood Center
Surveillance Unit, Quezon City Health
Office
Field Epidemiology Training Program
Alumni Foundation, Inc. (FETPAFI)
National Epidemiology Center
SACCl, San Lazaro Hospital
Research Inslilute for Tropical Medicine
NVBSP, National Center for Health
Facilities and Development
Physician's Diagnostic

Allan Ignacio

National Epidemiology Center

Ma. Pureza Fontalera, MD


Ruth Ann Sison, MD
Cynthia Rosuman, MD, MPH
Pedrito Tagayuna, MD
Irene Grafil, MD, PHSAE
Ma. lorela Sunas-Averilla, MD, PHSAE
Noel Palaypayon, RN
Susan leano, RMT
Hazel Galang, RMT
Marites Estrella, RN

Contributors during the Writeshop


Aura C. Corpuz, MD, PHSAE, MPH
Jose Gerard Belimac, MD
Rosario Jessica Tactacan-Abrenica, MD, MPH, FPSVI
Rossana Ditangco, MD, FPCP, FPSMID
Fortunata Baco
Ruth Ann Sison, MD
Marietta Go, RMT
Jessie Fantone, MD, PHSAE
Pedrito Tagayuna, MD
Irene Grafil, MD, PHSAE
Ma. lorela Sunas-Averilla, MD, PHSAE
Joel Atienza, RMT, MPH
Susan leano, RMT
Marites Estrella, RN
leovy Aguila
Noel Palaypayon, RN
Allan Ignacio

NHSSS, National Epidemiology Center


NASPCP, National Center for Disease
Prevention and Control
AIDS Pavillion, San Lazaro Hospital
Research Institute for Tropical Medicine
Department of labor and Employment
Philippine National Red Cross
Bureau of Health Facilities and Services
PNAC Secretariat
Philippine Blood Center
Surveillance Unit, Quezon City Health
Office
Field Epidemiology Training Program
Alumni Foundation, Inc. (FETPAFI)
NASPCP, National Center for Disease
Prevention and Control
SACCl, San Lazaro Hospital
NVBSP, National Center for Health
Facilities and Development
OWWA
National Epidemiology Center
National Epidemiology Center

ACKNOWLDEGEMENT
Other Contributors
Ricardo Mateo, MD, PHSAE
Guada Villanueva, MD, FPOGS
Janice Campos-Caoli, MD, FPSMID
Elizabeth Telan, MD
Dr. Rolando Villote, MD
Lina Roxas, MPH
Adelfa Espantaleon, RMT
Joseph Cario Sangco, RMT
Felicitas Marlano
Corazon Orlizo

Family Health International


Philippine General Hospital
Tropical Disease Foundation
SACCl, San Lazaro Hospital
AMCOW
Tropical Disease Foundation
SACCl, San Lazaro Hospital
SACCl, San Lazaro Hospital
Bureau of Healih Facilities and Services
Philippine Overseas Employment Agency

The Advisory Body


Enrique A. Tayag, MD, PHSAE, FPSMID

Director IV, National Epidemiology Center


National Epidemiology Center

Agnes Benegas-Segarra, MD, PHSAE

Medical Officer VII, Surveys, Risk Assessment


and Evaluation Division, National Epidemiology
Center

The External Experts


Aye Aye Mon, MD
Mariyn Borromeo, MD
Nerissa Dominguez, MD, MPH
Nguyen Thuy, MD, MSc

UNICEF
UNAIDS
WHO-Country Office
WHO-WPRO

The Secretariat
Fe Sinson, MA in Math
lea Mylene Rebanal
Joel Jacob

Surveys, Risk Assessment and Evaluation


Division, National Epidemiology Center
Surveys, Risk Assessment and Evaluation
Division, National Epidemiology Center
Field Epidemiology Training Program Alumni
Foundation, Inc. (FETPAFI)

The National Epidemiology Center (NEC) wishes to give special thanks to UNICEF,
WHO and UNAIDS for their technical support and generous contribution to the
development of this manual. NEC also acknowledges FETPAFI for rendering its
technical expertise and administrative assistance in this endeavor. Finally, NEC extends
its gratitude to the clients of Physician's Diagnostic who voluntarily participated in the
pre-testing of the new HIV Registry forms, to all the accredited HIV testing centers in
Cebu, Davao, Manila, Pasayand Quezon Cities and their respective CHDs (C. Visayas,
S. Mindanao and NCR) for their unsolicited support dUring the pilot testing of the
protocol.

TABLE OF CONTENTS
I.

The National Epidemiology Center


Historical Background
AIDSWATCH
The HIV/AIDS Registry

07

II.

Data Collection
How the HIV/AIDS Registry Works
The HIV/AIDS Registry Forms
DOH-NEC Form A
DOH-NEC Form B

09

III.

HIV/AIDS Case Reporting Protocol


in Hospitals with HACT

........................................................... 18

IV.

Blood Donors

V.

HIV Testing and Counseling

VI.

Laboratory Section

VII.

Bureau of Health Facilities and Services

VIII.

Addendum

ANNEXES

15

22
.................................................. 26
30

........................................................... 31

............................................................................. 32

Annex A - Department Circular No. 176 s. 2001


Annex B - Department Circular No. 224 s. 2004
Annex C - HIV/AIDS Registry Information System
Annex D - DOH -NEC Form A
Annex E - List of Accredited HIV Testing Laboratories
Annex F - DOH - NEC Form B
Annex G - Administrative Order No. 18 s. 1995
Annex H - List of HIV Treatment Centers
Annex I - Administrative Order No. 2005 - 0027
Annex J - Administrative Order No. 2005 - 0032
Annex K - Department Order No. 393 - E s. 2000
Annex L - Administrative Order No. 55-A s. 1989
Annex M - Memorandum Circular No. 2006 - 0075

ABBREVIATIONS
AIDS
AMCOW
ARV
BHFS
BSF
CHD
DOH
DOLE-OSHC
EQAS
HACT
HIV
NASPCP
NCDPC
NEC
NHSSS
NRL
NVBSP
OFW

01
OWWA
PA
PBC
PDOS
PEOS
PMTCT
PNAC
PNRC
POEA
RITM
SACCL
SLH
STI

rns

UNAIDS
UNICEF
VCCT
VNRBD
WB
WHO
WHO-WPRO

Acquired Immunodeficiency Syndrome


Association of Medieal Center Overseas Workers
Antiretroviral
Bureau of Health Facilities and Services
Blood Service Facility
Center for Health Development
Department of Health
Department of Labor and Employment-Occupational
Safety Health Center
External Quality Assurance
HIV/AIDS Core Team
Human Immunodeficiency Virus
National AIDS/STI Prevention and Control Program
National Center for Disease Prevention and Control
National Epidemiology Center
National HIV/AIDS Sentinel Surveillance System
National Reference Laboratory
National Voluntary Blood Services Program
Overseas Filipino Workers
Opportunistic Infection
Overseas Workers and Welfare Administration
Particle Agglutination
Philippine Blood Center
Pre-Deployment Orientation Seminar
Pre-Employment Orientation Seminar
Prevention of Mother-to-Child Transmission
Philippine National AIDS Council
Philippine National Red Cross
Philippine Overseas Employment Agency
Research Institute for Tropical Medicine
STD/AIDS Cooperative Central Laboratory
San Lazaro Hospital
Sexually Transmitted Infection
Transfusion Transmitted Infections
Joint United Nations Programme on HIV/AIDS
United Nations Children's Emergency Fund
Voluntary Confidential Counseling and Testing
Voluntary Non-remunerated Blood Donor
Western Blot
World Health Organization
World Health Organization-Western Pacific Regional Office

I.

The National Epidemiology Center (the HIV/AIDS Registrar)

Historical Background:
When the first AIDS case was reported in the Philippines in 1984, the
Department of Health declared HIV/AIDS a notifiable disease in 1986. The
following year, the HIV/AIDS Registry was institutionalized in the Department of
Health under the Health Intelligence Service Office. The goals of the Registry
were to log all confirmed HIV positive cases, analyze their profile and monitor the
progression of the disease.
However, the system encountered limitations namely the delayed reporting
and under reporting. To address this gap, the National HIV/AIDS Sentinel
Surveillance System (NHSSS) was established in the same office of the
Department of Health in 1993, under the AIDS Surveillance and Education
Project (ASEP) of the USAID with technical support from the World Health
Organization. The NHSSS initiated the active serologic surveillance, to serve as
warning signal of an impending HIV epidemic. To complement the serologic
surveillance, another active surveillance, the behavioral surveillance system was
established in 1997 to monitor the behavior that put people at risk for HIV.
The passage of Republic Act 8504 otherwise known as the Philippine
AIDS Prevention and Control Act of 1998 ushered in the establishment of a
comprehensive HIV/AIDS monitoring program or AIDSWATCH in the Department
of Health. Upon the effectivity of the Implementing Rules and Regulations (IRR)
of RA 8504, AIDSWATCH integrated unto itself the NHSSS and the AIDS
Registry (section 38, rule 6, IRR, RA 8504).
In 2000, with the reorganization of the Department of Health, the Health
Intelligence Service (HIS) and the Field Epidemiology Training Program (FETP)
were lumped into one Center, the National Epidemiology Center. The Center
gave birth to three divisions: Applied Public Health where FETP lodges, the
Public Health Surveillance and the Surveys, Risk Assessment and Evaluation,
where the AIDSWATCH lodges.

AIDSWATCH

This is a comprehensive HIV/AIDS monitoring program which aims to


determine and monitor the magnitude and progression of HIV infection in the
Philippines and to evaluate the adequacy and efficacy of countermeasures being
employed. The monitoring role shall be performed through the passive
surveillance (HIV/AIDS Registry) and the active surveillance (NHSSS).

HIV/AIDS-related health reports shall be received, collated, evaluated and


disseminated by AIDSWA TCH. Epidemiological data shall be made available
always to various stakeholders and the public (section 39, rule 6, IRR, RA 8504).

The National HIV and AIDS Registry


This is the official record of the number of HIV positive and AIDS cases
and deaths confirmed by the two National Reference Laboratories (NRL):
STD/AIDS Cooperative Central Laboratory (SACCL) for patients and by the
Research Institute for Tropical Medicine (RITM) for blood units.
All reactive blood samples from accredited clinics, hospitals and
laboratories are sent to SACCL or RITM for confirmation. Reports of all confirmed
HIV positive cases will be sent monthly to the National Epidemiology Center for
analysis, publication through the National HIV and AIDS Registry and posting at
the NEC website.
The Registry is backed up by legal mandates: Republic Act 3573 (Law of
Reporting of Communicable Diseases) mandates all attending physicians to
report all diagnosed HIV infection to the AIDS Registrar of the Department of
Health and to submit written report at the time of any of the three events: (1) time
of diagnosis; (2) progression to AIDS; and (3) death. Department Circular 325-B
series 1997 lists HIV/AIDS as one of the notifiable or reportable diseases. The list
of notifiable or reportable diseases was revised through the Department Circular
176 series 2001 (ANNEX A) which specified submission of all reactive samples
from screening to SACCL for confirmation. It was also embodied in the Circular
that attending physicians should transmit the HIV Case Reporting form directly to
NEC once progression to AIDS or death is noted within five working days
following the event. This was amended by Department Circular 224 series 2004
(ANNEX B) which clarified the roles of SACCL and RITM as NRL and the
reporting of all Western Blot confirmed HIV positive cases to NEC.

Evolution of the Registry

The Department of Health remains steadfast in monitoring the HIV


situation in the country. The NHSSS has evolved into what is known as the
second generation surveillance wherein magnitude of HIV infection is determined
not only by serologic sentinel surveillance but also the correlation of behavioral
surveillance, STI surveillance and estimates of the high risk groups. On the other
hand, NEC has also seen the need for the Registry to evolve because of the
advent of the National Monitoring and Evaluation initiated by the UNAIDS and the
projection estimates by WHO. A technical working group was convened in May
2006 to revisit the system, identify the gaps, recommend solutions, revise
reporting forms and develop a feasible working protocol.
The revised system factored in pre and post test counseling as essential
feature before a case is reported in the monthly HIV and AIDS Registry. Other
changes were the adoption of the WHO age grouping, the inclusion of adult and
pediatric anti-retroviral therapy and treatment of opportunistic infection, salient
information on prevention of mother-to-child transmission (PMTCT) and
information on being orphaned.
The new registry also featured a new database where all the new
variables will be inputted (ANNEX C).

II.

Data Collection

A. How the HIVIAIDS Registry Works

Presentation of Person for HIV Antibody Testing (Fig. 1)


In an OFW Clinic:

Filipinos who are applying for work abroad are referred by their respective
recruiting or manning agencies to accredited OFW clinics for medical clearance.
History taking and physical examination are done prior to blood extraction. In
countries where HIV antibody testing are required, he or she undergoes pre-test
counseling, signs a written informed consent and fills out the NEC-DOH Form A
(Personal Information Sheet) [ANNEX OJ.

In Other HIV Accredited Testing Centers:

A person may access an HIV accredited testing center (clinic, hospital,


laboratory) [ANNEX E] for several reasons: (1) for voluntary testing; (2) referral
by a physician; (3) for immigration; (4) legal purpose; (5) others. Prior to blood
extraction, he/she will be given a pre-test counseling by a trained counselor,
signs a written informed consent and asked to fill out the NEC-DOH Form A
(Personal Information Sheet).

Blood Extraction
The person proceeds to the blood extraction room for HIV antibody testing.
The HIV proficient medical technologist checks the completeness of the NECDOH Form A and signs the written informed consent. He or she shall see to it
that the written informed consent has also been signed by the person prior to
affixing his/her signature. The pathologist on duty shall also countersign the
consent.
The medical technologist will enter the person's code in a logbook and
assigns a laboratory code. He or she shall label the test tube with the said
laboratory code. Upon extraction, advice will be given regarding the date of return
for the result. A result claim card or receipt will be given to the person, whose
blood was extracted, indicating the date of extraction, the laboratory code, and
the date of return and the name of the medical technologist. The person will then
be advised to present the result claim card or receipt on the date of return
specified.

Referral to the National Reference Laboratory


All reactive blood samples will be sent to the National Reference
Laboratory for confirmation. The blood sample has to be accompanied by a
referral form and a copy of the NEC-DOH Form A with the signed written
informed consent. The medical technologist checks the completeness of the
referral form and whether the label of the specimen tallies with the laboratory
code in the referral form. Any discrepancy will be criteria for rejection of the
specimen.
If a reactive blood sample belongs to an already dead person highly
suspected for HIV/AIDS, the NRL may receive the specimen for confirmation
provided that the NRL referral form accompanies the specimen and duly
endorsed by the medical doctor who has attended the patient prior to his/her
death.

Release of Result
Release of result of HIV/AIDS testing shall be confidential. Upon
confirmation by the NRL, result will be sealed in an envelope and released
accordingly:
a.
b.

c.
d.

e.

by mail if request was done through mail by a referring accredited


HIV testing center
personally to a walk-in person who requested for the HIV
antibody testing or to his/her guardian if minor, orphan, mentally
incapacitated
personally to a duly authorized representative of the accredited
HIV testing center
personally to a duly authorized representative of a Judge of the
Lower Court! Justice of the Court of Appeals/ Supreme Court
Justice
by mail if request was done by mail of a Judge of the Lower
Court! Justice of the Court of Appeals/ Supreme Court Justice

If confirmatory test result is positive, a blank NEC-DOH Form B


(Physician's Case Reporting Form) [ANNEX F] will accompany the said
confirmatory test result. Likewise, the NRL will also copy furnish the NEC with the
patient's positive confirmatory test result and the NEC-DOH Form A.
At the referring accredited HIV testing center, result will be released only
to the person himself/herself, tested for HIV, the guardian if the requesting party
is minor or mentally incapacitated/judge/duly representative of a Judge of the
Lower Court! Justice of the Court of Appeals/ Supreme Court Justice. No
manning agency or any other person than specified above can be furnished with
the result. Doing so would mean violation of RA 8504 and entails a corresponding
sanction.

10

r
Post Test Counseling. Treatment, Care and Support
Post test support and services are crucial. The results of HIV testing
should always be offered to the person being tested, along with appropriate posttest information, counseling, and referral to care, support and treatment.
If the referring hospital has a HIV/AIDS Gore Team (HAGT) [ANNEX GJ,
post test counseling will be done by any member of HAGT and assessment of
patient will be done by the medical doctor. HAGT ensures that proper
management will be given to the patient. The NEG-DOH Form B will be filled out
and signed by the physician and sent to NEG within five working days upon
receipt of the result.
If the referring hospital, clinic, laboratory has no HAGT, any trained
counselor on HIV/AIDS shall do the post test counseling and the in-house
medical doctor qualified to do the assessment of HIV patient shall do the initial
assessment and fills out the NEG-DOH Form B. The referring hospital, clinic,
laboratory is responsible to submit the completed and signed NEG-DOH Form B
to NEG. The hospital, clinic, laboratory or medical doctor shall then ensure that
the patient is referred to treatment hub for clinical management and psychosocial support (ANNEX H).

Option for a Private Attending Physician


Patients who are referred by their private attending physicians may opt to
be seen and managed by the latter. The hospital, clinic or laboratory where HIV
antibody test is done will still ensure that post test counseling is given prior to
discharge of the patient with the confirmatory test result. The attending physician
will then be responsible to fill out and sign the NEG-DOH Form B and to submit to
NEG. He or she may also have the option to manage the patient personally or
refer to an HIV treatment hub.

11

Fig. 1

Flow Chart for Accredited HIV Testing Centers

Walk-in request!
consultationl
referral
Fills out Personal
Information Sheet
(DOH-NEC Form A)

Disagree

r-------,
Advise to
come back
if with risk
factors

Refer to VCCT)-----oi

Refer to attending
physician or HACT for
Post-test counseling &
Physician's assessment

Agree
Screening

Sends Personal Information


Sheet wi Confirmatory Result to
referring testing
laboratories/attending physicia

Care & Support &


Treatment

"Fills out Physician's HIV


Case Reporting Fonn &
submits to -NEC

Yes

Yes

Yes

Positive
Test?

Confirmation

No

ubmits Personal LInfonnation Sheet &


-SACCL Referral
fonn to SACCL

-'

Release result to
attending physician or
"**HACT for post test
counseling of diem
Submits to HIV Registry when there Is follow up, conversion to AIDS or death
--HACT-HIVIAIDS Core Team

No

Sends Personal
Information sheet
wi Confirmatory
Result to NEC

HIV
Registry

Release result to attending


physicianiHACT for post test
counseling of dient

"""'VCCT.Voluntary Confidential Counseling & Testing

"'if walk In client In SACCL, refer clients dlrectty to Inhouse HACT


****SACCL-5TDIAIDS Central Cooperative Laboratory
--NEe-National Epidemiology Center

B. The HIV/AIDS Registry Forms


DOHNEe Form A (Personal Information Sheet) (ANNEX D)

The DOH-NEC Form A (Personal Information Sheet) is a client's record


containing his/her demographic data, the reason for subjectinq himself for HIV
testing, employment history, travel history, risk factors, information received in the
testing facility where he/she will be tested and other sources of information.
The DOH-NEC Form A is a self-administered form. However, for clients
below 18 years old/who are mentally incapacitated, a guardian may fill out the
form on behalf of the client. Prior to filling out the form, an informed consent
found at the back of DOH-NEC Form A has to be signed by the client upon full
understanding of the content of the consent form and willingness to proceed with
the test. In cases where clients are minor/mentally incapacitated, the guardian
should have full understanding of why the test is being done, what a positive or a
negative test would mean, what are the services available. In the latter case,
informed consent will have to be thumb marked by the client should both parties
/guardian agreed on proceeding with the HIV testing.
If the HIV testing center allows for a one-on-one pre-test counseling, then
the client will be ushered in to the counselor who reinforces the provisions stated
in the informed consent. If the HIV testing center allows only for a group
information, the clients will be ushered in a room where the group can avail of the
said service.
Only after signing the informed consent will the client proceed to filling out
the front side of the DOH-NEC Form A. The filled out form will be handed to the
medical technologist who will then extract the client's blood. After checking the
completeness of the form, including the signature/ thumb mark, the medical
technologist will then sign the informed consent for countersigning by the
pathologist-on-duty.

Reactive/Indeterminate Result
A copy of the DOH-NEC Form A will accompany the NRL referral form and
specimen in sending the latter to the NRL for confirmation.

Positive Confirmatory Test Result


The NRL will also send a copy of the DOH-NEC Form A to NEC together
with a copy of the HIV confirmatory test result for encoding in the HIV/AIDS
Registry database. A copy of the said form will accompany the confirmatory test
result form and will be sealed in an envelope.

13

DOH-NEC Form B (Physician's HIV/AIDS Case Reporting Form) (ANNEX F)


Physicians are mandated to report to NEC confirmed HIV positive patients
in the following instances:
a)
b)
c)
d)

initial diagnosis of patient


follow-up
conversion from HIV to AIDS
death

DOH-NEC Form B contains the patient's demographics, type of report,


date of referral and the name of referring facility, WHO classification, probable
mode of transmission, whether born to an HIV infected mother/parents, orphaned
by HIV positive parentis, if on PMTCT (for pregnant women), feeding practice of
a two year old child, whether the patient has started or is currently on
ARV/prophylaxis.

Initial Diagnosis of Patient


After post-test counseling of the patient, he/she has to be assessed by a
physician. The physician has to fill out the DOH-NEC Form B for submission to
NEC within five working days upon receipt of the result. The WHO Classification
is found at the back of the said form where the physician has to encircle signs
and symptoms manifested by patient. He/she then proceeds to the completion of
the said form.
Upon completion, he/she affixes his/her signature, the name of the facility
and the date the patient was assessed.

Follow-Up
Should there be changes in the patient's record like placing him/her on
ARV/prophylaxis/PMTCT (for pregnant women), a follow-up report should be
done to NEC. A new DOH-NEC Form B has to be filled out and sent to NEC
within five working days upon assessment.

Conversion from HIV to AIDS


Once conversion from HIV to AIDS is confirmed by the attending physician,
a new DOH-NEC Form B has to be filled out and submitted to NEC within five
working days upon confirmation of the status.
Death
Death of an AIDS patient has to be reported by the physician to NEC
within five working days after the patient's demise. DOH-NEC Form B has to be
filled out and submitted to NEC.

14

III.

HIV/AIDS Case Reporting Protocol for Hospitals with HIVIAIDS


Core Team (ANNEX G)

The approach to management of patients with HIV/AIDS in the hospital


settings is no different from what is required for other diseases. Components of
good practice such as professionalism, respect for patient's privacy and access
to continuum of care and universal precaution must be observed at all times
regardless on the overwhelming adverse medical and psychosocial
consequences once these good practices are abandoned. HIV/AIDS is a wakeup call for all health care workers to go back to the basics of standard medical
care.
More frequently, however, due to fear of being discriminated, patients with
risks for HIV do not know how and where to access the needed services. Several
undertakings are endeavored by the DOH to address these problems.
Continuous capacity-building for the clinical management of HIV/AIDS for HACTs
are undertaken. More recently, a more comprehensive approach to prevention,
treatment and care for HIV/AIDS was adapted by the DOH through the Voluntary
Counseling and Testing (VCT).
Several HACTs and Social Hygiene Clinics staffs in the country were
trained on VCT. To uphold the IRR of RA 8504, pre-test counseling should be
given to clients prior to testing. HIV testing should be purely voluntary and
confidential.
Clients may access the services of VCT especially in hospitals with HACT
either as:

Client initiated
Provider initiated

A. For Patients at the OPDlWalk-in


Patients consulting at the OPD or ER may not know or may not reveal
their HIV antibody status. OPD/ER clerks nurses, interns or attending
physicians may collect general data of patients. At the hospital setting,
initial clues to consider possibility of HIV infection include:

Having multiple sex partners


Unprotected sex (without) with a person having multiple sex partner
History of Sexually Transmitted Infections
Presence of clinical conditions suggestive of HIV infection in the
absence of the causes of immune deficiency
Sharing injecting needles/equipments
Children born to HIV positive mothers

Counseling prior to HIV testing is important because of the profound


psycho-social impact of HIV antibody positive diagnosis.

15

Counseling is recommended:

By a trained counselor
In a place conducive for counseling
Emphasis on confidentiality

All hospital personnel with whom the patient may interact for the conduct
of HIV testing (social worker, laboratory personnel, billing and cashier
personnel) should act professionally to ensure confidentiality of the test.
Release of Reactive Result
1. Results should only be released to the client as described in the RA

8504
2. Cross-check clients 10, blood samples and records
3. Clients should be the one to open the results
4. Post-test counseling should be provided to the client with reactive
result
5. For non-reactive results, post-test counseling should consider behavior
change modification and window period implication
6. Serum samples reactive to HIV are automatically sent to the SACCL
for confirmatory testing
For HIV Ab seropositive individuals, intensive post-test counseling should
be done by the counselor and referral to appropriate services if indicated
(Treatment hubs, Support Network) should be emphasized.

HIV/AIDS Case Reporting


The physician should report to the HIV/AIDS Registry at the NEC of
DOH using the DOH-NEC Form B (Physician's Case Reporting Form)
within 5 working days after the release of result.

B. Referred Patients
a. Asymptomatic but HIV status unknown
i. Patients referred to HACT for evaluation and assessment for
possible HIV infection shall be offered with VCT services.
He/she will undergo the same process described in section A.
b. Symptomatic but HIV status unknown
i. Clinical symptoms of patients referred to HACT for
evaluation and assessment for possible HIV infection shall
be addressed first before offering VCT services. If clinical
symptoms are already addressed, the referred clients will
undergo the same process described in section A.

16

c. Asymptomatic and HIV status is known

i. Patients referred to HACT for evaluation and assessment for


HIV infection shall be given post-test counseling by the VCT
counselor of the HACT. In case where referral forms are not
furnished to the receiving hospital and the confirmatory result
from the SACCL or RITM is not available, the receiving
hospital shall request for a confirmatory test prior to reporting
to the AIDS Registry of NEC.

d. Symptomatic and HIV status is known

i. Clinical symptoms of patients positive for HIV antibody shall


be addressed accordingly by the HACT. Hospitals may
set/adapt criteria for admissions where necessary. If referral
forms of patients are not furnished and the confirmatory test
results (Western Blot Result) are not available, confirmatory
test result should be requested from SACCL or RITM prior to
reporting to the AIDS Registry.

e. Clients with No Confirmatory (Western Blot) Result

i.

If no confirmatory test is done at the NRL, client will be given


pre-test counseling and the option to subject himself/herself
to an HIV antibody testing prior to report to the HIV/AIDS
Registry.

17

IV.

Blood Donor

Blood safety is one of the priority issues for prevention of HIV/AIDS. World
Health Assembly 45.35 states that there should be improved measures for the
prevention of HIV due to blood and blood products: by promoting transfusion
services that provide for the screening of all blood donations, counseling and
guidance and other preventive elements.
As a global health policy for blood safety in any country, the World Health
Organization (WHO) requires voluntary blood donation to prevent Transfusion
Transmitted Infections (Dis) to ensure the provision of adequate safe blood in
the country.

Advocacy and Recruitment


Healthy individuals from low risk population should be encouraged to
donate blood at least every three months. Blood donor recruitment should be
centered on humanitarian values. Every voluntary non-remunerated blood
donors should be given the highest regard and respect for performing such a
noble act.
Blood testing especially for HIV/AIDS and other TTls, shall never be used
as an incentive for blood donation. This will only attract individuals who suspect
themselves of being infected, thereby, increasing the likelihood of collecting
infected blood from donors within the window period. Persons who go to blood
collecting units for this purpose shall not be accepted and donors shall instead be
referred to VCCT.
Process of blood donation (Fig. 2)
Donor Selection

The voluntary non-remunerated blood donor (VNRBD) fills out the Donor
Data sheet as a self-screening tool for risk factors. The donor may self defer
based on this. If the donor finds no reason for self-deferral he would undergo
Donor screening by qualified blood bank staff. The donor must be assured that
information concerning his medical and social history shall be treated as highly
confidential and shall not be discussed even with his relatives and friends. Donor
interview and physical examination must be done in an area, which ensures
visual and auditory privacy. The importance and epidemiological significance of
donor recall shall be emphasized, ensuring that it will not discourage future blood
donations.
If risk factors are present blood donation shall be deferred. If one of these
factors is HIV/AIDS related, the blood donor shall be referred to VCCT. In the
absence of these risk factors the blood donor shall be advised that in the event

18

that the donated blood is found positive for TTls, especially HIV, he shall be
recalled for repeat testing, confirmatory tests, and referral if necessary.
If the donor qualifies, he/she must sign a donor medical declaration form,
which is witnessed and signed by the interviewer. This medical declaration form
shall include consent for HIV Testing and recall.

Blood Donor Screening and B/ood Collection


The donor shall be screened for adequate hemoglobin level (~12.5 mg/dl).
Blood collection from venipuncture shall be done subsequently.

Testing of Collected Blood Units


All blood units collected shall be tested for TTls. In the case of HIV, AntiHIV 1 & 2 shall be tested using at least 2 nd generation Enzyme Immunoassay
(EIA) and Particle Agglutination (PA). Initial reactive results warrant a repeat
testing. Repeatedly reactive blood units, i.e. done twice, are pulled out from the
pool of collected blood and blood sample shall be sent to RITM for confirmation
(Department Circular 224s. 2004) [ANNEX B]. The Blood Service Facility (BSF)
shall submit Donor Data Sheet and RITM Referral form to RITM.

Donor recall

Confirmed HIV Positive Test Results

A. Submission to NEC for HIV registry:


RITM shall submit the Donor Data Sheet and Confirmatory results of
seropositive blood donors to NEC to be included in the blood unit database of the
HIV Registry. He/she will not be included in the Registry as a case until the said
donor receives post-test counseling from RITM/BSF/HACT and the DOH-NEC
Form A has been received by NEC.

B. Donor Recall by Blood Service Facility (BSF):


The BSF shall notify the Medical Director/Chief of the nearest government
hospital where the donor lives for the required counseling and clinical care. The
health care facility staff or AIDS surveillance unit shall contact the donor, perform
any necessary confirmatory or additional test and manage or refer the patient
accordingly based on the confirmatory test results (Manual of Standards).
If the blood donor returns to BSF he/she undergoes post test counseling and
fills out the DOH-NEC Form A (Personal Information Sheet). He/she will be
assessed by the physician for possible treatment, care and support.

19

The physician fills out the Physicians HIV case reporting form (DOH-NEG
Form B) and submits to NEG together with the DOH-NEG Form A and
confirmatory test result within five working days upon receipt of the confirmatory
test result.

Negative Test Results


It is a good opportunity to thank and motivate them for regular donation.
The other purpose is to reinforce their knowledge and motivation to keep them
healthy and avoid getting infected with blood borne diseases. These measures
are ways of expressing appreciation and concern and strengthening rapport
between the donor and the blood bank (Manual of Standards for blood bank and
blood centers).

20

Fig. 2 Flow Chart of Blood Donors at the BSF

Walk-In
Donor
p",.

Fills out Donor


Interview Sheet

donation
Information

Risk
Factors
Present

Donor Recall

Prevention
Reinforced

IV

Refer 10 -VCCT

Fills out
Personal
Information
Sheel & refer
lo-HACT

No
Sends
Confirmatory
Result to referring

Blood
Donation &
Screening

Refer to
HACT for
Post-test
counseling &
Physician's
Assessment

-Fills out
Physician's
HIVCase
Reporting
Form and
SUbmits to
-NEC

Yes

-BSF

Post-donatlon
Counseling

~-"---

Yes

Yes
Reactive

Confirmation

Positive?
Submits Donor Interview
Sheet and Confirmatory

Submits -RITM
Referral form 10 RITM

No

Care.
Support &
Treatment

HIV

Registry

Resurt
(Blood Unit Infonnatton)

Release result
to referring
Enters pool of
healthy donors

BSF

"Refer to NEG when there is fo(low up, conversion to AIDS or death -*RITM-Research Institute for Tropical Medicine --*HACT HIV/AIDS Core Team
-VCCT-Voluntary Confidential Counseling & Testing

*-*BSF-Blood Services Facility

---NEC-National Epidemiology Center

V.

HIV Testing and Counseling

HIV Testing and counseling services are a gateway to HIV prevention, care
and treatment. The benefits of knowledge of HIV status can be seen at the
individual, community and population levels. They include the following:

For the individual - enhanced ability to reduce the risk of acquiring


or transmitting HIV; access to HIV care, treatment and support; and
protection of unborn infants
For the community - a wider knowledge of HIV status and its links to
interventions can lead to a reduction in denial, stigma and
discrimination and to collective responsibility and action
At the population level - knowledge of HIV epidemiological trends
can influence the policy environment, normalize HIV/AIDS and
reduce stigma and discrimination

Voluntary Counseling and Testing (VCT)


The acronym VCT (voluntary counseling and testing) is widely used in
reference to HIV testing and counseling services. It covers a variety of
interventions in different service settings:
1. Testing and counseling in clinical treatment settings, where sick people
are being offered HIV testing that may possibly aid their clinical
diagnosis and management. This process of offering testing and
counseling - with the option of "opting out" of testing - is the standard of
care in tuberculosis treatment, and hospital/medical in-patient and outpatient services diagnostic;
2. Testing and counseling in services for antenatal care for prevention of
mother-to-child transmission, and in STI clinics and targeted
interventions for vulnerable and marginalized populations, including
MSM, sex workers and injecting drug users routine offer; and
3. Voluntary testing and counseling services for people who are
asymptomatic and wish to learn their status client initiated
VCT in the traditional sense is simply one approach to ethical HIV testing and
counseling procedures that should be expanded and radically scaled up to meet
the urgent requirement for greater access to ARV treatment and prevention.

22

Ensuring Rights Based Approach


The voluntariness of testing must remain at the heart of the HIV policies and
programmes, both to comply with human rights principles and to ensure
sustained public health benefits.
The following factors, which are mutually reinforcing, should be addressed
simultaneously:
1. ensuring an ethical process for conducting the testing, including defining
the purpose of the test and benefits to the individuals being tested; and
assurances of linkages between the site where the test is conducted
and relevant treatment, care and other services, in an environment that
guarantees confidentiality of all medical information
2. addressing the implications of a positive test result, including nondiscrimination and access to sustainable treatment and care for people
who test positive;
3. reducing the HIV/AIDS stigma and discrimination at all levels, notably
within health care settings;
4. ensuring a supportive legal and policy framework within which the
response is scaled up, including safeguarding human rights of people
seeking services; and
5. ensuring that the healthcare infrastructure is adequate to address the
above issues and that there are sufficient trained staff in the face of
increased demand for testing, treatment and related services

UNAIDSIWHO Policy Statement on HIV Testing


The current reach of HIV testing services remains poor, even in settings in
which VCT is routinely offered. The reality is that stigma and discrimination
continue to stop people from having an HIV test. The conditions under which
people undergo HIV testing must be anchored in a human rights approach which
protects their human rights and pays due respect to ethical principles.
The conditions of the 3 C's, advocated since the HIV test became available in
1985, continue to be underpinning principles for the conduct of HIV testing of
individuals. Such testing of individuals must be:
-

confidential
be accompanied by counseling and
only be accompanied with informed consent, meaning that it is both
informed and voluntary

In many low and middle income countries, the primary model for HIV testing has
been the provision of client-initiated voluntary counseling and testing services.
Increasing, provider-initiated approaches in clinical settings are being promoted,
i.e., health care providers routinely initiating an offer of HIV testing and
counseling in which the provision of, or referral to, effective prevention and
treatment services is assured.

23

Four Types of HIV Testing


Voluntary Counseling and Testing - client-initiated HIV testing remains critical to
the effectiveness of HIV prevention. Pre-test counseling may be provided either
on an individual basis or in group settings with individual follow-up with a posttest
counseling session for both HIV-negative and HIV-positive individuals.
Diagnostic HIV testing is indicated whenever a person shows signs or symptoms
that are consistent with HIV-related disease or AIDS to aid clinical diagnosis and
management.
Routine offer of HIV testing by health care providers (a.k.a. provider-initiated)
should be made to all patients being:
-

assessed in a sexually transmitted infection clinic or elsewhere for a


sexually transmitted infection to facilitate tailored counseling based on
knowledge of HIV status
seen in the context of pregnancy to facilitate offer of anti-retroviral
prevention of mother-to-child transmission
seen in clinical and community based health service settings where HIV
is prevalent and anti-retroviral treatment is available (injecting drug use
treatment services, hospital emergencies, internal medicine hospital
wards, consultations, etc) but who are asymptomatic

Explicit mechanisms are necessary in provider-initiated HIV testing to promote


referral to post test counseling services emphasizing prevention, for all those
being tested, and to medical and psychosocial support, for those testing positive.
The basic conditions of confidentiality, consent and counseling apply but the
standard pre-test counseling used in VCT services is adapted to simply ensure
informed consent, without a full education and counseling session. The minimum
amount of information that patients require in order to be able to provide informed
consent is the following:
-

the clinical benefit and the prevention benefits of testing


the right to refuse
the follow up services that will be offered

in the event of a positive test result, the importance of anticipating the


need to inform anyone at ongoing risk who would otherwise not suspect
they were being exposed to HIV infection (a.k.a. disclosure)
For provider-initiated testing, whether for purposes of diagnosis, offer of
antiretroviral prevention of mother-to-child transmission or encouragement to
learn HIV status, patients retain the right to refuse testing, i.e., to 'opt out' of a
systematic offer of testing.

24

Mandatory HIV Screening


UNAIDSIWHO support mandatory screening for HIV and other blood borne
viruses of all blood that is destined for transfusion or for manufacture of blood
products. Mandatory screening of donors is required prior to all procedures
involving transfer of bodily fluids or body parts, such as artificial insemination,
corneal grafts and organ transplant.
UNAIDSIWHO do not support mandatory testing of individuals on public health
grounds. Voluntary testing is more likely to result in behavior change to avoid
transmitting HIV to other individuals. Recognizing that many countries require
HIV testing for immigration purposes on a mandatory basis and that some
countries conduct mandatory testing for pre-recruitment and periodic medical
assessment of military personnel for the purposes of establishing fitness,
UNAIDSIWHO recommend that such testing be conducted only when
accompanied by counseling for both HIV-positive and HIV-negative individuals
and referral to medical and psychosocial services for those who receive a
positive test result.

25

VI.

LABORATORY SECTION

Antibody Screening test

RA 8504, AO NO.2005-0027 (ANNEX I) states that only licensed or


accredited clinical laboratories and/or blood centers are allowed to operate an
HIV testing center and shall have a licensed Medical technologist with training on
HIV Proficiency testing.
The most widely used screening tests for the diagnosis of HIV are EIAs as
they are the most appropriate for screening large numbers of specimens on a
daily basis. A variety of simple, instrument free rapid tests are also now available
which are more suitable for use in testing and counseling centers and
laboratories that have limited facilities and process low numbers of specimens
daily.
Testing centers should use only HIV test kits evaluated and recommended
by NRL-SACCL-SLH, which have been registered by BFAD with a valid
Certificate of Product Registration (CPR). BFAD shall issue a list of registered
kits to BHFS for dissemination. BHFS shall monitor testing laboratories on the
use of unregistered kits. Violations by the testing center will be given sanction by
BHFS, while violations by the manufacturer/distributor will be sanctioned by
BFAD.
Prior to testing, all patients must undergo pretest counseling, fill-up the
Personal Information Sheet (DOH-NEC Form A) and sign an informed consent
form. Testing laboratories should follow the testing algorithm as recommended by
NRL. All reactive samples tested from patients shall be referred for confirmatory
testing to NRL-SACCL-SLH. Reactive blood units shall be referred for
confirmatory testing to NRL-RITM NVBSP. Reactive samples should be sent to
NRLs within 72 hours after testing by the screening laboratories.

Fig 3- Testing Algorithm for Screening Laboratories


anti-HIV Screening test (EIA or Rapid)
~

It
Nonreactive

Re~ort

Inconclusive/Gray zone/Reactive
Repeat in duptcate or use another test format

~-

J+

R~fer for confirtatOry testing

Retort

(SACCL-patient; RITM-blood
Units)

26

Confirmatory testing

All reactive samples/blood units should be referred to designated NRLs


together with corresponding (DOH-NEC Form A) and referral form properly filledout. In cases of rejection of sample by NRL due to insufficient sample, lipemia or
hemolysis, the patient will be required to provide a new blood sample for testing.
The present testing algorithm (Fig. 4) will be used. This algorithm can be modified
after a thorough consultation and review of technical and other related issues
regarding HIV testing.
NRL will test referred reactive samples using a highly sensitive combined HIV
Y. Ab-Ag assay and a more specific antibody assay. If both test results are
negative, results will be released as negative to anti-HIV within/after a week.
Discordant or both positive screening results will be subjected to confirmatory
testing. Due to budqet constraint, testing is done in batches twice a month (every
15t h and 30 th) . Cut off date for receiving referred reactive samples will be one
week before the running date. Confirmatory results and Physician's HIV/AIDS
Case Reporting (DOH-NEC Form B) will be released to the patienU
guardian/referring agency one day after testing. DOH-NEC Form B should be
filled out and submitted to NEC by the attending physician within five working
days upon receipt of the confirmatory test result. A copy of confirmatory result
and corresponding DOH-NEC Form A will also be submitted to NEC by NRL.

Fig 4- Testing algorithm for Referred Reactive Samples (Confirmatory)

Testing Algorithm (Referred reactive samples)

--..

EIA Ag-Ab/Rapid(PA)

Both NR

..

Discordant

Reiortas
Negative to anti-HIV

Both method (R)

.>

-.
WB/IFAlLIA

/~~

Report
Indeterminate
Negative (repeat after 3-6mos)
to anti-HIV

27

Report
Positive
to antiHIV

Why do SACCL Re-screen Referred Reactive Samples?

Table 1. Result of the Screening and Confirmation Tests Done, 20012004


(Basis for shifting to the new system)
Initial Result
(Referral)

(- )

(+)
(+)
(+)

Action of
referring
laboratory
Release as
neqative
Re-test;
Refer
Re-test;
Refer
Re-test;
Refer

SACCL Result
Test 1
Test 2
(EIAAa/Ab (RaDid/PAI

(+)

(+)

(+)

(-)

(-)

(-)

Confirmatory
Test Result
(WB/IFA)

100%

(+)

Indeterminat
e,
Neqative
Negative
100% (-)

Interpretati
on

(+)
Indeterminate or
Neqative
Negative

Based on these findings by SACCL, the rate of false positive results are
50%-60% (private laboratories) and 30%-40% (government laboratories). It must
be noted that an average referral from HIV testing laboratories is around 500 per
year. Analysis of the cost by SACCL showed that if all referred reactive samples
will be confirmed, the Department of Health will be spending around P1.75M
against PO.85M per year if two negative screening tests (repeat screening by
SACCL) will no longer be confirmed.

Delay in the Release of Confirmatory HIV Test Results


The present algorithm requires that referred reactive samples will be rescreened by SACCL before proceeding to Western BlotlIFAlLIA. The running
date of which is on the 15 th and
of the month.

so"

Confirmatory testing is done by SACCL free of charge on the designated


running date provided that all required documents are submitted. Should the
person/HIV testing laboratory wish to have the test done earlier, expenses shall
be shouldered by the requesting party.
Quality Assurance

The laboratory should establish sufficient control over purchased


equipment, supplies, reagents and testing materials to ensure that
laboratory operations are not adversely affected by the inadvertent use of
substandard equipment or supplies.

All laboratories must establish some means to ensure that testing is


operating within control by engaging in intra- and inter laboratory testing

28

programs and implement Guidelines on the Quality Assurance of our HIV


Testing Laboratories stated under the Administrative Order No. 2005-0032
of the DOH (ANNEX J)
~

Adequate, complete records of testing and results of such testing


programs must be documented and retained.

The NRL-SACCUSLH shall conduct a continuing assessment of the


proficiency of clinical laboratories and blood centers performing HIV
testing through participation in EQAS (for a fee). Participation in EQAS will
be a requirement for seeking accreditation to BHFS (ANNEX I).

Personnel involved in testing should have sufficient training to enable them


to generate and report accurate, precise and complete data.

Legal Mandates
~

RA 8504 - confirmatory testing required

RA 7179 - All blood products must be tested for TTl including HIV

DO 393 E s 2000 - Designation of SACCL as Reference Laboratory


(ANNEX K)

Department Circular 224 series 2004 - Delineation of RITM and SACCL


(ANNEX B)

AO 2005 0027 - Rules and Regulation Governing the Regulation of HIV


Testing Laboratories (ANNEX I)

29

VII.

The Bureau of Health Facilities and Services (BHFS)

ROLE OF BHFS WITH REGARD TO THE NATIONAL HIVIAIDS REGISTRY


(OFW MEDICAL CLINICS, HOSPITALS, LABORATORIES)

LICENSING AND ACCREDITA TlON DIVISION:

The Licensing and Accreditation Division of the BHFS regulates or


accredits all HIV testing laboratories. These laboratories may be attached either
to a licensed clinical laboratory or blood banks in all levels of hospitals, OFW
medical clinics or other institutional based and free standing clinical laboratories
and blood banks.
Ocular inspection is being conducted to determine the compliance with the
standards and technical requirements. An odd-even scheme is applied in the
conduct of inspection. The even numbered Centers for Health Development
(CHD) are being inspected based on even number year while the odd numbered
CHDs are being inspected based on the odd number year.
The BHFS conducts initial (new or changes) inspection of all HIV testing
laboratories based on application received. It also conducts renewal of HIV
testing laboratory in levels 3 and 4 hospitals and is synchronized with odd-even
scheme.
The Centers for Health Development also conducts renewal of HIV testing
laboratories except levels 3 and 4 hospitals.
Permission to operate an HIV testing laboratory shall be included in the
License to Operate a Clinical Laboratory or Blood Center. Renewal is being done
annually.
The Licensing and Accreditation division conducts an unannounced onsite monitoring and documents the overall quality of the laboratory set-up. It
issues administrative sanctions, revokes accreditation and closes HIV testing
laboratories found to be non-compliant to the minimum requirements.

A.O. 55-A s. 1989 dated 02 January 1989 Section B (ANNEX LJ and A.O. 20050027 dated 15 August 2005 Section V. No. 4- sub-sections a-d (ANNEX I)

Each HIV testing laboratory shall report monthly the number of tests done,
results and referrals of seroreactive samples in accordance with the format
prescribed by the BRL-DOH. This report shall be accompanied by copies of
invoices and purchase of HIV kits the previous month.

30

VIII.

Addendum

HIV/AIDS Education for Filipinos Going Abroad

Filipinos going abroad, consisting of all overseas Filipino workers (OFWs), as


well as diplomatic, military, trade and labor officials and staff who will be assigned
overseas, shall attend an HIV/AIDS education seminar prior to departure.
For OFWs, the HIV/AIDS education seminar shall be part of the PreEmployment and Pre-Departure Seminars supervised by the DOLE. For the
diplomatic, military, trade and labor officials and staff and their families, the
appropriate agencies shall integrate the HIV/AIDS education into their existing
training programs.
The HIV/AIDS education prototype and the modifications made therein, in
partnership with various agencies and sectors of government and nongovernment organizations, to meet the specific needs of the target audience shall
be used for the seminar and training program. Additional self-learning materials
such as brochures, flyers and or tapes shall be available to each participant
(Section 16, Rule 2, IRR of RA 8504).

Role ofOWWA
OWWA encourages PDOS providers/trainors to strictly follow PDOS
standardized module. It also intensifies discussion of HIV/AIDS prevention in the
Personal Health Care module of PDOS for OFWs and encourages returning
OFWs to undergo voluntary counseling and testing.

31

Acubt Bloody Diarrhea


ADJte dlarmea (three or more bouts of loose stools) with vlslble blood In the stool
Food Poisoning

Previously welllndMdual who develops at least two of any gastrointestinal, neurologic or


generalized slgns and symptoms with onset at least 30 minutes aftel' taking the
Implicated meal (Indudes food poisoning such as 5taphylocoocal, streptococcal and
botulism with Isolation of causaUve organism with laboratory support)
.

Chemical Poisoning
Indudes chemical and pestldde poisonings that are diagnosed with laboratory support

Appendix B
Depertment of Health
National Epidemiology center
San Lazaro Compound SIa. Cruz Manila
Tel. No. 742-39-45 Telefax: 743-60-76 Emall:nh18s0m9lro.n9l.ohor nsc_dohOyaboO.com

HIY/A1DS Cue Reporting Form


The Low on RtpOdlng DIWH (R.A. 35731 requtres physicians to reportall diagnosed HIV InfecUons
(asymptomatic and symptomatic cases) to the AIDS Raglslrer, NlIUonal Epidemiology Center(
Department of H~ItIl. A written reportmust be submitted at the time of any of the following eVlints:
') Urne 01 diagnosis; 2) progre88lon to AIDS; 3) death.
-

Patlanfs Code:
Addre88:
Nationality:

Lab. Code:
-..,.
_
Bll1bdate'
Age:
_
Sex: _ _ CivilStatus..,..-Oocupatlon: _ - - - - - - - - - -

History of Travsl Abl'Olld (for the PIIst 6 veers): ( ) None ( ) Yes


Inclusive Dstn
Where

Hsve vou been tested In other laboratories? ( 1No


Where

ClasslflcsUon:

Puroo..

( 1Yes If ves:
When

Result

() HIY ( ) AIDS

Mode of Transmlnloo'
Sexual Intercourse:
( ) Heterosexual
( ) Homosexual
( ) Bisexual

IV druo use (sha~no needles and svMoesl


Transfusion with contaminated blood
Pe~natal (mather to Infantl
Unknown

Report Type: ( ) InltlaJ () Conversion to AIDS ( ) Death; data 01 death


Yes ()
HIV Related Death: No ()

Date Report: _-=---,,..,--_


Refer~ng AgencylPhysicians signature:
_
AddresslTel No.
. AddltJonallnformation:
------------------------

Annex A
Department Circular No. 176 s. 2001

33

Annex B
Department Circular No. 224 s. 2004

34

li0l'"hlic orlh~ I'J,ilippillCo


n~jlartllle"l of llealth
OFI,'ICE 01" Tim SECIU:1'Alty

..

1-,

~luljju,~ 1. Sao Lataro Compound, Rlzlll Avenue, Slit CiUl, Manila 1003

T.I. ~,,",, 14J.8l01 locals 1125, 1132. Fax ',32) 1431829,7431785, Dlla1 711.95Q2, 711,,~03
(J:>et@l:k~l

gailph

31 May 2004

DEPARTMENT CIRCULAR
No. JJ4
.s, 2004
TO:

ALL CENTER FOR HEALTH DEVELOPMENT


DIRECTORS, PROVINCIAL HEALTH OFFICERS,
CITY HEALTH OFFICERS, MUNICIPAL HEALTH
OFFICERS, CHIEFS OF HOSPITALS, HEADS OF
LABORATORIES, AND BLOOD BANKS

SUBJECT:

Emphasizing
the
Monitoring' System . and
Clarifying the Roles of the STO/AIOS Cooperative
Central Laboratory (SACCL) and the Research
Institute for Tropical Medicine (RITM) in
Confirmatory Testing for HIV/AIOS in the
Philippines

This issuance serves to clarify the monitoring system for HIV/AIDS and the roles
the confirmatory laboratories. play with regards HIV/AIDS testing within this
system.
Pursuant to Article V, Sections 27 and 28 of Republic Act {RA), Number 8504,
otherwise known as "Philippine AIDS Prevention and Control Act of 1998", the
National Epidemiology Center (NEC) of the Department of Health (DOH) shall
serve as AIDSWATCH or the Comprehensive HIV/AIDS Monitoring Program
'mandated to determine and monitor the magnitude and progression of HIV
infection in the country. In pursuit of this, a standardized Case Reporting FOJm
shall be disseminated to concerned institutions for completion upon identification
of HIV-positive individuals on screening (Annex A).
In relation to this, in the 1998 Implementing Rules and Regulations of RA 8504,
the Research Institute of Tropical Medicine (RITM) was mandated to perform
all confirmatory tests related to HIV. In 2001, by virtue of Department Circular
No. 176 s 2001, the mentioned mandate for RITM was modified, In the said
Department Circular, blood specimens reactive to HIV screening tests should be

submitted to the STD/AIDS Cooperative Central Laboratory (SACCL) for


conflrmatory testing.
In order to improve the HIV/AIDS Reporting system and to specifically designate
the roles of SACCL and RITM in confirming screened HIV-positive cases, the
following guidelines are to be followed:
Confirmed HIV and AIDS cases nationwide shall be reported to the NEC in
accordance with the following system (pis. Refer to attached flowchart):
1. All blood samples screened through DOH-accredited hospitals, clinics,
laboratories, and testing centers and subsequently found positive for HIV
shall submit the HIV-reactive samples together with an adequately filled
out Case Reporting Form to the SACCL for confirmation through WesternBlot. The SACCL shall then submit the Case Reporting Forms of
Western-blot confirmed cases to the NEC for recording.
2. All samples of blood products and blood units screened through blood
banks and subsequently found positive for HIV shall submit the HIVreactive samples together with an adequately filled out Case Reporting
Foim to the RITM for confirmation through Western-Blot. RITM shall then
submit the Case Reporting Forms of Western-blot confirmed cases to the
NEC for recording.
3. Individual physicians caring for HIV patients shall submit directly to NEC
the Case Reporting Forms within five working days of the following:
i. new diagnosis of AIDS in an HIV (+) individual
ii. death of an AIDS case.

For information and guidance.

Republic ofthe Philippines


Department of Health

OFHCE OF THE SECRETARY


Building 1. San Lazaro Compollnd. Rlzo' Avon.e. Sra Cruz Manila 1003
Tel. NOS. 743~301 toeals 1125, 113~. Fa>: (li3~1743-1829, 7431780; Dilect 7119502, 711.9503
osec@dah.gov.ph

July 27, 2001


DEPARTMENT CIRCULAR

No.

IT b s 2001
TO:

All Regional Health Directors, Provincial Health Officers, Chiefs of


Hospitals, City Health Officers, Municipal Health
Officers, Laboratories and all others concerned.

SU6JECT:

2001 Revised Ust of Notifiable or

ReportabJ~Diseases

Pursuant to section 3 Act 3S73 otherwise known as the Law of Reporting of Communicable
Diseases, the list of notifiable diseases In the Philippines specified In Department Circular No.
325 - 6 s 1997 dated December 4, 1997 is hereby revised to indude the following:
Notifiable Diseases

ICD No. (10" revision)

A22

Anthrax
Cholera
Diphtheria
Viral Encephalitis
Viral Hepatitis
Leprosy
Leptospirosis
Malaria
Measles
Viral Meningitis
Neonatal Tetanus
Non-neonatal Tetanus
Meningococcal Infection
Paralytic Shellfish Poisoning
Rabies
Typhoid and paratyphoid fever
Whooping cough (Pertussis)

AOO
A36
A83-86
615-17

AJO
A27
650-54

605
A87
A33

AJ5
AJ9
T61.2
A82
A01

AJ7

These diseases have been selected due to their tendency to occur in epidemic
proportion, are targeted for eradication or elimination, or subject to international health
regulation.
Signed

De-

Received in the/REcords
~ )/01
f I

Section on

Because of the changing pattern of Infectious d1sease threats and the possibility of new
emerging and re-emergln~ diseases, unusual occurrences of the following syndromes should
alSo be reported:

Acute flaccid Paralysis (AFP)


Aalte Hemorrhagic Fever Syndrome (e.g. Dengue Hemontlaglc Fever)
.AcUte Lower Resplratory Tract Infection and Pneumonia
Acute Wa~ry Diarrhea
Acute Bloody diarrhea (e.g. Shigella)
Food Poisoning
"
Chemical Poisoning
For these diseases and syndromes, the establlshe!l mechanism for notification and
reporting of morbidity shall apply specifically with reference to the weekly notifiable reports as
presa1bed In the Fleld Health ServIce Information System (FHSIS). Outbreaks of these
diseases/syndromes should be Immedl~ reported to the Regional Epidemiology and
National
Surveillance Unlls(RESUs) at the center for Health Development or to the
Epidemiology Center (tel/fax no. 741-70-<18; e-mail: nec_doh@yahoo.com)
For HIVI AIDS Reporting: Blood specimens that are reactive after screening ~ for
HIV should be submitted to the STD/AIDS COOperative Central Laboratory (SACCL) at san
Lazaro Hospital fir confirmatory testing. The HIV/AIDS Reporting Form (Appendix B) should' be
accomplished for every dlent with reactive sample. For HIV positive cases that progress to. AIDS
or those who died, the physldan should transmit the HIV/AIDS case reporting form directly to
NEe within five working days following the event. Reports could also be sent by email:
nhsss@metro.net.ph or nec_doh@yahoo.com

DAL:/I.Vl'

UfL ..
Secretary of Health

Appendix A
Case Definitions of Notifiable Diseases

Anthru:
(A22)
".
'

An Illness with acute onset characterized by several dlnlcal forms. These are:

(a) locallzedform:
CUtaneous: skin lesion evolving over 1 to 6 days from papular through a
vesicular stage, to a depressed black eschar Invariably accompanied by edema .
that may be mild to extensive
(b) systemic forms:
gastro-lntestfnal: abdominal distress characterized by naLJliea, vomltlng, anorexia
and followed by fever
.
pulmonary (Inhalation) briefprodrome resembling acute viral respiratory Illness,
followed by rapid onset of hypoxia, dyspnea and high temperature, with x-ray
evidence of mediastinal widening
menIngeal: acute onset of high fever possibly with convulsiOns, loss of
COftSdousness, meningeal signs and symptoms; commonly noted In all systemic
Infectlons
Chollll'll (AOO)
Acute watery diarrhea and lsolatlon of VlbrfQ cholerae from stool or rectal swab

culture
Diphtheria (A36)
An Illness of the upper respiratory tract characterized by laryngltls or pharyngitis or
tonslllltls, andadherent membranes of tonsils, pharynx and/or nose
Viral Encephalitis (A83-86)

Inflammatlon of the brain which manifests as mild disease with headache and a general
malaise and muscle ache similar to that associated with Influenza. The more acute and ser10us
symptoms may Indude fever, delirium, convulsions, and coma.
Viral Hepatltl. (115-19)
Acute Illness characterized by fever, jaundice, dark urine, anorexia, malaise,
and extreme fatigue, right upper quadrant tenderness. This Indudes all kinds of
Hepatltls diagnosed dlnlcally with or without laboratory support

LeproIy (A30)

A person showing one or more of the following features, and who as yet has to .
complete a full course of treatment:
hypoplgmented or reddish skin lesions with definite loss of sensation
Involvement of the peripheral nerves as demonstrated by definite thickening with
loss of sensation
skin smear positive for add fast badlll
l.eptDspll'Oll. (A:27)
Acute febrile Illness with headache, myalgia (especially of calfmuscles) and prostration
associated with any of the following symptoms:
.
conjunctival suffuslon
meningeal Irritation
anuria or oligUria and/or proteinuria
. jaundice
.
. hemorrhages (from the Intestines; lung bleeding Isnotorious In some areas)
cardiac arrhythmia or failure
skin rash
and a hlsllory of exposure to Infected animals or an environment contaminated with
animal urine (e.g. wading Inflood waters)
Malaria (850-54)
Fever, chills, headache plus isolation of malorial parasites In the blood
Measlet(BOS)
SUspect: Fever of at least three days duration with maculopapular rash and any of the
following: cough, coryza, or conjunctivitis
Confirmed: A suspect case positive for measles 19M antibody or suspect case with
epidemiologic linkage to an 19M antibody positive case
VIral Menlngltl. (AS7)

A case with fever 38.S oC Ind oneor moreof the following:


neck stiffness
severe unexplained headache
neck pain and :2 or more of thefollowing:
photophobia
vomiting
abdominal pain
pharyngitis with exudates

For children < :2 years of Ille a case Is defined as


Fever 38.SoC andoneor more of the foUowlnll:
Irrltabillty
Bulging fontanel

SSESS Installation CD
Step I: Insert the installer Disk in to CD Drive..
Step 2: On the taskbar click START> RUN).
Step 3: Browse CD Drive
Step 4: Double-Click on the file SETUP.EXE.
Step 5: Follow on screen instructions.
Using HIV/AIDS software
After installation, a HIVAIDS shortcut icon will appear on your desktop. Click on the
shortcut to start program or the program can be started by selecting
'Start>Programs>HIVAIDS Registry'. Click on either to start the program.

"if- - - -

ij) - - -

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.--

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lllI ,...,.-

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~_

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tMvMcNlt 2005 frill YI2

ij)_
fusion Pt.

i:ll-........_
~

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ij)"

HlVAJDS Re9StJY

lllI

....

e.-

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i:ll-

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~ Maosdt *-Istulo 6.0

CD NItZtl Dcwri:Iod Dnln J.5

..

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Tr

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ll!I POI>Oot z.s

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.,

1: start

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ij)
ij)<:S'lo'..
~ <:S'lo 2.5
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iill"ll!I .....

rtilll4' ~Text ......

37

~-I!I """
Ill! """'"
II fIIcro5IDft Pc:Jwer9l:*'t
1 1 -........

i1--

,,'

Note: Initially, the software default Password is HIVAIDS then click ok

DATA ENTRY
The main HIVAIDS screen will appear and the menu choices are available on top of the
screen

PIS 0.<0 Entry

Step 1: Click
Data Entry Menu

Step 2: Click
PIS Data Entry

38

Step 3: Data Entry Screen for Personal Information Record will appear.

Hi
~tH8

Have you Expa..-ienced nny of this


Employment History

ory of HIV T eut


nat Informotion

Step 4: Click New


Record to Start

Recolve!Source of Information
Truvol History

Date of Reglsb'atlOn

II

If fOr E""loyment
If Other Please Specify

FrstName

M.I.

LaatName

..-....s,
RegIOn

:::::J

Provnce

Contact No.

sex,

BO'1hday

:::::J

,.",rnber Oliidren

CMIStatu9

Fig. 3 Personal Information Record Screen


Step 4: Navigate thru the Tabs to enter data.
Explanation for each Tab Menu and the information to be enter.
Personal Information Tab - Demographic Data of the patient
Employment History Tab - Previous and present Employment data of the patient
Travel History Tab - Previous and recent travel history of patient
History of HIV Test Tab - Result of HIV Test, location of the testing center and date of
test
Sexual Encounter Tab - Patient's sexual experience and other information such as
current and previous ST!, Blood transfusion and so on.
Information Source Tab - information source regarding HIV/AIDS in the facilities

39

Step 5: Enter the patient code

History 01 HIV Teet


eelsonal Information

Sexual Encounters

EmploymBnt History

Source o1lnlDnnation

T'BVeI History

PatientCode 1123a
P\IpOS8ofT"b1g

Ifftr

E"""'
''''
0hIr
If

1 " " 1- - - - - - . . ,

Pease Specify

.---IlIi

- _.... 1 - - FntName

MI.

::1

Note: After you entered the patient code the computer will check if the patient code
already exist and will advice the user for any possible duplication, then the system will
automatically fill up the rest of the fields. If patient code does not exist on the database,
the entry fields will remain blank.

40

Step 6: After doing all data entry on the Personal Information Screen, Click Save button
to add the patient to the database. After saving, click the physician button to start
entering the physician case reporting data of patient.

,,"i~;'~"'~'---:--

~-~~'~"'~$
.. I>hysu:ian'sIIiV/AIl)S C<1S(!

txl

I~cporlmr.

PHYSICIAN'S CASE REPORTING DATA ENTRY


NW/AAT

Data Vbut

Type of

Ifllea1ll. Data

Step 7: Click new record


to add new laboratory
information

Lalxra'....."""",.....---;:,.---,-------'
Mon1ll

I
NewAecxwd

QUI

Figure 4. Physician Case reporting data entry


Step 8: Enter all information needed on the screen.
Step 9: After doing step 8, click save button to add the information on the database.
To add new patient, close Physician Case reporting data entry Screen and repeat the steps
in data entry.

Report Menu
Step I Click on
report menu after
clicking 3 sub
menu will appear

F1Q. 1 HlV Ab 5eroposttve Cases by Year


Flo. 2 HIVAb ..._
c.... by Gende. and "-"'"

Step 2: Click the desired report you want to produce

41

3 Sub Menus

Mode of Transmission Menu

Mode of I ransmfssicn Report


PatientGr~

Enter Month
EnterYeac
OK

CANCEL

Explanation of Each field on Mode of Transmission Menu


Patient Group - you may choose among OFW or ALL (All means all groups patient on
the database is selected)
Enter Month - month to report (January to December)
Enter Year - Year to be reported (Valid years 1984 to present)

P:"IN~/,""JltrrWJ~~'~i,._;\i<~""~":;";
D_~..: EI"~~'

Repc-t

.,';' - ...'S

Mode of I ransmtsston Report

Patient Group

IA'IlO"'ll OFW

Enter Month

10_

::::J
::::J

Enter Vear

..

::::J

OK

CANCEL

L
Step 1. Click Ok after
entering all fields

42

Step 2: Table from Microsoft Excel will appear and ready for printing
~l Micro""olllxrci

;@) Elo

: CJ ~ g
C13

t+3
~
5

\lOW

Irano;l<lh1

I'gmIt

lido QIIa

e 15 ~ ~ i '" : on -I" J: - tiiD loOot.

i< 0
A
! .~I~ 1z:~~~OlIed Modes 01 T,.nsmi..ion
I:llV/tJ~S, ~.nU8!l' 1984 October 2IXIi

REPORTED MODES OFTRANSMISSION

CONTACT
~ '!ET!'BQSEXUAl.
HOMOSEXUAl.
CONTACT
r-l,BISEXUAL CoNTACT
~
9 BLOODIBt..OOi:l PRODUCTS
iNJECTING DRUG USEfT, NEEDLE PRIci<INJURIES
PERIN.6JAI. 13 NO EXPOSURE REPORTED

:! Mol

'c

---1-----

281

-- -

n-34
23
7
3
0- - - 0
- - - -0 - - - - - -1
0
-

--

138
19
7
3

-=

~oba, 2IXIi

464

37

I_ _

N= 2533
1584

'IT

Jonu!!\' 1984 Oetobe, 2IXIi

ffo

~
15

- (i)

-_."
__

'

o.

I
I

~
-~---_.

HIV Ab Seropositive Cases by Year Menu

HI\I Ab seropositIve cases

Patient Grtu>
Enter Month
EnterYear
OK

CANCEL

HIV Ab Seropositive Cases


Patient Group - you may choose between OFW or ALL (All means all groups of patient
on the database is selected)
Enter Month - month to report (January to December)
Enter Year - Year to report (Valid year 1984 to present)

43

HIV Ab SEll oposltlve cases

..

~ON

Patient Grow
Enter Month

1m;

EnterVear
OK

.lLey~.

CANeR

U14jJU !.lUlU .lUll V(llU U14}Jll.U,...,:) 7'0 WIH

il
il
il

r-

appccu a.uu lcauy

Step I. Click Ok after


you enter all fields

lUI P1U.llUJ.

HIV Ab Seropositive Cases among OFWs


HIV/AI DS Registry, Jan, 1984-May 2006 (N=878)

"'"
eo

I_AJDS

----------

eo

20

0
TOTAL
ASYMPTOMATIC

'" os

CEATH

------------

---_

_--------_

----------- .......... ---------.-

--.----

_-_. __

,.-

--.-

-.- .. -.-

__ ._---_.--_

.. -----.--- ............

,,
,
,

,,
,

0
0
0
0
0

,
3
2

,
,

3
3

=ABVMF"TOMA,TIC

3
3
2
3

44

----

_---------_

_---, ..

-.-

HIV Ab Seropositive Cases by Gender and Agegroup Menu

------~--~

----

---

- IIiV/AIDS R(GIS TRY


Cl..Jta Entry Report

ut(;:ies

IHIV Ab

Sel oposltlve

cases By Gender

andAgegr~

::;:]
::;:]
r----::;:]
::;:]

Patient GrOLO

Enter Month
EnterVear
Type of Report
OK

QlNCEL

HIV Ab Seropositive Cases By Gender and Agegroup


Patient Group - "OFW" or "All" (All means all groups of patient on the database is
included)
Enter Month - Month to report (January to December)
Enter Year - Year to report (Valid year 1984 to present)
Type of Report - > Cumulative means reports from 1984 to present
> Month means report for the desired month and year only

45

~ij~"i~!~~,~ii~m:::;;;:'!'?V~\~~qi.;:':;r&~~JAsj!It,~,~,~ '~0~(h ' : :'-t~"' :?~;" : ;~-_, -";i::~'_: '


r.~ :r~r'l

R...' !=nt

"

"c.;, ..,
C'.',

c.",

-,.. ~
0'

t.r-s

Ab seropositive cases
and Agegroup

HIV

Patient Group

lA'""'O ON

Enter Month

1_

EnterYear
Type of Report

1m;
1!i!!!!llM

-- --

OK

CANCEL

BV Gender

3
3
3
3

Click OK and a Graph from Harvard Graphics 98 will appear and ready for printing.

HIV Ab Seropositive Cases by Gender and Age


Group Among OFWs
HIV/Re

. Oct. 2006

0-01
2-04

5-14

15-19
20-39
40-49
>50

121 080604020020406081 12

Male
Ferral.

0-01

2-04

5-14

0
0

0
0

0
0

15-19 20-39 40-49

0
0

46

1
1

0
0

>50

0
0

HIV/AIDS Registry .
Information System

HIVIAIDS REGISTRY USER GUIDE

National Epidemiology Center


Department ofHealth

36

Flow Chart of HIVIAIDS Reporting System

Hospitals. Clinics,
Laboratories

HIV Reactive Samples


'SACCL
--... Case Reporting Forms""---"

Blood Banks

--... HIV Reactive Samples--... RITM


Case Reporting Forms

Case Reporting
- - Form of WesternBlot Confirmed
HIVCases

Physicians

,---... Case Reporting Forms --... NEC


Of HIV cases who
progressed to AIDS or
AIDS cases who died

NeonatlllTetanUi (A33)

:~ . :

OC:curence of the following symptDms Ina nonnal newborn within the J'" to 28111 day
post partum:
Inability to suck
generalized muscle spasm (stiffness)
convulsions and
r1sus sardonlcus

Non-lI4IOIIIItal tGInUi (A35)


Development of Irritability, trtsmus or lockjaw, muscle spasms, or rlsus sardonlcus
secondary to either an open wound, dental carll!$, otIUs media or any surgical
procedure Ina person more than 28 days old

Meningococcal Infection (A39)

SUdden onset of fever and any of.the following: neck stiffness, altered consciousness,
other meningeal signs, petechial or purpural rash, gram negative cocci on gram stain of
CSF or skin saaplngs and without apparent cause.

Paralytic Shelln.h Poisoning (T6L2)


PrevlousJywelllndMdual who develops two sensory and two motor signs and symptoms
after taking shellllsh (bivalve) meal or soup; shellfish In water source found positive for
saxltoxln

bbl. (A82)

history of animal blte/saatch or human bite or eating brain of proven rabid


animal
hydrophobia and
any two of the following: foaming of the mouth, convulsions, bladder paralysis,
papillary dilatation, difficulty Inswallowing

Typhoid and paratyphoid fever (A01)


Fever of at least 5 days duration with any of the following:
dlantlea or constipation
.
abdominal discomfort
malaise
with SBlmoneila typhJ or paratyphl.srown from blood or stool/rectal swab culture; (+)
Typhl dot

Whooping cough (Pertuals) (A37)


Cough

lasting at least two weeks with at least one of the following:


paroxysms (I.e. fits) of coughing
Inspiratory 'whoopingpost-tussIVe vomiting (vomiting Immediately after coughing)
without other apparent cause

SYNDROMES:
Aeut8Placdd PlI'lIIyIII (APP)

'~,

Sudden onset of flaccid ("fIoppyj paralysisIn a child below 15years old Indudlng those
diagnosed to have Gulllain Barre Syndrome for which noother cause could be Identlfled

Aalt8 Hemorrhagic Fever Syndrome (e.g. Dengue HeJ'normaglc FeVer)

Acute onset of fever of less than 3 weeks duration In a severely III patient and any 2 cif
the following
hemorrhagic or purpuric rash
epistaxis
hematernesls
hemoptysis
blood Instools

other hemorrhagic symptom and noknown predlsposlng host factors for.


. hemorrhagic manifestation

Acute Lower Reapll'lltory Tract Infectlonl (aLRn) and Pneumonia


Cough anOior dyspnea
and
other constitutional signs and symptoms with noapparent cause
Pneumonia
cough or difficulty'of breathing and

breathing >50/mln for Infant aged 2 months to <1 year


breathing >40/mlnute for child aged 1 to 5 years and
no chest Indrawlng, stridor or danger slgns
Sevei'll Pneumonia
cough or dlfflculty of breathing + any general danger slgn or chest
Indrawlng or stridor In a calm child.
GMenlI danger IIgnl:
For children aged 2 months to 5 years
Unable to drink or breast feed, vomits everything, convulsions, lethargic or
unconsdous
Aalte Watery DlarThea

Acute watery diarrhea (passage of 3 or more loose watery stools In the past 24
hours) with or without dehydration

r
Republic ofthe Philippines

DeparbnentofHeatth
BUREAU OF HEALTH FACILITIES AND SERVICES

Manila
LIST OF ACCREDITED HIV TESTING
LABORATORIES
As of December 31, 2005
ADDRESS

NAME

CHD NATIONAL CAPITAL REGION


ABM MEDICAL AND INDUSTRIAl. CLINIC AND LAB. 2462 UnlInola a, G.,dal ... Nmo, MlkIll elty
MP MEDICAL CENTER V. L... Rood, O.C.
ALABANG MEDICAL CENTER AIIb1ng-la.... Rood, M.ntinl.plCity
AUF MEDICAL AND DIAGNOSTIC LABORATORY 11580 AgoncUIo eldg..Tift A... cor. P.GlL Mlnlll
AMANG RODRIGUEZ MED. CTR S.m.long HlghWIY, SIo. NIBo, 1lIl1~", City
AMERICAN OUT.pATIENT CLINIC 2JF FEIlD B~g., A. BotllnO St., Intmnu,"" MonDI
ANGELINA APOSTOl PUNZAlAN MEDICAL CLINIC
ANGelUS MEDICAL CLINIC, INC.
AVENUE DIAGNOSTIC CLINICAL LAB.
ARGUEllES MEDICAL ClINIC,INC.
ASIA PACIFIC MEDICAL & SERVICES, INC. 3iF '2053 EdllOl1 SL, Son b~ro, Makod CIty
ASIAN HOSPITAL AND MEDICAL CENTER Civic 0""', Flllov'" Corp. CIty, AIIbIng, M.ndn. CIty
ASIATIC MEDICAL LABORATORIES 88D8 Dng"n St.,_ . 205U05, SII. Cna, MlnlLl
ASSOCIATED MEDICAL & CUNICAL SERVICES,INC. 3iF KIlIYlln B~..cor. _

& De~ ROil SII.

AVS MEDICAL CLINIC, INC. 2JF.1214 ....."" T"dl c.."It,....."" St., Enn"" Mil
BIO-LAB MEDICAL SYSTEMS, INC. CLINICAL LAB. 8103 VA RuBno 8U.Ig.IlpiVIlIagl, M_
BIOMED DIAGNOSTIC & HEALTHCARE CTR, INC.
BIOMEDIX, INC., MEDICAL LABORATORY 82015 Modica! P~u Bldg., Ortlgll, SanMlg",'A......g
BIOSCAN CLINICAL lABORATORY Unit g J TlOlIoro St.,.... A..n." G.... Plrk, Col. CIty
CALPE MEDICAL CLINIC 81421 A.llablnl SL, Enn""

Monl~

CAPITOL MEDICAL CENTER ScL M.gbanul cor. Panty A'lL, uc,


CBZ MEDICAL CLINIC 81507 San MorceJlno St.,Enn"" Mlnlll

CHO NATIONAL CAPITAL REGION


CENTRALLE MEDICAL DIAGNOSTICS & POLYCLINIC, INC. 6ill AVI .. Cor. M.H. Dol P111t St.,Clioocon CIty
CENTRO ESCOLAR UNIVERSITY CLINICAL LAB. Mln_, IIan"
CHINESE GEN. HOSP. AND MED. CTR 286 BI.montrltt, SII. Cna, Mil.
CHRISTIAN MEDICAL CLINIC, INC.
CHRISTIAN E.CANGCO MEDICAL CLINIC & LAB. .1167Dan Chino Roc.. Ava., P.T_ MlkIll City
CLEMEN'S MEDICAL CLINIC 8445 ellmon' B~8, ....."" SL, Enn"" MonlLl

CLINICAL OCCUPATIONAL MED. & TREATMENT CTR.,INC. ..70 San An.... c. U.H. Dol PUar51., U.,..., U",~
CLlNILAB MEDICAL SERVICES, INC. 7JF .2303 Bid;., Chin. R_ Ell!., U.kaII City
CLlNIMEO BIODIAGNOSTIC CENTER W4GoC P.1m Court,PC
CUNJTECH DIAGNOSTICS Unit 4,Parlan Commerdal Center, Common.earth Ave., Q.c.

CO MEDICAL & DIAGNOSTIC' CLINIC 8011I101 Uulm BIdg.,G UlllnO"'"y St., BllIon", Monl~
DE LOS SANTOS MEDICAL CENTER 1201 E. RodrlOu" SLA"AC
DEPT. OF PATHOLOGY VETERANS MEM. MED. CTR. Nortll Avo., Dlllm", C.C.
DONICA DIAGNOSTIC AND IMAGING SERVICES .12ADr. A. San... Ave., P.""",u. City
DR. FE DEL MUNDO MEDICAL CTR. FOUND. PHILS.INC BonlUl S1, CC
DR. JESUS C. DELGADO MEM. HOSP. 17Klmunlllo Rd., CC.
DR. JOSE FABELLA MEM. HOSP. Lopod. VOO', SII. Crvz, UII.
DR. JOSE N. RODRIGUEZ MEMORIAL HOSPITAL T.,.,CoJoocan City
DR. VICTOR R. POTENCIANO MED. CTR. 1163 EDSA, U"doIuyonO City
EASTERN DOCTORS CUNIC
EBN SIMA MEDICAL DIAGNOSTIC
E.C. TORRES MEDICAL CLINIC Rm. 320 C.1t Sy ~mond BIdO., PlllY CIty
EAST AVENUE MEDICAL CENTER eoltAv"C.C.
ECHAVEZ MEDICAL SERVICES

Arl. SqUill

Unit E, "'7 EDSA, U"doIuyonO City

EL ROI MEDICAL CLINIC & DIAGNOSTIC CTR. INC. ..... 5dl St., Klmunlno, Qu"on City
FAR EASTERN POLYCLINIC I6BO J."n Condo, S.... Blvd., cor SImIt St, Uondo
FATIMA MEDICAL CENTER 120 IIcArUn.!f Highway, 1111111 , Valenzuela City

CHD NATIONAL CAPITAL REGION


FEU-NRMF MEDICAL CENTER

DlhU.Cor.Rooo~d.Avo.

WlltF.hvlow,CC

FIRST MULTI HEALTHCARE SERVICES T.ft Avo. c. Qulrln. Avo., Mo~.. , U~.
FMT HEALTHCARE SPECIALIST GROUP
GAlENUS CLINIC, INC. 3F F'rvuIOn Pm Tow,', ".H.de1 Pilar, Ermlta, Mia.
GEN MEO HEAlTH SERVICES 40Cuevas Tower, raftAn.,cor. P. Gil St.,M.llte, Mia
GOOD HEALTH DIAGNOSTIC CENTER Gen. M.lvaf Avenue, Ataneta Center, Cubao, a.c.

HEALTHLAB,INC.
HEALTH POINT MEDICAL CLINICS & DIAG. CTR. 5T7 P.... FIUII St., Emili, UI,
HEALTHWAY MEDICAL CLINICS 2F Ay.l. Ufo BldO., 16788 Ay.l. Avonuo, U.kaII City
HEALTHWAY MEDICAL LABORATORY
HEARTLAND MEDICAL & DIAGNOSTIC CENTER 11585 Gon. Luoo 51., P.co, Usnll.
HOLY ANGEL MEDICAL CLINIC, INC.
HOPE LOVE FAITH MEDICAL CLINIC & LAB. 35-<: Quozon Av"uo C. Cordill", St., Cuo... City
HOSPITAL OF THE INFANT JESUS 1558 L.onOI.on St. S.mpoloc, Yonll.
INTERNATIONAL DIAGNOSTIC CENTER. INC. IDCl BldO., RImed... 51., MolIlI, Uon",
IPPOKRATIS DIAGNOSTIC SERVICES CTR.,INC,
J/J MEDiCAl & INDUSTRIAL CLINIC t2001

CUIVII

Tower 38,P.GU St, cor. Taft Ave., Malate

JABEZ MEDICAl DIAGNOSTIC eTR., INC. Rm. 305 Boo Bldg., 202 E.RodDoulZ Sr, Avo., Q.C.
JOSE L GlITlERREZ CLINIC & CLINICAl LAB.
JOSE R. REYES MEMORIAl MEDICAl CENTER RIul AVL, StL Cna, M~.
KING OF KINGS LABORATORY & DIAGNOSTIC CTR. I4O-A V. Luna Road, Qu.... CIty
LABSTAT DIAGNOSTICS & DRUG SCREENING LAB.
LAKAMBINI DIAGNOSTIC CENTER '1991 Unit E& FWardlly B1dg., Taft AnnUl, PIIIY

ely

LAS ptAAs CITY MEDiCAl CENTER, INC. 1314 M..... A1vIlWZ Avo., Talon I,La. Pl... CIty
LAS PIAAs DISTRICT HOSPITAl PulanO Lup., La. PUl.. CIty
lAS PIAAs DOCTORS HOSP. 8009 JIAguilar AVe., Pullnglupa U, lis PlA.. CI~

UB CLINICIANS DIAGNOSTIC CENTER cor. Edl... SI., Son.G' PuyaIAvL, M.kati CIty

CHD NATIONAl CAPITAl REGION


LOPEZ MEDICAl & X-RAY CLINIC. INC. 1998 Qu.... A..nva, QuIZ . . City
L.R MEDICAl & X-RAY CLINIC 12931 ftnland~ oor.llautiltl Sta.,......., Man',
LUCAS & ASSOCIATES MEDICAl CLINIC A26 Gan. M.I... SI., M.~ .. , Manl~
LUNG CENTER OF THE PHILIPPINES

Qu.... Avo.Q,C.

MABINI MEDICAl CLINIC, INC. .1946 FAg..,IIlo SI., M.~, Manl~


MAKATI MEDICAl CENTER 2Amon'"St, Kika' CIty
MANILA DOCTORS HOSPITAl &6 U.H. A... Emll MIL
MANILA ADVENTIST MED. CTR. & SCHOOL OF MED. ARTS, INC. 1075 Don.d. SI., P , CII\'
M.nl~

MARITIME CLINIC FOR INTERNATIONAl SERVICE 10F Tim.. Plaza B1do., ..,UN A
MARITIME MEDICAl & LAB. INC. 1531 2f Pa..gon Towar, AFI

SI., Em", Manl~

MARY JOHNSTON HOSP., INC. 11221 J. N~aco Bl,T..do, Manll.


MCU.fllTMF HOSPITAl Sam... Rd., Kat....nCity
MEDEX LABORATORIES mog.<; Ilagtikan SI., San Antonio VUI.ge, M.kati city
MEDHAUS MULTISPECIALTY & DIAGNOSTIC CLINIC 1691 IlIltran Bldg., V. dol FI.... SI., GagalanOIn ,Tondo
MEDICA INSTITlITE MEDICAl AND DIAGNOSTIC CTR, INC. 2F Manl..nBldO., 0802 Karnagono Bl,SAV, M.kat! City
MEDICAl CENTER MANILA 1122 GanLuna SI., Ennl",M~
MEDICAl CENTER pARAflAQUE Dr, A. San... A..., Sue.. Rd,P......vaCity
MEDICAl DENTAl TEST CENTER, INC. 3F Oat".. nB1dO.,.1&4 ...... Blvd, San Jvan
MEDISENSE LABORATORY CENTER

.mp.Fau.. SI., Un"441,442 _

...... Plaza, Emll..

MERITA DlAGNOSTIC. CLINIC .1990Taft Ave. cor. P.Qulrlno Ava., "alate, "'nO,
METROMED CLINICAl LABORATORY 12m M.blnl sr, Mal"', ManU.
METROPOLITAN HOSPITAl 1357 G. Mmngka, SI., StLCruz M~.
MHYCARE DIAGNOSTIC CENTER 75-C Main AVL, Murplly, Cubao, ac.
MICAH MEDICAl CLINIC & DIAGNOSTIC LAB. '1971T.ft Avanva, M.,..., Man"
MOTHER SEATON CLINICAl LAB 11577 MaNy Man...,F. Tva... Bl,StLt.na, Manl.
MP~

MEDICAl CENTER MUNTJNLUPA 38 National Rd.. PulIIIn, Muntirilupl CIty

MSC MEDICAl DENTAl DIAGNOSTIC SERVICES 11153 DoVIDa B1do., II.H.d.1 PDar SI.,EnnI.. ,Manll.

MT. GILEAD MEDICAL & DIAGNDSTIC SERVICES, URa Townhom..,""'ng. Zlpoto Rd., La. P~II
M-TECH MED. DIAGNOSTIC &THERAPUETIC CTR, 1379 Son. Gil Puyol Avo" Bel.AJr VBI.g., ...... City
MVR LAB, DIAGNOSTIC CENTER 11636 T'" Kola. St,Ennlto, nI~
NATIONAL CENTER FOR MENTAL HEALTH

"IV' d. Foin.. St,.ondlluyang CIty

NATIONAL CHILDREN'S HOSPITAL 1264 E, Rodrigu" Sr.Av.,Q.C.


NATIONAL KlDNEY& TRANSPlANT INSTITUTE eo"Av.,llIUmon,QC
NEOCARE DIAGNOSTIC CLiNIC, INC, I232T Lapu...... St ~ C...., Boc~..., PmII.quo City
NEWWORlOlABORATORY II2OSCD, TuozonSt, Qu"onCI!l'
NEWTDN MEDICAL & DIAGNOSTIC SERVICES, INC,

11~2'"

N_ St., IIokoti CIty

NOTRE DAME MEDICAL DENTAL CLiNIC INC, 11268-1' UN Avonuo, Poco, Nonlla
OSPITAL NGMAKATI Slmpallulta cor. Dahill St, Fort Bonifacio, ... kIt! CIty

OSPITAl NG MAYNILA MEDICAL CENTER Qulrlno Av. COf.Rom Blvd, nli.


OSPITAl NG MUNTINLUPA Allnv'" Corpol'll8 CIty, Allbong, .untinlup. a!l'
OUR lADYOF FATIMA MEDICAL CLiNIC tI89 P. P."dB St.cor. N. Roy.. St.,S.mpoloe, .onl~
OUR lADYOF KNOCK MEDICAL CLiNIC 144" Sln~on St.,

a!l'

OUR lADYOF LOURDES HOSPITAL 46 P. Sonch" St.,S1L

,....

OUR lADYOF PEACE HOSPITAL Aguln"do Blvd, SinDIon~Io, Pm"qu. a!l'


PATIENT FIRST HDSPITAl CORPORATION 3F

.''''Ul)' Bldg., Glori'" Bldg., Ayo~ Con...., .."'ti

PGMA HEAlTHCARE & DIAGNOSTIC LABORATORY "53'oCF. Agonclllo St.,Ennl", .onl~


PHILIPPINE CHILDREN'S MEDICAL CENTER Qu"on Av~, QC.
PHILIPPINE HEART CENTER eo" A~, D.C.
PHILIPPINE ORTHOPEDIC CENTER ri. am St.,QC.
PHILiPPINE TUBERCULOSIS SOCIETY, INC, E.Rodrigu" Sr. Blvd., QC.
PHIL.GEN HOSPITAL BLOOD TRANSFUSION SERVo

T.ftAvonuo"'~

PHiLiPPINE MEDICAL TESTS SYSTEM Rm. 203-2001 Bon-Lor Bldg., Quozon A~, Qu"on CI!l'
PHYSICIANS DIAGNOSTIC SERVICE CENTER t533 Phyoldon.' Towor, UN Avonuo, .........
PNP GENERAL HOSPITAL Comp CnIme, D.C.
PNRC QUEZON CITY CHAPTER BLOOD CENTER Now a!l' H.IICompound, Dlllmon, QC.
PRJME LABORATORY .17Gen. Urn Sl COl'. Gen. DeJesul St., San Juan, ....
PROBE POLYCLINIC & DIAGNDSTIC CENTER, INC. 3F AIlIC Bldg.

.,845 Toft Avonuo,

,.onlla

PROSPERITY MEDICAL CLINIC AND LAB, INC. 2F Eothor Bldg.l1l145 T.ftAvonuo,

PTJ MEDICAL CLINIC 1217. NICE Cmpd..2F Building T.ftAvonuo, ~.....


QUEZON CITY GENERAL HOSPITAL Somlnory Rd..EDSA, QC.
QUIRlNO MEMORIAL MEDICAL CTR. Kotlpunon Rd., Pn>j. I, QC.
RESEARCH INSTITUTE FOR TROPICAL MEDICINE All"", .untllliupo CIty
RMO HEALTH SERVICES CTR., 1NC.~l'f(l~~S(lloUiblliil>iir;7-'

~:Al'/*i.~;;.1> :'2:'

s ,; . ~~.,--,---",,==~"'4

RSS cm HEALTH SERVICES 121 P"'g Blvd. ExL, Conlogon, PIIlg CIty
SAN JUAN DE DIOS EDUC, FOUND., INC. 2T72 Roxoo Blvd, P..oya!l'
SAN LAZARO HOSPITAL QuIrlCidi a, S1L CM, .

SANTO TOMAS UNIVERSITY HOSPITAl E.po",SampaJce, Mia.


SEAMEN'S HOSPITAL Clblldo Cor.San Jon SUntl'lmuroIlIIL

SOUTH SUPERHIGHWAY MEO. CTR. Am. 17 Wul _ ' " Rd.,

_.qu.

MM.

ST. ANDREW MEDICAl AND CLINICAl DIAG. LAB., INC. 397 J.P. RJuI 81. "".Illnokod Sl., M.WCity
ST. IGNATIUS DE LOYOLA HEAlTH CARE SERV.(Maln) 239 Shoo Avo., SIll. Millo, M.r1kIn. CIty
ST. LUKE'S MEDICAl CENTER

t27'l E. RodrlgllUSr. Blvd., Colllldl1l H.~h",

a.c.

ST. PATRlCK'S HEAlTH CARE SYSTEM 56llSh.wBlvd., _luyongClty


ST. STEPHEN MEDICAl CLINIC, INC. 1711 OILn 81., "".Emlllo, "'ILnon, MoW CIty
ST. THOMAS DIAG., MED. AND DENTAl CLlNIC,INC.~poij.~stCi(l';

~.~;;:;?i . ~;...~:~::;:,:;,:; ,,"":.c."'~,,--"--,",,,-,-,,,,"~~

THE FAMILY CLINIC AND HOSP., INC. " .." M.n. ctoro 81., SampaJce, MIL.
THE MEDICAl CITY Sin Mlgull Ave. cor. lounl.. Rd.,lIandiluyong City

TONDO MEDICAl CENTER 1lI1"'- 7ondo, MI.


UERM MEM. MED. CTR. Au.... Blvd., ac,
UNiSUN MEDICAL CENTER

Victory Un... Com~, Som'on Rd., CoIOOClll CIty

UNITED DOCTORS MEDICAl CENTER III M. RomJrwz Sl., ac,


UNIV. OF PERPETUAl HELP RIZAL MEDICAl CTR

Pom~on., Lao PIfta. CIty

SAN MARCELINO MEDICAl CLINIC


ROO LAB. & INDUSTRIAL DIAG. CTR., INC.
RUBEN C.BARTOLOME, M.D. CLINIC, INC.
SANDA DIAGNOSTIC CENTER
QBM MEDICAl AND DIAGNOSTIC CLINIC
RBG

R1CHSTONE SURGICARE CENTER


RNL MEDICAl AND DIAGNOSTIC CENTER, INC.
ST. JAMES MEDICAl AND DIAGNOSTIC CLINIC 1<31 LBH BId;., Moblnl Sl., Ennita, Monll.
ST. YELENA MEDICAl CLINIC, INC. 2386 Loon Guinto 81., M~''', Monll.
ST. PETERPAUL MEDICAl CLINIC,INC.
ST. LUKE'S MEDI<; .L EXTENSION CLINIC
ST. MARTIN POLYCLINIC,INC.
ST. VINCENT X-RAY AND LABORATORY
SIM CLINICAl LABORATORY, INC.
S.M. LAZO MEDICAl CLINIC
ST. CAMILUS POLYCLINIC
ST. MAGDAlENE DIAGNOSTIC CLlNIC,INC.
ST. CHRISTOPHER MEDICAl CLINIC CORP.
ST. CECILIA POLYCLINIC

STANOARD MEDICAL &DIAGNOSTIC CENTER


SAGRADA CORAZON MED. &ALUEO SERV. CTR.
THE GOOD SHEPHERD MEDICAL CLINIC
UNITED DIAGNOSTIC LABORATORY, INC.
TRANSGLOBAL HEALTH SYSTEM
V1ZCARA DIAGNOSTIC CENTER
TRANSNATIONAL MEDICAL &DIAGNOSTIC CTR.
WORLDWIDE DIAGNOSTIC CENTER, PHILS.
WESTMED DIAGNOSTIC CUNIC, INC.
VALENZUELA DISTRICT HOSPITAL
YGEIA MEDICAL CLINIC. INC.

CHD ILOCOS REGION


BETHANY HOSPITAL, INC. San_
DAGUPAN DOCTORS V1UAFLOR MEM. HOSP.

ClIy. LaUnl",

IlIyombo

Dlot.. Dogupan ClIy. P"g.llin..

ILOCOS TRAINING AND REGIONAL MEDICAL CTR CIty ofSan Fe........ LaUnIOn
LAUNION MEDICAL DIAGNOSTIC CENTER & HOSP _OIl St., ClIy ofSanFtmando, La Union
LORMA MEDICAL CENTER CWtan, ClIy ofS.. F......do. LaUnIOn
MARlAND MARCOS MEM. HOSP. AND MED. CTR. 1lOIIe, II_ Norto
PANGASINAN CENTER FOR FAMILY MEDICINE, INC. Amodo Sl, TIpI" DioOid, Dagup.. CUr
PANGASINAN MEDICAL CENTER
PNRC lLOCOS NORTE LAOAG CITY CHAPTER

BLDG. CTR.

N.~.

a, D.gupon City

Bonl~d. St., La..gCIty

PNRc. PANGASINAN CHAPTER u. H......" West. Dogupan CIty


REGION I MEDICAL CENTER AnIIJno a, Dagupan Clty
SPECIALIST GROUP HOSPITAL AND TRAUMA CTR TIpI" Dlltriet, Dagupan Clty
VIRGEN MILAGROSA MEDICAL CENTER, INC. San Co1Ioo CUr. Pangaol...
SAINT JAMES HDSPITAL

V1g... I1.... Sur

GABRIELA SILANG GEN. HOSPITAL Y2005


METRO V1GAN CooPct<ATIVE HOSPITAL Y2005
NAZARETH GENERAL HOSPITAL' Y2005 Dagu... City. P

oIn..

MEDICAL CENTRUM DAGUPAN, INC. Y2005 Dagup.. CIty. P

oIn..

PANGASINAN DOCTORS HOSPITAL Y2005


GOV. ROQUE ABLAN SR. MEMORIAL HOSP. Y2005
LAUNION MEDICAL CENTER Y2005 Agoo, LaUnl'"
LAOAG POLYCLINIC .Y20D5 La..g...... N....
PNRC DAGUPAN
CHD CAGAYAN VALLEY REGION

CMJAYAll VAllEY MEDICAL CENTER CIJIg, Tuguoganoo ClIy, Clgayan

CAGAYAll VAllEY SANITARIUM AIlD HDSP, M.blnl St, Sanl!lgo C~


PNRC NUEVA V1ZCAYA Bayombong, NuIV' VIlelY'
SAIl MATED DIAGNOSTIC LABORATORY NaUonal Hlghw.y, Sa"......, I_~
8T. PAUL HOSPITAL Ug.c HI-w.y, Tuguag'r1l0 City

VETERAIlS REGIONAL HOSPITAL NaUon.1 Hlghw'y, Bayombong, HulV. Vlzcay.

VICENTE L. DAIlGUILAIl MEDICAL CUNIC Burg.. St,Olat. 4, Solano, NulVl VI.ClIY'


SOUTHERN ISASELA GENERAL HOSPITAL Y21105 SantIago City
GOV. FAUSTINO DY SR MEMORIAL HOSP Y2005 Saga",lubaI.
CITY DIAGNOSTIC LAB. Y2005

CHO CENTRAL LUZON REGION


AIlGELES UNIV. FOUND. MED. CTR McArthur H~'way, AngaIu City

BULACAIl PROVINCIAL HOSPITAL

M~o",

MaIol.., Bul.,,"

CENTRAL LUZON DOCTORS' HOSPITAL Hopa. 0rIvt, Sa"VlClIIlto, T'Ne City


DRPAUUNO J. GARCIA MEM. RES. & MED. CTR 1Ilbl"' St, Clbl. ...... City
JAMES L GORDON MEM. HOSPITAL "'"an, Oloogapo City
JOSE B. LINGAO MEM. REGIONAL HOSPITAL McArthur Highway, DaIo<o', Sa" FernIOdo C~
N.E. GOOD SAMARITAll GEN. HOSP., INC. Burg......, Clblo'~10 City
NUEVA ECUA DOCTORS' HOSP.,INC. IIlhartIIla Highway, Cabl"WlO City
PHOPRES. RAMON MAGSAYSAY MEM. HOSP"lOgl'lO,lbl,ZAmbll..
'8iii'i;iiil.$l.~~Sla.-:roiiOlij,~-CIIi'~, ~. - " . ",,,,,;:!.,..,,::,
flfn~P:~i;;~~;.,q::</:: :l~;.
."; _"_. ~:--;. ,.i, t;"':,J~i;::~;;t~~!;~::::>.
PREMIERE GEN. HOSP. OF NUEVA ECUA, INC. M.,.~1ka Hlghw.y, 0... ~~ Cabl......n C~

PNRC. AIlGELES CITY BLOOD BAIlK

it

SUBIC BAY MEDICAL CENTER Cubl .oln~ Soble FIHpM Zo"" O'aog.po City
TALON GENERAL HOSPITAL F. TIOadoSt,T'Ne
TARLAC PROVINCIAL HOSPITAL Sao Vice""" Twe City
vi, MAKABAU MEM. HOSP., INC. B.Mondoza St, Sa" Ferna""City, "",,"ga

CYBERCARE LABORATORY Y2005 Don M,Ilt<m'''. Brgy. IoU"",Ballbabo,AC


DIASERV DIAGNOSTIC LABY2005 S1ndaWl, Cityof Sa" Ferna"do
SUBIC DISPENSARY LAB.Y2005 Soble Bay _

Zo"" 0I0~ C~

OLONGAPO HEALTHCARE SPECIALIST DIAG.l.AJl.Y2005 .1 10001' St,W.llljle b~lC, Olongapo City

OSPITAL NG STAo CRUZ


BRITON CUNICAL lAB-Y2005 Mojoa, M~a101, BulJ<In
PNRC BATAAN CHAPTER

~cl~ CapItal,

BaJanga all

PNRC. OlOHGAPO CITY CHAPTER Old HOIp. Rd., EulT....IC, 0Iangap0 QI


OUR lADYOf lIT. CARMEL MEDICAL CENTER Km 78 McAI1Ilur Highwoy, S.gwn, 8FC. P.mp.
PNRC TARLAC CHAPTER CaplloI Cmpd., San_

T.rIIC CIIl

PNRC. NUEVA ECUA CHAPTER llano.. SI., Old CaoIloI Cmpd.,Clban...an


DR. AMANDO L GARCIA MED. CTR..INC. (new)

sa Rlzal SI.. AIIgal.. ClIl

JECSON MEDICAL CENTER _ur Hwoy.llalalalalb, Twc City


ST. JUDE FAMILY HOSPITAL (new) _

eaal,llaJocbaJlC, OIongapo City

CHD SOUTHERN TAGALOG


ANDRES BONIFACIO MEMORIAL HOSPITAL T.... llartlm QI,CIvlII
BATANGAS CITY LABORATORY, INC. P, BurgOl Cor. Apaclbl. Sta, Balanga, QI
BATANGAS REGIONAL HOSPITAL Kumlnlang lbaba, Balanga. City
CALAMBA MEDICAL CENTER

CnlI~ng

Cl....ba QI.Laguna

DANIEL O. MERCADO MED. CTR. Pnl. Laural High_if. Tlnauan, 81t1npl


EVANGELISTA MEDICAL SPECIALTY HOSPITAL Ilacuta A.... PaellaComplax, San......., Laguna
GEN. EMILIO AGUINALDO MEM. HOSP. 1Ilgy. luciano, T.... M."'m City
GOLDEN GATE GENERAL HOSPITAL P. Pristo St.,Balanga. QI
HERMANO (SAN) MIGUEL FEBRES CORDERO D..l1IIrlft... Cl~la
MED. EDUC. FOUND., INC.
MOLINO DOCTORS HOSPITAL Nat'l. Ro.d, Mallno2, Bacoor, CIvlII
IPHQ. QUEZON MEM, HOSPITAL Quozon A...,Gulanggulang, Lu..... QI

LC DIAGNOSTIC CENTER 230 M,n:han SI., Lu..... all


L1PA MEDIX MEDICAL CENTER Natlon,' Hlghw,y. BaDntawall. Ups all

MA. ESTREllA GENERAL HOSPITAL T.wlran, CIItpan QI,Orl_ Mlndore


MADONNA GENERAL HOSPITAL Batayan, Balangll
MARY MEDIATlIX MEDICAL CENTER J.P. Laural Hlghw.y, M,w... Lups, Ups QI
MINDORO DIAGNOSTIC LABORATORY. INC. 11 A.Bonllaclo St.,DlyA Cllapan QI, Orlanlallllndoro
MY. CARMEL DIOCESAN GEN, HOSP, AIl.ray Exl., Lucan. all
N.LVILLA MEM. MED. CTR. Ups CIIl, Balangat
OCCIDENTAL MINDORO PROV'L HOSPITAL (new) Mamburao, Dcc Mlndo..
ORIENTAL MINDORO P~OVINCIAL HOSPITAL ClI.psn CII. Dlttnlal Mln_
PAGSANJAN MEDICAL CLiNICI GEN. HOSPITAL 1Ilgy. Slmptloctn, p._jan, Lagu..
PALAWAN ADVENTIST HOSPITAL SanPtd.., POW PMCOI' QI.Pmwan

PHQ. LAGUNA PROVINCIAL HOSPITAL J. do LIllll 81., SII. CM, Legun.


PIONEER CUNICAL LABORATORY 2P."- BId;. P. BUill" 81., Btttngu CIIy

PNRC- LAGUNA CHAPTER (new) J. deltorl St. cor. P. OUIY&m Ave., Sta. Cruz.ulIun.
QUEEN MARY HELP OF CHRISTIAN HOSPITAL CtIthln, Conl"'., RIW
SAN PABLO COLLEGES MEO. CTR. 1l'llY. Stn Rtft'L Stn P.blo ClIy
ST. OOMINIC MEDICAL CENTER Aguinaldo Hlghway, T.~bI, eacoor, Co~llI

ST. FRANCES CABRINI MEDICAL CENTER Pob. 211.h.rIIka Hlghy, &to. Toma., Batang..
ST. PATRICK'S HOSP. MED. CTR. Lopez Jain' St, BallI.... City

LC DIAGNOSTIC CENTER Y2005


QUEEN MARY HELP OF CHRISTIAN HOSPITAL Colahtn.Ctnlona, RIW
PUERTO GALERA MUNICIPAL HEALTH LAB.
DR. DAMIAN REYES MEMORIAL HOSPITAL
PNRC PALAWAN

CHO BICOL REGION


BICOL MEDICAL CENTER CCW>ctpcion Ptquana. N.g. City

BICOL REGIONAL TRAINING AND TEACHING HOSP. RIW St, L....pl City
ESTEVEZ MEMORIAL HOSPITAL Dan....nS. E _ 81.. GUIVa.. Subel., Le... pl ClIy
MOTHER SETON HOSPITAL Roxu Av...Dlvlnlon, N... CIIy
REGIONAL HEALTH LAB. AND BLD. BANK NO. V Legu,l CIIy
SAN ANTONIO DIAGNOSTIC LABORATORY GIF AMVVSLAJ BId;., Rlul a, Legu,l City
ST. JOHN HOSP INC. Ptn..nlbln 81., .... ClIy
STA. MARIA JOSEFA HOSPITAL Y2005
MASBATE HOSP. & HEALTH SERVICE COOP., Y2005 IIubllll CIIy
STS. PETER & PAUL HOSPITAL Y2005

_09'"City

SAN ANTONIO DIAGNOSTIC LABORATORY Y2005 N... CIIy


ALBAY DIAGNOSTIC LABORATORY Y2005 Data.., AIbIy
ODH-CHD REGIONAL BLOOD BANK Y2005 Legupi City

SORSOGON MMG & HEALTH SERVICE COOP., Y2005 _ogon City


EASTERN BICOL MEDICAL CENTER Y2005 VInIc, Colllndulntl
NAGA CITY HOSPITAL Y2005
PNRC Y2005 N'g< CIIy, Cam..... Sur

PNRC Y2005

o.d, Carnarln..

Nortt

CHO WESTERN VISAYAS REGION


BACOLOD SANITARIUM AND HOSP. TICUDng, BacoIod City
CADUCEUS CLINICAL LABORATORY AND SERV. DolIoCity
CJM CLINICAL LABORATORY
CORRON LOCSIN MONTELIBANO MEM. REG. HOSP.

_ " , , 0 , IIdlo Cl1r

Laca... St, Bacolod Cl1r, ..... 0CCId_

DR. PABLO O. TORRE MEM. HOSP, as. Aquino 1lItY', Bacolod Cl1r
OR. V.T. TALEON MEDICAL CLINIC, X-RAY & VllCA Bldg, 1znartSt., DoIloCity
DIAGNOSTIC LAB.
ILOILO DOCTORS' HOSP., INC. Wo.. Ave., MoIo, IIoDo Cl1r
ILOILO MEDICAL CENTER CLINICAL LABORATORY Ddlo City
IMSMC DIAGNOSTIC CENTER Jarv, IIolIo aty
JAflA.CLlNICAL PATHOLOGICAL LABORATORY BacoIod aty, ..... ~ I
JARANIllA MEDICAL LABORATORY Lapaz, 110110 Cl1r
MEDICUS (ILOILO CITY) INC. BRANCH DolIo City
MEDICUS OLOILO CITY) INC. MAIN 110I10 City
MEDISENSE LABORATORY CENTER, INC. (new) Door 3AU & 80M Bldg., BuIVOl St.,Bacolod aty
PNRC- BACOLOD CITY CHAPTER lDlh La..... St, BacoIod Cl1r
PNRC BLOOO BANK LABORATORY IJalJo City
PNRC- CAPIZ CHAPTER BLD. CTR. Dlnggoy Rom "."'lC~1

11<, 5800 RomCity

ST. ANTHONY COLLEGE HOSP. SIn Roqu. Ext., Roxu aty,Cap~


ST. PAUL'S HOSPAL Gen. Luna a, llollo City
THE DOCTORS' HOSPITAL as. Aquino Ilrtvo, Bacolod Cl1r, Neg... OccIden1ll
VIllANUEVA CLINICAL LABORATORY BacoIod City, Nogroo 0CCId0n1Il
WEST VlSAYAS STATE UNIV. HOSP. E.LopuSl,Jaro,llolloCl1r
WESTERN V1SAYAS MEDICAL CENTER

Q. _

St, M"''''''o, 11ollo City

Z SOJACASTRO CLINICAL LABORATORY Ddlo City

CHO CENTRAL V1SAYAS REGION


AMOSUP SEAMEN'S HOSPITAL CEBU (new) CamIno Vlc:lnot St.,Umupod, Ibndaut aty,Cobu

casu (VELEZ) GEN. HOSPITAL

79 F. Ramos St.,CIbuCity

CEBU CITY HEALTH DEPARTMENT LABORATORY Gon.lIullom Ext., CIbu Cl1r


CEBU CITY MEDICAL CENTER N. Bacal.. Ave., Cabo aty
CEBU DOCTORS' HOSPITAL Oomw Blvd., Cabu Cl1r
CEBU NORTH GENERAL HOSPITAL (_) SIn ..... Rd., T_ban, Cobu CIty
CHONG HUAHOSPITAL FuenllOomw,ClbuCl1r
DR. IGNACIO M. CORTES GEM. HOSP., INC. RIzaI St.,_

.. Ibn_ aty,Cebu

GOV. CELESTINO GAllARES MEM. HOSP. II. ..... St.,T.gblla... aty,I!olloI

H.W. MILlER MEM. SAN. & Hoop. _

Till d. AIlril SL, Coilll CIIy

HOLY CHILD HOSPITAL Dum.g.'" City


J.S. MEDICAL CLINIC Ay.l.AcctII Rd.. Cob. City
MACTAN DOCTORS' HOSPITAL, INC. 1lIuk,upKipu City
MEDICAL MISSION GROUP OF HOSPITAL SOHOL T.gbill... CIIy
NEGROS ORIENTAL PROVINCIAL HOSPITAL PI.p!, Dum.g.'" City
PERPETUAL SUCCOUR HOSPITAL

Goro"", A"., Coilll

City

PHYSICIANS DIAGNOSTIC SERVICES F. RlmOi St.,Coilll City


PNRe- EASTERN VlSAYAS REGIONAL BLOOD CTR Otlllllll Blvd., Coilll CIIy
PNRC. NEGROS ORIENTAL CHAPTER L.glt'" SL, O.moguttoCity
RAMIRO COMMUNITY HOSPITAL C. Gill. ... SL, T.gbll",nCity, Soh.1
REGIONAL BLOOD COORDINATING COUNCIL RHO 17,Jon.. Av., CtilIlCity
SACRED HEART HOSPITAL

VU~

AInIr. UrgeD. SL, Coilll City

SILUMAN UNIV. MED. CTR. FOUND., INC. V. Aldoc.. Rd., ilIro, Dumogutll City
ST. PETER.pAUL MEDICAL CENTER

v. GuI~. SL, Cob. City

TAGBlLAR.AN COMMUNITY HOSPITAL T.gbillnn City


VICENTE GULLAS MEM. HOSPITAL (new) IlInIl.d, IlInd... City
VICENTE saTTO MEM. MED. CTR. B. Rodriguez SL, Cob. CIIy
VlSAYAS COMMUNITY MED. CTR. Jon.. A"., Cob. City
GILLAMAC DIAGNOSTIC AND MEDICAL LAB. Y200S
BIOPATH CLINICAL LAB,Y2DDS
LH PRIME MEDICAL CLINIC Y200S
STANFORD DIAGNOSTIC CLINICAL LAB. Y2DDS
PNRC BOHOL Y200S
PNRC CEBU Y2DDS

CHO EASTERN V1SAYAS REGION


BETHANY HOSPITAL Roll St., T.d_ City

DMNE WORD HOSPITAL Avenld_ V'tarlinOl, r,e1ob1n City, Leyte


PNRC. LEYTE CHAPTER (new) M'gIIYUY Blvd. T.doben CIIy
EASTERN VlSAYAS REGIONAL MED.CTR Y200S TlClobIn City

BILIRAN PROVINCIAL HOSPITAL Y2DDS 801...


LEYTE PROVINCIAL HOSPITAL Y2DDS
HILONGOS DISTRICT CLINICAL LAB. Y2DDS
ORMOC DISTRICT LABORATORY Y200S

SOUTH LEYTE PROVINCIAL HOOP. Y2lIOS


EASTERN SAMAR PROVINCIAL HOSP. Y2lI05
PNRC ORMOC CITY Y2lI05
PNRC SOUTH LEYTE Y2lI05 Mauln, l.eyto
CALBAYOG CITY HEALTH OFFICE .Y2lI05
SAMAR PROVINCIAL HOSPITAL Y2lIOS
DMNE CUNICAL LAB Y2lIOS
NORTHERN SAMAR PROVINCIAL HOSP. Y2lIOS

CHD ZAMBOANGA PENINSULA


BRENT HOSPITAL R.T. Um Blvd., ZJmbo. City
NORTH MATERNITY AND HO.SPITAL Tumo, OIpolog City
PNRe- ZAMBOANGA CITY CHAPTER BLD. CTR RlzaJ St, _

Barrackl, ZJmboonga City

THE AGAPE CUNICAL LABORATORY P. RImon St,OIpolog CIty


ZAMBOANGA DEL SUR PROVINCIAL HOSPITAL Tuburan 0I1trlct, Plgldl. . City
ZAMBOANGA CITY MEDICAL CENTER Dr. Evangalll1l St., ZJmbo. CIty
CITY HEALTH OFFICE
SIA CUNICAL LABORATORY
ZAMBOANGA DEL NORTE PROVINCIAL HOSP.
DRJOSE RIZAL MEMORIAL HOSPITAL
ZAMBOANGADELNORTECOOP.HOS~

CHD NORTHERN MINDANAO REGION


BETHEL BAPTIST HOSPITAL &TOO FOI1lch St, MllaybaJoy CIty
BU,JDNON PROVINCIAL HOSPITAL Mllaybalay City, Bu~dn ...
CAGAYAN CAPITOL GEN. HOSP. FOUND., INC. SIn Pod"', Con, Clg. lit Oro CUy
CAGAYAN DE ORO MEDICAL CENTER, INC. T1an_calaban SlI..Cag. de Oro City
CAGAYAN DE ORO POLYMEDIC GENERAL HOSP. CIgay.. dl Oro CIty
COMC MULT1SPECIAUST DIAGNOSTIC CENTER Cigay.. lit Oro City
CEDAR SCIENTIIFIC AND LABORATORY CIgay.. da Oro CIty
KCLM MEDICAL DIAGNOSTIC CENTER CIgay.. de Oro CIty
MADONNA AND CHILO HOSPITAL Sarlna St, Carmen, Clg. dl 0", City
MARIA REYNA HOSPITAL Cigay.. lit Oro City

MAYOR H1lAR10N A RAMIRO, SR. REG. TRNG. & ."dog, Ozam~ City
TEACH.HOSP.
MEDINA GENERAL HOSPITAl. 0wnI. City
MERCY COMMUNITY HOSP., INC.

Kom"'" IU,.. City

MINDANAO SANITARIUM AND HOSPITAl.

llbIn,., lOgan City

MISAMIS UNN. MEDICAl. CENTER NatI",~ High" IlIgoJlay, 0zamIz City


NORTHERN MINDANAO MED. CTR. ClpItDI Compound, C.~ d. On> City
PHIUPS MEMORIAL HOSPITAl. PhlUpI, ...~. FOItIch
PNRC MINDANAO BLOOD BANK Co,.yan d. On> City
PNRC-ozAMIS CITY 0wniI City
ST. MARY'S HOSPITAl. Qu..... Av~, Ext, P....., "lganCity
VMEDSTAT DIAGNOSTIC CENTER Y2005
PHILUPS MEMORIAL HOSPITAl.
PNRC IUGAN CITY Y2005
PNRC OROOUIETACITY Y2005

CHD SOUTHERN MINDANAO REGION


BROKENSHlRE INT. HEALTH MINISTRlES,INC. ...PO HO~, DIY'. City
COMMUNITY HEALTH AND DEV'T. COOP. HOSP. An" Rivlmd., ~~n" S1., Dan. City
DAYAO BLOOD CENTER 8Ij ... S1., Om. City
DAYAO DOCTORS' HDSPITAl. 118 E.Qulrln.AV~, Dan. City
DAYAD MEDICAl. CENTER 8IjI" 51., Dav City
DAYAO REGIONAl. HOSPITAl. _n, T.g,m City
GEN. SANTOS DOCTORS HDSP" INC.

NItI",~

High" Otn. SlntoI City

MMG HOSP. AND HEALTH SERVICES COOP. OF DAYAO 3nl A"., lion Gm~ SL,Dan. City
MMGH & HEAl.TH SERV. COOP. OF TAGUM

~.yan VD~ .., T.gum elty

PNRCo DAYAO CITY CHAPTER . Rou. A~, Dav City


RIVERA MEDICAl. CENTER, INC. 7JIl3 S.. Frond.coSL, P...bo elty
SAN PEDRO HOSP. Of DAYAO CITY, INC. C.GlWNln SL,Dan. City
TAGUM DOCTORS' HOSPITAl. High ., 5<, T.g... City, Da". d.1N...
ACCULAB MEDICAl. SYSTEM, INC.

OUR LADY OF MERCY DIAGNOSTIC CENTER


ST. PETER-PAUL MED. CUNIC & LAB., INC.
PHYSICIANS DIAGNOSTIC SERVICE CENTER
UM MEDICAl. & MULTITEST DIAG. CTR, INC.

ALXIAN BROTHERS
MLS PRIME HEALTH AND DIAGNOSTIC CENTER
RICARDO UMSO MEDICAL CENTER
ORMEDIC
ST. CAMILLUS HOSPITAl.
MATI PROVINCIAl. HOSPITAl.
DIGOS DOCTORS HOSPITAl.

CHD CENTRAL MINDANAO REGION


COTABATO REGIONAL AND MED. CTR. S1noul! Avo.. Cotabato City

GENERAL SANTOS CITY HOSPITAl. ugao. GIn...,8antoo City


HOWARD HUBBARD MEMORIAL HOSPITAl. PoI.....ok,South Colobato
NOTRE DAME OF MARBEL UNIVERSITY CUNIC TRAINING & NOMU CmpcI. A1unon Avo. Kanln.dol CIty
DIAGNOSTIC LABORATORY
PNRC- COTABATO CHAPTER BLD. CTR. p.c. HIli. Colobato CIty
PNRC- GEN. SANTOS CITY CHAPTER BLOOD CTR CItyHall c...poand, GIn. Santoo City
PNRC SOUTH COTABATO BLOOD CTR. MobInl SL. K.....adol CIty
SOCSARGEN COUNTY HOSPITAl. Bub-lagao RlI. cor. _ _ SL. GIn._
SOUTH COTABATO PROVINCIAL HOSPITAl. AQuJnaldo SL. City of Kanlnldal
ST. ELIZABETH HOSPITAl., INC.

NalI",aI Hlghw.y. GIn. santoo City

SULTAN KUDARAT PROVINCIAL HOSP. bubn. Sultan Kudo...


THE DOCTORS CUNIC AND HO.SPITAI. Gon...1sa_ 0

K.....da1 CIty

MADONNA GENERAL HOSPITAl. Y2QOS


SULTAN KUDARAT PROVL. OFFICE .Y2QOS

CHD CORDILLERA ADMINISTRATIVE REGION


ABRA PROVINCIAL HOSPITAl. sanguld,_
ATOK DISTRICT HOSPITAL (now) Bayangan. - . Bangut!
BAGUIO GEN. HOSP. AND MED. CTR. Bagulo CIty
BAGUIO HEALTH DEPARTMENT Now Ludlan. Bagulo CIty
BAGUiO MEDICAl. CENTER IlIIIWy Cut'"
BAGUIO MEDICAl. LABORATORIES Aaallmllllon Rd. EJI.. Bagulo CIty
BENGUET CUNlCAL LABORATORY """0 - . Baguto City
BENGUET GENERAL HOSPITAL (now) u Trlnldod. BanguI!
BONTOC GENERAL HOSPITAL _IlL_nco
FAMILY POLYCUNIC

_Ion

Road, Bagulo CIty

CIty

Annex D
DOH-NEe Form A
(English and Tagalog Version)

48

Personal Information Sheet (DOH-NEe Form A)


Please read Basic Information at the back ~f this form. All Information given will be strictly

confidential. Please fill out form as honestlV as possible. If below 18 year. old, or

physically/mentallV Incapacitated, the guardian I. requested to fill out this form on behalf
of the Individual/client.

t. Purpose

or Testing (Plelllse check only one box)


DYes

Personal
EmploYlnent

0
0
0
0

Local
Abroad
Legal':lnsurance

Entrance to School

No

0
0
0
0
0

Yes
Yes
Yes
Yes

No
No
No
No

If others, Please: spedfy:

II. Demographics (Please fill up all Information asked:)

c::J

I
last name

MI

First Name
permanent lIddress/malllng address:

Contilct No: _ _ _ _
6Irthd.y[M'I/DD/Y,n): --1--1_ _
No.of Children (if applicable):

Age: _ _

Sex (M/F):_

Civil Status:

Nationality:

------

Ill. Employment History (Answer as honestlV as possible)


Present OCtupatlon:
the last 5 years:

Occupaucws in

IV. Travel History (Answer as honestly as po"lble)

Travel abroad in the past 5 years:


If yes, What country/countries:

Purpose of travel abroad:

If OFW

Yes

No

Tourist
0 Educatlon!Trelnlng
Buslness/Offldal
Employment
See-Based
0 land-Based
- (Please check box/a that .-;D~l-

V. History or HIV 'rest

0 No

PrevIous HIV Test?


DYes
If Yes, where (Fill out appncebtc Information)
Name of Ho~pltal:
Name of Clinic:
Name of Blood Bank:

Result( +1-): ,__


Result(+/,):
Result(+/-):

Date:
Date:
Date:

I. Have you experienced any of this? (check all that applies)


MultIple Sex Partners
D.ves
ONo
If Yes,
0 Sex Itlth opposIte sex
Sex wIth both maleltemale
Sex with same gender
Injecting drugs without doctor's advice
Born to HIV Infected mother
Current or Previous Syphilis, gonormea, genital discharge, genital ulcer
Surgery
Date: .cYear).
CountrY:
Country: _ _ _ _ _
Blood Transfusion
nate; (Year).

o
o
o
o
o

VII. Did you receive information on HIV I AIDS In these facilitv?

If yes, please check ell that applies

0
0

0
How a person can get HIV
Services AvaUable (O:lIl1UClln;, lr"eatmentarc 6 $UpJlOIlJ 0

DYes

ONo

What to do If tllV screening is reectlve


What to do If HIV conflnnatol)' test Is posttlve

VIII. What are your other sources of Information on HIV I AIDS (check all that applle.)

0
0
0

0
0
0

One on One Counseling


Pre-Departure Orlentatlon Seminar (POOS)
PamphlefS/Posters

Group Counseling

Video
Other, Please spedfy:

IX, FOR PHYSICIANS ONLY


kame of AgenCY!Hl>spltaVClilllC/Lab:
Address:

--~

Name and Slglldlure of MD:


Contact No.:
. -- -

--

--

49

--

--

_.

_._- . -

--,

Informed Consent and Pre-test Counseling Details for Laboratory Retroviral


The Department of Health (DOH) has existing program on the prevention and control of HIV/AIDS In the Phlllppines. In this regard, National Epidemiology Center (NEe) of DOH is collecting Information which can help in planning the activities of the program which will be beneficial to the people. Your
full cooperation is highly Important to undertak.e this activity. We are encouraging you to answer all questions ,as honestly as possible.
EXPLANATION ABOUT THE TEST

1. What is HIV antibody testing?

HIV antibody test Is a blood test. It will show If you have antibodies to
HIY- - the virus that causes AIDS. A sample of blood will be taken from
your arm. If the first test (screening) shows a positive reaction, another
test (confirmatory) will be done to make sure that the first test Is really
positive. A positive antibody test means you have been Infected with HI\{,
a negative test means you are probably not.Infected because It takes
time for the body to produce antibodies. So If you have been exposed recently, you need to be retested after 3 6 months to make sure you are

not infected.
2. What are the benefits of taking the test?
If you test negative:
You can learn how to protect yourself from getting infected by practldng
safer sex (e.g. monogamous relationship, condom use).
If yoy test positive:
You can learn how to avoid transmitting the virus to others like your partner or unborn child and how to take good care of your health properly by
adhering to your doctor's advice. You can also seek assistance from the

My Question about HIV testing has been answered. I therefore


agree to take HIV antibody test.
Date:
Signature:
Name/Code:
Age:

Sex:

Address:

---------------------------------------------------FOR PHYSICIAN & MEDICAL TECHNOLOGIST


I have explained the HN antibody test, how It Is done, the meaning
of the results and the possible consequence of disclosure.

HIV/AlDS Core Team (HACT) of govemment and private institutions.


3. Voluntary HIV testing
Taking all HIV antibody test is voluntary. If you do not want to be
tested, you have the right to refuse the test. If you want to have the test
but don't want to reveal your Identity, you can use a codename.

4. Confiqentially of Test Results


Your test results are confidential. It will only be given to you
personally or to those you authorized to know about the result.

Physician
Medical Technologist
(signature over printed name)

Agency/Hosplta.l:

Date:

Personal Information Sheet (DOH-NEe Form A)


Mah.lauallg TlIuublllnl PaklbiUla po ang Impormuvon .. lIkod. Ang Iohat po ftl lblblgay nyollllI Importnllayon av
menaNtUing IIhlm. Paldl.&Sllp lang pong aaguttn ang mg. uRong ne buong lulbpatan. KU"iiI 8ng edad av mababll . .
18 taon, may plsJklll 0 pangkallipang kapanun8n hlnlhillng po na lung tag.pangal.". (guardian) ang Rim_got . .
'Orl1lllD Ito peril sa k.Ilyente.

t.

KadahlJan.an n9 ppgpapll5url ng DU80 (Paldlauyan ng check [I) ang plnak. ongkop n'8 Algot

, ,

panSar111
Trabaho
Pillplnas
Abroad

'0

00

HIndi

00
00

HIndI
HIndI
Hindi
Hindi

0
0

I.egal/InSunlnce
PagpDsok sa Paii!lralan:

00
00

0
0

Ibang Silgot (Pakisulat kung may Ibeng sagot):

II. Personal na Impormasyon (pakllagvan ng sagot ang lahet ng katanung_hl)

c::

Pangalan

::=J

llrahal1/Address ne pW",deng

c=J

I
Apelyldo

paopadelhan ng SUlat:=================

retepcnc: __ ~_ _.".._-=-----.,

---------

Kapilnganakan(BuwaniAraw/Taon): --1_1
Dllang ng

anak ne

HI

Kasarlan(M/F):_
ll1ababe sa Ie teen (Saguun kung I\aaangkop): __

Edad: _ _ Estttdo:
Lilhl:

III. Trabaho (SaliJutln ng Buang katapatan)


Trabaho sa kasetckuvan:
lrabaho oooog nakalipas na 5 teon:

IV. Paglalakbay (Sagutln ng BLiong katapatan)


raglftlllkbllV sa Jabas oy Pluplnas sa nakDllpas n8 5
Kung 00, ancnq bensa:

patuten 09 Paglulakbay:

_L . _ . . . . . .

Pagpapasuri sa HIV 0 AlDS

tUndl
_

PlJg-aaral(TllIlnlng
Trabaho
;:J. pall~: lupa

Nakapagpa HIV Test kl!l'na ba?


0 00
Kung 00, saan1 (Pllklsagutan 8ng oaaangkop)

00

TUrlS\'D
Business/Official

Kung OFW, 9P.~,n.~-dagat

v.

taon:

pangalan ng nspnet:

Petsa:

Pilngalan ng Klinlka
Pangalan "9 Blood Benk:

Petsa:

Hindi

Resulta(i/-): _
Resulta(+I-):

Petsll:

VI. Nakaranas na ba kayo ng mga Ito? (lagyan ng c:hec:k ang naaangkop

mil

Dilot)

Pakikipagtaltk S;;J Ibat-ibang partner:


000
0 Hindi
Kung 00, 0 Paklklpagtallk sa bebee OPaklklpegtalik sa babae at lalald 0 pakiklpagatal1k 53 kepere
hong kesarten
Nug- Inject na wDlang payo ng doctor
P1nelllganak og lsaflg Ina na pcstttbc sa HIV
DatJllg may Syphilis, gOflorrh9, tulc, sugat sa an
Operasycn
Petse: 'rreon)
Bansa
PB9~!ialjn ng dugo
Petsa: (Taon)
,
Bansa

VII. Mav natangvap lea bang lmporm..yon tungkal sa HIV at AIDS sa kUniQ. o&;pltal 0 laboratoryo
itol 00 0
Hindi 0
Kung 00. pakllauyan ng check [IJ BUg box na naaangkop

o
o

n.

Paano nakukuha 8no HIV


.'
0 AnD ang gagawln kung eng HIV screening test ay posltJbo
Serbisyong neketaan (c;oullil:llng. trcotmlMt u~ .. Suppolt) 0 Ana aog gagowln pao posltlbo ang HIV ccnnrmetorv

test

VIII. Ano 0 Alln ling Ibll pIIng plnanggagallnlilan ng Ivonlillmpormuyon tufllilkDl HIV at AIDS (Iagvan ng check
oS na ngkOp na IIDClot)
U
One on One Counseling
Pre-Departure Orientation SeminaI' (POOS)
PamphletS/Posters

IX. FOR PHYSICIANS ONLY


Name of Agency/HospitllI/ClJnlC/18b:

Address:
Name and Signature of MO:
Contact No.:

51

Group Counseling

At Iba pa:

Video

Informed Consent and Pre-test Counseling Details for Laboratory Retroviral


Ang Department of Health (DOH) ay may programa para pigilan ang pagdami n9 sakit na AIDS sa PlIiplnas. Dahll dito, ang National Epidemiology Center (NEC) n9 DOH ay kumukuha ng mga inpormasyong nakakatuJong sa pagpapaganda 09 programa para sa mga tao. Hinlhlngi po aog inyong

pakikilsa sa pagsagot po nq buong ketapeten.


paliwanag sa HIy Test
1. Ana ba ang HIV antibody Testing?
Ito ay pagsusuri 09 dugo para malaman kung may antlbody sa HIV
virus. May kukunlng kauntlng dugo sa loyeng braso. Ito ay dalawang beses susuriin. Ang una ay tinatawag na "screening" at aog pangalawa ay

"confirmatory'". Kung aog resulta sa screening ay reactive, aog dugo ay

. Ang mga katanungan ko tungkol sa HIV testing ay lahat nasagoL


Ako ay sumasangayon sa pagpapakuha ng HIV antibody test.
Petsa:
Lagda:

mullng susurlin (confirmatory) para mekasfqurc na posltlbo "ga sa HIV.


Ang pasttlbong antibody test ay nangangahulugan na lkaw ay may impeksyon og HIV, ang negative test ay maariog wala ka pang Impeksyon.
Ang pagkakaroon og antibody ay matagal, kung nagkaroon ka ng
"exposure" sa virus sa pamamagitan "9 pakikipagtallk sa lba't-lbang
partner oa walang proteksyon 0 pagjloiksyon ng gamit oa hiringgilya,
kailangan ulitin ang HIV test pagkatapos og 3~6 na buwan.

2. Ang kabutlhan ng pagpapa HIV test?


Kung negative ang resutta:
Makakapag Ingat ka kung paano rno me-proteksvonan ang saril1 sa
pamamagitan og paggamit n9 condom 0 pagkaroon ng Isang tapat oa ka
relasyon (monogamous relationship)
Kung posltlye ang resylta:
Makakapag Ingat ka kung paano rno ma-lwasan oa makahawa sa
iba at paano mo ma-pangangalagaan ang iyong sarill. Maari ka rio humlngl n9 tulong sa mga gobyerno 0 prlbadong lnstitusyon oa may HIV/

Pangalan/Alyas:
Kasarlan:

Edad:
Address:

---------------------------------------------------PARA SA DOKTOR/MEDICAL TECHNOLOGIST


Aklng nalpallwanag ng tama ang pagpapakuha ng HIV antibody test,
ang kahulugan ng resulta at ang poslbleng mangyarl sa pag bubunyag nlto.

AIDS CoreTeam (HACT).


3. Kusang loob sa pagpapa-test "9 HIV
Ang HIV testing ay boluntarvc 0 kusang loob lamang, di ka maarlng pilltln kung ayaw mo na magpakuha ng test. Mananatiling IIhim ang
Iyong pangalan at lba pang personal na impormasyoo kapag iyong nlnais.

Doktor

Medical Technologist
(Pangalan at Lagda)

4. Pagkuha n9 resulta
Aog resulta og HIV test ay mananatiling Ilhlm. AAg resulta ay ibibigay Jamang salvo 09 personal 0 sa taong blnlgyan ma "9 kapangayar1han

Agencia/Hospltal:

upang kumuha n9 resulta.

Petsa:

Annex E
List of Accredited HIV Testing Laboratories

53

FORT OElPILAR STAllON HOSPITAL PIIA,Bag.l. City


LUIS NORA MEMORIAL REGIONAL HOSPITAL Ba.ko, Ill. P _
SLU HOSPITAL OF THE SACRED HEART AI"mption Rd. ExL, Bag." City
STO. NlAo JESUS MEDICAL CENTER Low" P. Buill'" Bag.1o CIty

CHD-CARAGA
BUTUAN MEDICAl CENTER Butu.. CIty
CARAGA REGIONAL HOSPITAL RlzaI St. Burigl. City
D.O. PLAZA MEM. HOSPITAL Patln...y, Prooparldad, AQuu, daI Sur
PNRCo BUTUAN CITY BLD. CTR. Capltol SI... Ag.... daJ
PNRCo SUR/GAO DEL NORTE CHAPTER (now) PI"'" eor. IlagaD

_ .. City
St. S.riga. CIty

Annex F

DOH - NEe Form B

54

Phvslcian's HIV I AIDS Case Renortlnq (DOH-NEC Form B)


he law on Reporting Disease (R.A. 3573) requires physicIans to report all diagnosed HIV tntectlcus (asymptomatic and symptomatic cases) to the AIDS Registrar, National Epidemiology center, Department of Health. A written report must be submitted at the time of any of the following:
1\ time ot dlecnosls: 2\ folfow-un 3' orccresstcn to AIDS' 41 Death

1. Demographics (Please fill up all information asked:)

first Neme

0MI

Permanent address/nleillng address:


Birthday (MM/ODjVYYY:---l-...J

I
Last name

Ovll Status:

Age:

II. Type of Report:

0
0
0
0

Initial'
Follow-up

Conversion to AIDS
Date (MM/DD/yyyy): ...../-----.1
Death

III. Dete Referred (MM/DD/YYYY): -----.1-----.1_


Referring Facility:
Date Confirmed (M~I/DD/yyyy): -----.1-----.1

IV.

urv/ AIDS

Laboratory Code:

Classlflcatlon (See WHO classification at the back) :

V. Mode or Transmission

0
0
0
0
0

Unprotected Sex with t-1ultlple Partners


Heterosexual
Bisexual
Sharing of unclean Injecting equipment
Blood Transfusion
Born to HIV Infected mother
Others, Please specify:

VI. For 18 years old and below


0 80m to HIV Infected Nether
0 Father died of AIDS
0 Nether died of AIDS

Homosexual

o Both parents died or AIDS

IVII. If female, does she have access to PMTCT during pregnancy


If yes, What Is the prophylaxis reqlrnen?
0 Nevtrepme
0 Nevtraptne + AZT
0 Others, please specify:
0 None
VIII. H female, does she have children < 2 years old?
If yes, What is the current breastfeeding practice?
0 Exclusive Breastfeedlng
0 Nlxed Breastfeedlfl9 .
length of exclusive Breastfeeding
0 <=6 months
0 7-17 months
0 18 + months

DYes

IX. If patient Is child < 2 years old, What is current feeding practice
0 Exclusive Breastfeeding
0 Mixed Breastfeedlng
X. If patient Is <::: 18 years old
0 On Cotrlmoxazole
0 OnARV

Started (MM/YYVY) :
Started (MM/YYVY) :

XI. Adult ART (If patient >_ 19 years old)


0 On ARV
Started (MM/YVYY) :

[n.

Physicians Name:
Contact Number:
Health FadIJty(Narne/Address) :
Dote Report (MM/DD/YYVY): -----.1-----.1

55

Yes

No

No

WHO Classification
Indicate in the columns below what disease(s) the patients has by placing a ring around the bullet point next to the disease or clinical problem

WHO Clinical Stage I


Asymptomatic
Persistent Generalised
lymphadenopathy

WHO Clinical Stage II


Unintentional weight Jess-e 10% of body
weight in the absence of concurrent illness
Minormucocutaneous manifestations
(seborrheic dermatitis. prurigo, fungal nail
infections,recurrent oralulcerations. angular
cheilitis)
Herpeszoster within the last 5 years
Recurrent upper respiratory tract infections
(ie, bacterial sinusitis)

WHO Clinical Slag. III


Orul curmidiaeis

Oral hairy leukoplakia with other


systemic features
Vulvo-vaginal candidiasis with
othersystemic features
Unintentional weight loss> 10%
of body weight in theabsence of
concurrent illness
Chronic diarrhoea> 1 month
Prolonged fever (intermittent or
constant) > 1 month
Active Pubnonary Tuberculosis
(PlB)
PTB within the past year
Severe bacterial infections (eg
pneumonia, pyamyositis)

WHO Clinical Stage IV


Hlv wastingsyndrome (weightJoss>
10% of body weight and either
chronic feveror diarrhoea in the
absence of concurreot illness)
Pneumocystis cariaii pneumonia
Toxoplasmosis of the bnrin
Cryptosporidiosis withdianhoea > I
month
Isosporiasis with diarrhoea > 1 month
Cryptococcosis, extrapulmonary
CytomegaJoviIuB of anorgan other
than liver, spleen or lymphnode
Herpes simplex infection,
mucocutaneous for> 1 month or
visceral
Progressivemultifocal
Jeucoencephalopathy

Any disseminated endemic mycosis


Caudidiasisof uesophagus, trachea
and bronchus
Atypical mycobacteriosis,
disseminated or hmgs
Non-typhoidal salmonella septicaemia
Extrapulmouaytuberculosis (EPTB)

Lymphoma
Kaposi'S sarcoma
HJV encephalopathy'

Annex G
Administrative Order No. 18 s. 1995

57

.SAN:i?~:tARO:COMPOUNO'':
RIZAl:AVeNve;STA. CRUZ
MANILA,:p!liLIPPINeS :: .....
reqlO. 7\ i -00'80 .

21 November 199.5

AD.l\w;tISTRATIVE ORDER
s, 1995
.
.

NO~.Ltr_

SUBJEc;I':.

1.

Revised Guidelines in Ille Mwmgem"nt ofHIWAIDS Patients in the


'. : Hospital
.
'

BAcKG;ROUND

by

1110 HlV/AIPS.pan<lomic has be~n declared a worldwide emergency


the World Health
Organization, This situation has serious healIll, social, economic and political implications for all
cO)Jnlries. 'TIle Philippines is not.spared of'the problems brought about by this pandemic as evidenced
by the current national statistics on/\lDS.
.

lnresponse to the emerging need for standardized procedures in the OPp. consultation and/or
hospitalization ofIDV/AIDS patients, the Department of Health through the Hospital Operations and
MamgemenlService in collaboration with the Nationill:AIDS/SID Prevention and CO"Jlrbl Program
issued Adminis!rllti"e Order 'No. 27 last :M:~c,h::l994;",Sincethen, the-guidelineshad been:
disseminated to concernedhospitals lJIfough.orie!,\!swlIisemfuars; Wid even through other training
r
workshops conducted
by
'
.
. the.national AIDS prognui
.
:.:' ,
More than a-year after'its issuance.' experisllcli'in field implementation had gradually
accumulated,
WiUllessons learned, the need for
.
. , '.
. .the revision.'of "this
. guidelines
'.
.. became evident.
"

"

II.

OBJECTIVES'
General Objective: . To strengthen the cap3,ll'ility~f:Uie hospital in the prevention and
control ofHIV infection!AIDS.,':
Specific Objectives:
To organize an HlV/AIDS Core,:TellliJ.
~. .
To formulate standardized guidelines: in the management ofHIV/AIDS.
3.
To provide holistic' care to HlV~infe~tediAIDS patients, their families and
signiflcant others including refe,~~~:and, networking withNGOs WId GOs.
4.. " To develop human resoufces';iiecessarv to' carry out the provisions of this
. guidelines,
5. . 'To' Implement Wid op,!,r~J'9.ll1.i,ze: HIVI AIDS-related programmes in the
. hospital.
1.

JJ. OROAtfJ
zArlotfAL1!,S:r;RUCrURE!
.
.. ..
-., .,.
.
'

:"

'

~,

I
I
I

COHMJTTEE
Otl HOSPJ TAL
POLJCJES

Otf

I
I
I
I

_ .J

IUDS

CHIEF
'OF 1I0SPJTfiLS

I--t .. "ACT

.. .
~

ADMI ttl SrHAT] \,IE

SERVICE

HEDICAL/DENTAL"

SERVJCE ..

NURSING

SERVJCE

N.

COMPOSmON AND FuNGTIONS OFTIIE HACT

.
Each DOH hospitalshal! organize lUI HN/AIDS Core TewII (HACf) wbibh shall direetly
reportto the ChiefofHospital. It shall be composed of, butnot limited to the folloWing: doctorts),
dentist(s), lIurse(s), medical social workerts), wid medical teclmologistts) wid have tho following
functions:
1.

Formulate hospitalguidelines on the comprehensive care and manngemeut


.annv'/AIDS poti ents,

2.

Provide cure nnd counsolling 10 UN/AIDS patients.

3.

Promote prevention und control meaaures/strategies such as'health ('!(hlCl1ion


.and hospital infection control,

4.

Facililate inter- and intra- departmental/agency coordination including


referral system and networkiug.

S.

Perfbnns rraining Wid research activities on fllWAIDS.

6.

Provide reconuneudations ill hospitlii planning nnd development related


toIllWAIDS.

7,

. Monitor compliance. of ethico-moral guidelines fOI: lUv/yUDs including


confidentiality ofrecords and reports Wid release ofillfonm/tioll.
:

8.

'.;'

Update records and submit


reports 10 concerned offices.
. .
'

9.

Condnclmonitoring and evaluation activities.

SPECIFIC FllNCTIONS OF EASH HACr MEMBER

1.

PHYSICIAN
1.1

Acts as chairperson ofHACT as designated by ihe Chiefcf'Hospital,

1.2

Coordinate with the Hospital Infection Control Conunilt~e" ill Ole strict
implementation of prevention ami infection control measures within the
hospital.
'.

1.3

In - charge of the rnedical management.

1.4

Ensures follow-up ofpatlents andreferral to otherspecialties as necessary.

I:~)'\Coi;duc~ Irninillg~ld rese~ch. '

. . ~::.:;::.: ';: .. ,~; '~:' .. , ::'~~:\";:~~' i;~:>:: "..~,.: . .:'..

..":' ....

1:6,,:i:;,:,S~blliit& ropI1l1s"ofHlV infection/AIDS to the National AIDS iRegistry.

.:':,~:.~y:.:~>~:.~~~.::i:;}:::.<.:~....

.-~

. \' .:

1.7::
<'provides post-test counseling,
. . '.'
~

2.

':: .-

'DENTIST
"

'

<

2.1

COOl'dinnles with Hospital Jnleclion- COJllrol Committee: in the strict


illq)lt'II~l1nlion ofprevention and infection control measures within the !Icntlll
clinic. .

2:2 '

III - charge of'the oral care and management,

2.3 '

Disseminates oral health infonuation and counseling

2.4

Ensures follow-up of dental patients and refers them to slledaJist when


necessary.

2.5
3.

,Conducts training Wid research related to dental field

NURSE

,..
,

, 3.1

In- charge ofthe nursing management

'3,2

Coordinates patientrcfcrralawithinthehospital.

3.3" ,Px;om~t~s heillUiedtication ll~!ivitics. '


.'

3.4
3.5
4.

:;.

' ,Malluges training and researchactivities for nurses and anxillaries.


Ensures implcmentntion of infection control guidelines.

MEDICAL SOCIAL WORKER


4.1

Provides psychosocial support services including counseling to HIVinfected!AIDS patients and their families.

4.2

Coordinates mid establlsheslinkagcs willi GOs mid NOOs in qrder to:


4.2.1

identify existing resources for efllcient networking,

4.2.2 assist in providing alternative source of income.


4.2.3 provide continuing psychosocial RUppOJ1.

.4.3:
'. .4.4

.Provides
beaiUI
education..
. .
.
"

~'.

Conducts bon~e visits/follow-ups.


.~

4.5

5.

Conducts trni/lill.~ and research related to social work activities.

MEDICAL'ruCHNOLOGIST
5.1

Ensures that pre-test counselling is provided with

WI

oral or written

.infonned consent,
5.2

Performe appropriate laboratory procedures according til set technical


standards.

. 5.3. .Ensures proper laboratory waste disposal.

5.4.
5.5

V.

Implements guidelines on laboratory safelyand preparations,


Ensures that test results aro reviewed and duly signed by! the laboratory
..chiefbefore releasing to HACTphysiciliu.

APPROACH TO MANAGEMENT
1.

Suspected or known HlV-inlecfed patieuts shall be referred to the I-IP"CT.

2.

.Inilial assessment sball be done by BACT physician.

3.

. .

Sl~'i(lecfed HIV cases s11~dllUldergo mv lUl(ibody testing with lUI infonued cousenr alter
a. pre-lest counselling, Post-test counselling shall be provided to all patients who

underwent HIV antibody testiug,


4.

The decisi 011 to admit known HIV-infecledlAIDS case shall be det~llniued by the
HACT doctor and shall be admitted to the appropriate ward according 10 the
presenting mrnliibslalion.

5.

A lIIullidisciplinwy approach 10 (be care and counselling ofUN-injected patients


shall be carried out by the lIACT.

6.

.AIl lIlY-infected/AIDS patients for discharge shall be provided] WiOI written


discharge instnlCtions on home care ami management,

7.

Asymptomatic patients shall he followed-up every 3 months, Symptomatic


patients shall be followed-up lIS necessary,

8.

Referrals/networking with other hospilals/lISE'lIcies shall be done as necessary.

-,'

Vl:,RECORDSANDREPORTS'

.;....':::/'i/,"

';fu~1i;~~G~i~tf~,~~:}~~~~~~~~:~,~:t~::~r;;/:;~ ;~::;'I~t~~lO[~'

';;;:'i;y .ri~t~;;!~{i~r~!~~~~~;;;;~~~'u:erocords
"

VII.

of ffiV/AIDS patients are complete aUd'

'. regulurlyupdated,

3.

HACTshnll submit to the Medical Records Office lhe records of HN/AIDS


patients with coded names. 111e name shouldremain with HACT for!safekeeping.
Howcwr.infilllllatfon related 10 such record shall be released only upon ,huUlorizMion
ofChiefofHospilltl unless otherwise delegates (0 the HACT chainuani

.4.

HACT shall submit updated reports 10 concerned offices for statistical purposes
(DOH-National AIDS Registry),

MONITORING AND EVALUNl10N

1.

HACT sIll/II fonnulale lJIonitoriug tools :llId guidelines for the lUV/AIDS program
of Ule hospital.

2.

HACT shall conduct annual evaluation of program implementetidn and make


necessary recommendations,

3..

HA~'Tshal1

4.

HACT shall CO;ldl;ctre~uhU';;evi~~ oHIIVlAlDS clinical management protocol.

toNASPCP.
.submit
' annual report
.

".

VIII.

guidelines .

. ".:':

. '.

. .:. . . . . .

GENElW, PROVISIONS
.
.
"'

,"

1.

..

'.

'

.....
,.1.-,.

Confidentiality

.
.
,
All HACT members shall ensure lhat all medical dala andinfonuation bfIllV/AIDS
p:dicllls lU'C maintained with ulmos(confidcntinlitY,. IfACT physicians are required to report
using Ow official HIV/AIDS reporting form (See'ANNEX 3) ~y lUV i1~ection/lm~ c:~e the
HACTmcmbenllulemlfo.lll order to protect the flmdamental right ofpnvacy of lUI individual
with AIDS or iuleeted with lIlV, (lui reporting must be limited 10 Ihe number ofAIDS cases
Wid other statisticsWiUlOUt divulging the .identity ofthe person unless (he pat~ent agrees in
~
writing to the disclosure. .
,

2.

Counselling

All BACT members should be able to provide counselliog to :III patients including
pre- nnd post-testcounaeling,

3.

Right to health care services

..

".

'

..'.; ..:lllVlA!DS'pptiimts'have the right to avail of healIII care services in oj1y health care
1hcilily. OnewhohnsHIY Jufecliou/AIDS shnll not be denied his right [0 medical uealment,
.

....

'..

".' .'

' : ' , ."..

'. ;. .
.

:" ~ ."
. . . ; : "":

.:.;".

4. .. . Hospital Implementing Procedure


.," :"

. ..... TIle HACI' shall be responsible for Iormulating 1l1E' implementing iprocedw'e of
Illis guidelines and such procedure shall be in accordance to the objectives B!ld provisions
of this Administrative Order. '111e scope and.limitations of the Hospital Implementing
Procedure shall be concurrent to the hospital set-up and capacity,
5.

Case Definition

Anyperson wilh or without overt signs and symploms of opporhUlisti~ infection and
gives a conlirmed positive HIV antibody test result is diagnosed to be lllV-ilillJcted. On the
odlerlllllK~ lUI AIDS.case lias one or more of theAIDS-dE'fining conditions (sl:'~ ANNEX 1).
6.

Universal Precautions

UniVerSllll'reclllltions assnule dmt blood, blood products and olher podyfluids


of
1
all patients are potential sourcesof infection independeut ofdiagnosis or perceivedrisk: It
is, therefore, mandatory for al/ ltospital porsounel to practice precautionary 111t1llSUrE'S (See
ANNEX 2) to preventtransfer of lIlV and other infectious agents,
7.

Post-Mortem Care

.
All dead bodies shall be considered potentially infected with liN( Procedures
tlmt would entail'physical contact with blood and oilier body fluids shall ~e carried out
with precautions, Cadavers should be properly placed inside a non-permeable material
such as plastic bag before burialor cremation, Physical barriers io prevent exposure of
skill mid ImJCOllS membranes to potentially infected bodyfluids during post-mortem procedure
shall beutilized. Patients who died ofAIDS shall be buried unembalmed within 24 how's or
cremated.

IX.

PENALTY CLAUSE
AllY individual wllo does lUI ac~ ill violation of any of the foresy,ing provisions or fails
todoanactprovided hereof, shall be subjectto appropriate' actlon by proper authorities afler
due notice Wid process.'
.

, .. .." ;':i;;'F!1bu!kd;;rSUp~~A~irlSlrativ~6I'd~rN~.:il>~.'1994'(S~bj;~t;")3~idelilles~n
~,'

'O,I>D,:;Consulf!l:lioIi and/or Hospi!a\ization of HIV/AIDS Patientsjandshall ,take effect

, ,,' ,,' i , ';; ,

inuUediStely."

#~.,

... ~r

HILARION J . - , JR., MD, MHA


Secretary 0 Health

ANNEX",,!,;
; -. :.' .;";::.1..: ..
.....

"

....

. :,;,.:JjSC.l;J!tl\r.sTo.r p~scase C;::ontro.(c;::~C)~'f;~Ip~J)~fining Conditions

.',

9;;~~i~~istt~;i~;~~,:i~~~l;;\)-~>;f':;''''>~'\''~ ,::'d':>',

.... ' ..' .. ,- .

.. ; .\::Ca,ididiasis, o(bronchi; trachea or.lungs ..: ..


;:" Candidlasls,' esophageal .
. . ~:'Coccidioidomycosis, dlsscmlnated or cxtrapuhuonary
. Cryptoceccosls, extrapulmonary
.: Cryplosporodiosis, chronic inlestinal (>lmontb's duration)
. " Cytomcgalovirus disease (other than livcr, spleen or nodes)
.Cytomegalovlrus retinitis (with loss or'vision)
Herpes simplex: .chronic ulcer(s)(>lmonthjs duration), or bronchitis, pneumonitis;
I
.'~~~~

Histoplasmosis, disseminated or cxtrapulmonary


Isosporiasis, chronic Intestinal (>1 month's duration)
MycobacterillllJ avlum complex or M. kansasil, disseminated or extrapulmonary
Mycobacterium tuberculosis, any sitc (pulmonary or cxtra-puhnonary)1 '
Mycobacterium, other species or unidentifled species, disseminated or
extrapuhnonary

Pneumocystis carlnil pneumonla


Pneumonia, recurrent
Progrcssive multifoeallcukoenccphalopathy
Snlmonella scpticacmia, recurrent
Toxoplasmosis of braiu
Malignancies
Kaposi's sarcoma'
"
Lymphoma, Burkitt's (or equivalent term)
Lymphoma, Immunoblastic (or equivalent term)
Lymphoma, primary of brain
Cervical cancer, Invasive
Encephalopathy, lIlV-related
Wasting Syndrome due to 1.,IV
..,.

Advanced immune deficiency (CD4 cell count <ZOO/uL)

ANNEX'Z:';
,.:UnivenaJ Precautions"

;:,,-,:".r~.~F;!.-'~!~i:~J~;~ bygien~e
': . , .... :'.,::.'

.... ,

procedures, espectallyhandwashlng] should be


:: followed at all times

b.

Hospitnl or medical centre guidelines for disinfection and kterilization


should bc consulted and followed faithfully.

c.'

'. Any skln disease or injury should be adequately protcetcdwith gloves


.or impermeable dressing to avoid contaminationwilh a p~tient's body
. fluids.

d.

Any spills of blood or other potentially contaminated material should


be liberally covered with household bleach (dilution 1 toIIO), left for
30 minutes then carefully wiped off by personnel wearing gloves.

e.

Gloves, masks and protective eyewear should bcworn during surgery,


childbirth and other procedures that might cause splash~ng of blood
.f ~r'body fluids wherever possible.

f.

Needles and sharp objects should be discarded in puncture-proof


containers. Do not bend or break needles by hand. Do not recap uscd
disposable needles. . .
.

g.

Reusable needles and syringes should be bandied wilh extreme care


and safely stored prior to cleaning and sterilization or dlslnfeetion.

h.

Linen soiled with blood or other body fluids thould be handled as


little as possible. Glovcs and a protective nprof should be worn while
handling soiled linen,

,:", "?>'"'' '.

..

pell~Wne~~"QK.;J:I~al$; .

/:;:";,':;,Na,tionalAD.:>SPry'~nti()ltX8n~:

ControlProgram

, ',., '<':'\San:La:rn.roCom.P()~ndi.S~;.C!-11Z;M~la
:' '. -c-, ' . : : ' . , '

."

....

.,- . '

.'

' .

mv AIDS Case Regottllg Form


7:11, LAW ON RBI'ORl1NG .COMMUNICABLE DISEASBS (A.CT 3'13) "'gut", att,ndlng p1l1lician' r~ "pon oll
t1IIIgfIQSfI BW ltI/,dI4ns (/Mlut1bl8. both IU1mp14~ tuUf qmp14~ com) 14 tit, AIDS R,Btstm" FI,ld
Bpld,mlology nulnlng l'rog/Tl11l (FETP), DtJHIrtlll,nl 01 H,olth. .A wrltt,n npoTt mU8t b, ,ubmllt,d pi /h.' Ifm. 01
tlJI1 olr1l,followlng ,,,nts:
1) nm, o/dIogno,Is:') l'rog"lSIo"tu AIDS; tuUf 3) D,arh. l'1i,sklDnlot,
,m:oumged

. . t4 "'f,rlI1I BIVIAIDS porl,nts 14


SD1t l..iu.tW Inf,crIolll
BUlpflDl, sra. Ow, MonJ1a t6, tit. Rlltorch.Im1Jlu1'lu, Tropful Mt4kln" A1MGng, Munlinlupo, MM. (T,l. Nu. 842-'U$, 842-219-1)10'long tinll
, follow-up.

DfI'M,

,1t1J"

Patient's InitiallCode:=

0'

~-_

Birthdate (MMIDD/Yy)::-.:--=.-:-=---,-_ Age _ _ Sex ---:..__


Date of IllV Diagnosis' (MonthlYear)
.... ;),.;:....::.;. -.t ,

----'----,----.-jf---

....

HIVI AIDS C~lOcaUon:; .: .'<


_ _ Class 1 (Acute InfectionF'
.
Class 2" (Asymptomatic HIV Carrier)
;
- - Class.3 (persistent ~etiera1izedLymphade~9pathy)
'.
!
_ _ Class 4A (Constitutional Manifes~t10ns;te::'prolonged fever, chronic diamhea, weIght
.loss, etc;) '.."
.: " ";"<~+
i
_ _ Class 4B (Neurologic31 Manifestations) ."
...
~
i.
_ _ Class 4C (Opportunistic Infections, Specify:
-'_
)

_-,-- Class 4D (Malignancies: Lymphoma, Kaposi's Sarcoma, etc)


_ _ Class 4B (OtherAIDS ReJated Conditiolls,~pecify:_

-,-_ _-t)

I
I .

,'"

Mode of TraIlSlD1ss1on:.. ' .


_ _. Sexual intercourse
Heterosexual ( ) Homosexual ( )

_ _ IV Drug Use (Needle Sharing)

__ Contaminated BlO9d Transfusion


Perinatal(Mother toInfant)
--Others, PIs. Specify:
_ _ Unknown

Initial

Report Type:

Date

- - Conversion to AIDS, Date (M~ilth/Year):


Death
Date (MontltlYear)::o-- - mv Related Death: ~Ycs __No
-,-

or Report:
..'

_
--,.

-:-__

AdcJressrrc1.N~.;--.

.;

"

ReCerrrlng Agency:'

.. ,

=:-":.../,...,..--------"-_

Reportlng Agencyll'hys!clan:.
. .AddIessJTe1:
No.:
,

.' c.

__._--!L
I

=l-

Annex H
List of HIV Treatment Centers

58

LIST OF HIV TREATMENT CENTERS

DR. ARTURO B. CABAN BAN

Chief of Hospital
San Lazaro Hospital
Telefax No. 711-6979

DR. FILOMENA DE LOS SANTOS

Medical Center Chief II


Vicente Sotto Memorial Medical Center
Telefax No. 253-9882

DR. GERARDO CUNANAN

Medical Center Chief II


Davao Medical Center
Telefax No. 221-7029

DR. REMIGIO OLVEDA

Executive Director
Research Institute of Tropical Medicine
Telefax No. 842-2245

DR. FRANCISCO A. VAlDEZ

Chief of Hospital
lIocos Training and Regional Medical Center
Telefax No. 888-3671

DR. CARMELO AlFILER

Medical Director
Philippine General Hospital
Telefax No. 524-2221

59

Annex I
Administrative Order No. 2005 - 0027

60

Republic of the Philippines


Department of Health
OFFICE OF THE SECRETARY
Manila

August 15, 2005


Administrative Order
No. 2005 OO~r
SUBJECT: Rules and Regulations Governing the Regulation of HIV
Testing Laboratories

I.

Background/Rationale:

In 1989, the Department of Health Issued Administrative Order No. 55-A s.


1989 otherwise known as "Rules and Regulations Governing the Accreditation of
Laboratories Performing HIV Testing" in accordance with Republic Act 4688:
"Clinical Laboratory Law" and Republic Act 1517: "Blood Bank/Center Law". Since
then, a number of testing centers have secured accreditation.
In order to promote a truly safe, effective and efficient blood transfusion
services, Republic Act 7719: "National Blood Services Act of 1994" and its
Implementing Rules and Regulations were passed. Further, to strengthen the fight
against the spread of HIV/AIDS infection, Republic Act 8504: "Philippine AIDS
Prevention and Control Act of 1998" was enacted. As mandated under Section 19 of
such law, all testing centers, hospitals, clinics and laboratories offering HIV testing
services shall seek accreditation of the DOH, which shall set and maintain
reasonable accreditation standards.
With the ratification of the above-mentioned laws, the advances in health
technology and the need to streamline the current procedure in securing
accreditation, review and subsequent amendment of Administrative Order No. 55-A s
1989 is believed to be indispensable.

II.

Objective:

These rules and regulations are promulgated to ensure utmost safety and
quality in the performance of HIV testing by laboratories.
III.

Scope:

Performance of any of the following laboratory procedures shall be covered by


these rules and regulations:
1.
Screening tests for HIV antibody
1.1
Enzyme Immunoassay (EIA)

2.

1.2
Particle Agglutination (PA)
1.3
Other screening tests for HIV antibody
Confirmatory tests for HIV antibody
2.1
Western Blot (WB)
2.2
Immunofluorescence (IF)
2.3
Radio Immune-Precipitation Assay (RIPA)
2.4
Other supplemental tests for HIV antibody

IV.

Definition of Terms:

A.

Applicant refers to the owner or head of a clinical laboratory or blood center


securing permission to operate an HIV testing laboratory
BFAD refers to the Bureau of Food and Drugs
BHFS refers to the Bureau of Health Facilities and Services of the DOH. It
shall exercise the regulatory function provided in this Order.
Blood Center refers to a blood service facility duly authorized by the DOH
BHFS pursuant to A.O. No. 2005-0002 with the following service capabilities:
1. Donor recruitment/retention and care of voluntary blood donors.
2. Collection of blood (mobile or facility based) from qualified voluntary
blood donors,
3. Processing and provision of blood components
4. Storage, issuance, transport and distribution of units of whole blood and/or
blood products to hospitals and other health facilities.
5. For National and Sub national and selected Regional Blood Centers only:
testing units of blood for five (5) infectious disease markers (Anti-HIV 1/2.,
Anti-HCV, HbsAg, Syphilis, Malaria)
The Blood Centers shall be classified into Regional, Sub national and
National whose service capabilities will be determined by the National
Council for Blood Services.
Confirmatoryl Supplemental Test refers to the test performed on samples
reactive to the screening test to ensure that the results were true positive.
This test includes but is not limited to Westem Blot (WB), Line immunoassay
(L1A), Immunofluorescence Assay (IF) and Polymerase Chain Reaction
(PCR).
DOH refers to the Department of Health.
EQAS refers to the External Quality Assessment Scheme. It is an external
evaluation of a. laboratory's performance using proficiency panels. It shall
evaluate the effectiveness of the quality assurance program.
HIV refers to Human Immunodeficiency Virus that causes Acquired Immune
Deficiency Syndrome
HIV Test Kit refers to the reagent used for the determination of the presence
of antibody, antigen, viral genome and viral particles in a clinical specimen
indicating infection by HIV types 1 and 2.
HIV Testing shall include the determination for the presence of antibody, viral
genome antigen/protein, viral particles in a clinical specimen indicating
infection by the Human Immunodeficiency Virus (HIV) types 1 and 2.
NRL refers to the National Reference Laboratories for HIV/AIDS, Hepatitis
and Sexually Transmitted Diseases or "National Reference Laboratories for
Confirmatory Testing of Blood Donors and Blood Units" designated by the
Secretary of Health as snpulated in Department Order 393E s 2000. It is a

B.
C.
D.

E;

F.
G.
H.
I.

J.
K.

L.

M.

N.
O.

P.

laboratory capable of doing screening and confirmatory laboratory services,


training, and surveillance and external quality assurance program for
laboratory tests. Whenever conflicting results occur, the NRL shall make the
final decision.
NRLRITM NVBSP refers to the Research Institute for Tropical Medicine. It is
the designated National Reference Laboratory for the Confirmatory Testing of
Blood Donors and Blood Units as stipulated in Department Order No 393E s
2000.
NRLSACCUSLH refers to the STD/AIDS cooperanve Central Laboratory of
the San Lazaro Hospital. It is the designated National Reference laboratory
for HIV AIDS. Hepatitis and SexuallyTransmitted Infections.
NVBSP refers to the NationalVoluntary Blood Services Program
Screening Test refers to initial serological test performed to determine the
presence of antibody and/or antigen against HIV 1 and HIV 2. This test
includes but is not limited to Enzyme Immunoassay (EIA) and Particle
Agglutination Test (PA) and Rapid Assay.
Specimen refers to the body fluid that is collected from a person and
submitted for analysis.

V.

Policies and Guidelines:

A.

General

1.
Only licensed clinical laboratory and/or blood center designated by the
NVBSP are allowed to operate an HIV testing laboratory provided that requirements
set forth in these regulations are met. Permission' to operate an HIV testing
laboratory shall be included in the License to Operate a clinical laboratory or blood
center.
2.
The BHFS or the CHD may conduct unannounced on site monitoring visits
and shall document the overall quality of the laboratory setting.
3.
The HIV testing laboratory shall be a section/unit /division of a clinical
laboratory or blood center.
4.
The number of HIV testing laboratory an HIV Proficient Medical Technologist
can handle shall be based on the Guidelines on Quality Assurance Program for HIV
Testing Laboratories set forth by the NRLSACCUSLH.
B.

Specific

1.

Physical Plant
There shall be a designated area within the clillical laboratory or blood center
adequate enough for the conduct of HIV testing. The designated area shall be welllighted and ventilated. dust free with adequate water supply and provision of an area
for decontamination of infectious/contaminated materials. Further, there shall be a
designated area (outside the laboratory) accessible for pre and post-test counseling.

2.

Personnel
The HIV testing laboratory shall have a licensed Medical Technologist with
training in HIV Proficiency Testing certified by the NRL-SACCUSLH. The HIV
Proficiency Certificate of the Medical Technologist shall be posted in a conspicuous
place within the laboratory.
3.

Equipment/Supplies
a.
The HIV testing laboratory shall have the appropriate equipment and
necessarysupplies for HIV testing which include personal protective devices.
b.
The HIV testing laboratory shall utilize reagents, such as HIV test kits,
which have been registered with the BFAD and with a valid Certificate of Product
Registration (CPR). However, for screening of blood donors, only BFAD registered
kits shall be used.
4.

Laboratory Reports
a.
The report form issued to the client shall indicate the name/laboratory
code of patient, age, sex, address, date of specimen received, requesting physician,
screening assay result (name of kit, lot number used, cut off value and patient's
absorbance, when necessary) and name and signature of the analyst and head of
the laboratory. Reporting of confirmatory result shall include among others
confirmatory assay results (name of kit, lot number used, brand present and/or grade
of IF results, If any).
b.
Each HIV testing laboratory shall maintain a documentary evidence (or
records) of all HIV testing performed, results and referrals of sera-active samples.
This should be made available during monitoring visitslinspection or at any time
deemed necessary.
.
c.
Reactive samples shall be referred for confirmatory testing to NRLSACCUSLH. Reactive samples for blood units/blood donors shall be referred for
confirmatory testing to NRL-RlTM NVBSP. Laboratories other than NRL may perform
confirmatory testing provided that the Philippine National AIDS Council upon the
recommendation of NRL- SACCUSLH deputizes it.
d.
Each HIV testing laboratory shall submit a quarterly report to the DOHNational Epidemiology Center on the number of tests performed, results and
referrals of sere-reactive samples and confirmed sero-active samples as required
under R.A. 3573 using the HIV/AIDS Case Reporting Format which can be
downloaded in this website: www.doh.gov.ph/saccl.
5.

External Quality Assessment Scheme


a.
The NRL-SACCUSLH shall conduct a continuing assessment of the
proficiency of clinical laboratories and blood centers performing HIV testing through
participation in EQAS as embodied in the Guidelines on Quality Assurance Program
for H/V Testing Laboratories issued by the NRL-SACCUSLH.
b.
A certificate of participation and SUbsequently a certificate of
qualification shall be issued by the NRL-SACCUSLH after the clinical laboratory
and/or blood center has achieved satisfactory results in the EQAS.
VI.

Procedural Guidelines

A.

The applicant shall submit the follOWing documents:


1. Intention letter to provide HIV testing services.

2. List
of
personnel,
including
photocopies
of
valid
PRe
identification cards and current certificates of HIV proficiency training
3. List of equipment with specifications
4. Current certificate of EQAS Participation from NRL-SACCUSLH (renewal
only)

B.

The BHFS conducts on-site inspection to determine compliance with the


standards and technical requirements.

C.

The BHFS approves or disapproves the application


1.
If approved, the BHFS includes in the License to Operate a clinical
laboratory or blood center, among its service capability, the performance of
HIV testing.
.
2.
If disapproved, the BHFS sends the findings and recommendations to
the applicant for compliance.
3.
If BHFS fails to process applications within sixty (60) days after Its
official receipt, it shall be considered approved.

VII.

Violations

Violation of these rules and regulations andl or commission of the following


acts by persons operating the HIV testing laboratory under their authority shall be
penalized:
1. Any material false statement on the documents submitted.
2. Conviction of the owner or manager of a clinical laboratorylblood center for any
criminal offense committee as an incident to the operation of the laboratory.
3. Any other causes that materially affect its ability to ensure full reliability and
accuracy of HIV testing and the accurate reporting of results (ex. use of
unregistered HIV testing kits, issuing laboratory reports without or incomplete
signatures).
4. Failure to submit seroactive samples for confirmatory testing to the NRL-SACCU
SLH or NRL-RITM NVBSP.
5. Failure to report confirmed seropositive cases to the AIDS registry, DOH.
6. Failure to participate in an authorized EQAS.
7. Failure to submit quarterly statistical reports to the DOH- National Epidemiology
Center.
a. Refusal to allow survey, Il"or'~oring of a laboratory by the BHFS/CHD at any
appropriate time.
9. Any act which is contrary to the accepted clinical laboratory/blood center
practices.
VIII.

Penalty

Any clinical laboratorylblood center performing HIV testing that violates these
rules and regulations shall be liable under the Clinical Laboratory Law (R.A. 4688) or
National Blood Services Act 0(-1994 (R.A. 7719) or Philippine AIDS Prevention and
Control Act of 1998 (R.A. 8504) and suffer penalties provided for- in the law and its
Implementing Rules and RegUlations. Such violations shall be basis for sanctions
including suspension or revocation of the license to operate the clinical laboratory/
blood center.

IX.

Appeal

Any HIV testing laboratory, or any of its personnel aggrieved by the decision
of the BHFS may, wlthin ten (10) days after receipt of the notice of the decision, file a
notice of appeal with the Office of the Secretary and serve a copy of the notice of
appeal to the BHFS. Thereupon, the BHFS shall promptly certify and file a copy of
the decision, including all documents and transcript of hearings on which the
decision is based, with the Office of the Secretary, for review. The decision of the
Office of the Secretary shall be final and executory.

X.

Separability Clause

In the event that any provision or part of this Order be declared unauthorized
or rendered invalid by any court of law or competent authority, those provisions not
affected by such declaration shall remain valid and effective.

XI.

Repealing Clause

These rules and regulations shall repeal and supercede all administrative
orders and previous issuances inconsistent thereof.

XII.

Effectivity

These rules and regulations shall take effect fifteen (15) days after publication
Ina newspaper of general circulation.

CO T.

D~E III. M.D., M:Sc.

Secretary of Health

Annex J
Administrative Order No. 2005 - 0032

61

Republic or the Philippines


De,artment or Health

OFFICE Of THE SECRETARY


'1./F Building 1, San'LazaroCompound, Rizal Avenn.e, Sta. Cruz, 1003 Manila
TrunkLine 743-83:.01 DIrect Line: 711-9501; Fas: 743-1829;743.1829j 7431786
URL: http://ytw\l(.doh.gov.ph: e-mail: osec@dohtA0Y.ph .

Administrative Order
No. 4.o~!i~oo99.
SUBJECT:

November 18, 2005

Guidelines on Quality Assurance Program (QAP) for all HIV Testing


Laboratories

I. RATIONALE! BACKGROUND:
HIVIAIDS isone ofthe diseases that have to be combated as reflected in the Millennium
Development Goal, proposed issuance alluned to the said international commitment. This is also
being addressed in the Medium Term Development Plan and the national directions/thrust. To
sustain this goal. HIV testing laboratories have to be standardized to maintain quality results for
proper diagnosis ot HIV/AIDS. The STD/AIDS Cooperative Central Laboratories! san Lazaro
Hospital (SACCL) was designated as the Nationai Re(erence Laboratory (NRL) for HIVIAIDS,
Hepatitis and STls. Pursuant to the Department Order no. 393-E s.2000 of the Department of
Health, the functions of the NRL-SACCUSLH are the following: to maintain Quality Assurance
Program (OAP) for laboratory tests - in coordination with the Bureau of Health Facilities and
Services, Department of Health (DOH); to provide laboratory referrals services, e.g. for
confirmatory testing, surveillance, research; to train laboratory personnel; and to evaluate kits and
reagents in coordination with the Bureau 01 Food. and Drugs (BFAD) and the Bureau of Health
Devices and Technology (BHDT), DOH. The NRL-SACCUSLH has lully deveioped their service
. capabilities including QAP for HIV, Hepatitis B, Hepalitis C and other Sexually Transmitted
Infections. NRL-SACCUSLH is responsible for all referrals Irom private and govemment
laboratories for confirmatory tests and for resolution ofdiscrepant and conflicting HIV test results.
The Quality Assurance Program (QAP) guarantees the accuracy of the final results
reported by a laboratory. It involves proper training oflaboratory personnel inhandling specimens,
reviewing transcriptional measures, verifying final results. and using most reliable assays. The
External Quality Assessrnent Scheme (EQAS) is established to evaluate the effectiveness of lhe
QAP. EQAS is an external evaluation ofa laboratory's performance using a proficiency panels.
. Failure ofthe HIV testing center to obtain satisfactory rating indicates deficiencies with the Quality
Assurance/ Quality Control (QAlQC) procedures in the laboratory.

All HIV testing laboratories need to be fully established and monitored through the QAP
to assess, and improve !he quality 01 testing and performance oflhese laboratories.

II. STATEMENT OF POUCY


II is the policy of the DOH to initiate health reforms 10 ensure quality health services.
NRL-SACCUSLH is responsible in the establishment ofa QAP in support to the Bureau ofHealth
Facilities and Services (BHFS) requirements in order to upgrade, assess and monitor the quality
of performance ofall HIV testing laboratories.
Ill. SCOPE
These guidelines shall apply to all HIV testing laboratories.
IV. OBJECTIVES:
1.
2.
3.

To establish and promote Quality Assurance Program for all HIV testing laboratories.
To provide training for medicallechnologists performing HIV testing.
To strengthen coordination thru networking among HIV testing laboratories.

V. DEFINITION OF TERMS
. QualIty Assurance - an overall program that ensures that the final results reported by the
laboratory are correct as accurate as possible.
Quality Assessment - is a means to determine the quality of results. It is usually an
external evaluation ofa laboratory's performance that relies on incorporating proficiency panels of
well-characterized sera into the testing routine. It challenges the effectiveness of the quality
assurance program.
External Quality Assessment (EQAs) Panels - a set ofserum samples that is used to
validate the performance of laboratories which are sent in support of the external proficiency
. program designed to determine the ability of the laboratories to accurately test samples and
report results.
External Quality Assessment Scheme (EQAS) - an external evaluation of a laboratory's
performance using proficiency panels and assessed by the National Reference Laboratory for
HIV/AIDS, Hepatitis and STls. Failure of the HIV testing center 10 obtain satisfactory rating
indicates deficiencies with the Quality Assurancel Quality Control (QA/QC) procedures in the
laboratory. Further, failure to participate in an authorized EQAs shall be grounds for suspension,
. non-renewal or revocation ofthe HIV accreditation ofthe laboratory.
EQAS Participants - laboratories participating in the External Quality Assessment Scheme
conducted by the NRL-SACCUSLH.
Training Participants - medical technologists who are undergoing HIV proficiency training
either for initial HIV accreditation orrenewal of HIV proficiency licenses.

.'

Proficiency Certificate- refers to the citation received by the medical technologist after they
have undergone initial and renewal ofHIV proficiency training.
Certificate of Qualification- refers to the certification issued after the clinical laboratory has
achieved satisfactory results in EQAS.
Certificate of Participation - refers to the certification issued after the clinical laboratory has
participated in EQAS.
. VI. QUALITY ASSURANCE GUIDELINES
A. Requirements for Quality Results
A.1. Recording
A.1.1. Record keeping. An efficient HIV laboratory shall be able to monitor the records
of specimens from the time the samples are received until the time the results are
released. Appropriate logbooks are essential step in recording. It must be kept
confidential and must include the following:
.
a. Name and/or specimen identification
b. Address or source ofspecimen
c. The date of sample collection
d. The name ofrequesting physician
e. The specific test required
f. Adequacy ofsamples received
A.1.2. Worksheets. This serves as a work map for each test run. This should be filled
up before the test is performed and must be kept for a permanent record. The results
after each test run should be reflected in \he worksheets and should also contain the
following:
a. Kit lotnumber
b. Expiration date
c. Date ofperformance
d. Medical technologist's initial
e. Supervisor's signature
A.1.3. Daily log sheets. this includes the daUy records of temperature of water baths,
incubators. refrigerators and freezers or any documents to show that the operating
conditions ofthese equipment are maintained appropriately.
A.1.4. Reviewing of transcriptional measures
Transcriptional or clerical error includes mistakes made during the transfer of
information from the test readout to the worksheet. and from \he worksheet to the

computer orreport fonn. System must be developed tore-check results in each of these
steps. The following mechanism shall be observed:
a. Have a second proficient medical technologist read the results from the
instrumenl/ worksheel/ computer to another technologist who will check the final
result, and/or
b. Have a supervisor check all results at the end of the day, before releasing the
results ofthe laboratory.

A.2. Testing
A.2.1. Testing algorithm for HIV testing
All HIV testing laboratories must estabtish their own testing algorithm patterned
on the NRL-SACCUSlH algorithm depending on the service capabOity they have. The
NRL-SACCUSLH testing algorithm is indicated in Annex 1 for both screening and
confinnatory tests. This will serve as a guide for the laboratory personnel in the proper
interpretation and management ofHIV diagnosis.

A.2.2. Verification oftrue positive and true negative


For samples found to be "reactive" by screening test, an aliquot from the initial
specimen should be retested. Whenever possible, a second specimen should be
collected from the individual and be retested. These specimen can be retested using an
assay based on an allemative principle, orsupplemental test.
Samples are labeled as "reactive" when results show such by screening
methods. These are labeled "POSITIVE" only after verifying the result through testing
with aconfinnatory assay.
Repeatedly reactive results by a screening assay supported by a positive
confirmatory assay are sufficient to verify positivity.. However, any confinnatory'assays
performed shall be validated by the NRL-SACCUSLH using the same and/or other
confirmatory assays before the final result isreleased Annex 2. Laboratories other than
NRL can pertonn confinnatory test only if deputized by the Philippine National AIDS
Council upon recommendation ofNRL-SACCUSLH.
Verification of negative results is also important in screening blood for
transfusion. A representative sample (10%) of initially nonreactive specimens may be
retested by the National Reference Laboratory -RITM for confirmatory testing of blood
donors and blood units.

A.2.3. Parallel testing of resubmitted specimen


Parallel testing should be dane an specimen which yielded indeterminate results.
The first specimen must be withheld until the resubmitted specimen is received some
time later, and then, both specimens are retested in parallel during the same run,

observing changes in reactivity. Specimens with indeterminate results shall be retested


and validated by the NRL-SACCUSLH for verification and confirmation prior to the
release ofthe final results.
A.3. Requirements forReporting of Results
Handling ofresults must be controlled in order to maintain confidentiality and the
rights of the tested indMdual upheld. Positive HIV test results are reported to the
submitting physician. who in tum will recommend further appropriate counseling of the
tested individual. A policy decision on the handling and reporting of results must be
enforced according to sec 43 ofthe IRR ofRA 8504.
In the HIV diagnostlc system, causes ofincorrect and misleading reports are the
following:
a. Reporting ofreactive screening assay results without confirmatory testing;
b. Use ofobsolete western blot interpretive criteria;
c. Reporting "HIV ANTIBODY POSITIVE" or the like without specifying the
methodls used in the assay.
Indeterminate result shall be reported with care indicating the importance of
resubmission of follow-up specimen to ensure that the clinician understands the
significance of such results. Results should be clearly indicated on the report form and
should provide comments as necessary.
Referral of reactive samples must indicate the following information to NRLSACCUSLH:
a.
b.
c.
d.
e.
e.

Name/ Laboratory code ofpatient


Age/sex
Date ofspecimen received
Address
Requestlng physician
Screening Assay results (name ofkit & lot number used, COV and patienfs
Absorbance for EIA)
g. Remarks and comments
h. Signature ofthe proficient medical technologist
i. Signature ofthe pathologist
Reporting of confirmatory results and/or validation of test results must indicate
the following Information:
a. Name/ Laboratory code ofpatient
b. Age/sex
c. Date ofspecimen received
d. Address orsource ofspecimen
e. Requesting physician
f. Screening Assay results (name ofkit &lot number used, COV and patlenfs
Absorbance for EIA)

g. Confinnatory Assay results (name ofkit &lot number used, bands present
and/or ofreactivity of IF results, ifany)
h. Remarl<s and comments
i. Signature ofthe proficient medical technologist
j. Signature ofthe pathologist
A.4. Storage of reactive and 'indeterminate specimen for follow-up testing
Reactive serum specimen must be stored in -20 C for follow-up testing
containing a minimum of 500 ulvolume, and placed in a plastic screw capped vial. A log
book containing all the pertinent information should be capable of identifying stored
samples. To preserve the integrity ofsamples, aliquot into several vials is recommended.
This avoids repeat freeze thawing.
Stored serum specimen must be labeled properly using water proof fine point
marking pens.

A.5. Specimen tl'lll1Sport

for referrals to NRL-SACCUSLH

Reactive specimen SUbject for confirmatory and/or validation oftest results must
be submitted and transported with care. The specimen must be packed with the
following instruction indicated in Annex 3 to ensure the safety ofthe personnel handling
the specimen during transport. A written communication must be attached
IndependenUy outside the package where the serum specimen are kept. 1\ is appropriate
to declare that the samples are potentially infectious and written clearly in the package.
Transport ofspecimen byair freight should follow the aircraft's rules and regulations.
B.Standard Operating Procedure (SOP).
Standard Operating Procedures (SOPS) should be adhered to in the laboratory
at all times. 1\ includes the detailed protocols, principles and explanations of all the
procedures performed within the laboratory. The laboratory manager shall monitor the
performance of the proficient medical technologists to ensure that the SOPs are being
followed. Package inserts can be used as areference but not as substitute for the SOPs.
C.

Monitoring of Labonrtory Personnel


Known samples (or samples already tested) must be provided by the laboratory
manager to monitor the performance of the proficient medical technologists. These
known samples are resubmitted discreetiy along wnh the routine workload. The
proficient medical technologist should not be aware when these samples are submitted
to prevent preferential treatment.

O. QUALITY CONTROL (QC)


0.1.lntemal Controls.
The internal controls provided inside the test kitshall be used only with the lot
number of the conesponding test kit during the assay. A full set of controls
recommended with the manufacturer's instructions must be included in every test run.
Validity of test runs must be observed based on the criteria of the test kit performance.
Results ofthe controls that are out ofrange invalidates the entire test and repeat test. In
such instances, repeat test runs are needed.
0.2. Extemal Controls.
These should be included on each HIV test run to monttor consistent
performance, lot-Io-Iot variation between kits and to serve as an indicator of assay
performance on samples that are borderline reactors.
0.2.1. Criteria forexternal controls:
a. Strong known positive and negative samples (pooled from daily samples orfrom
kit controls) which are properly filtered with 0.8 urn filter orinactivated at 56 Cfor
30 mlns.;
b. Borderline reactor (near the cut-off 0.0.)which has the ability to determine out of
range samples.
Any tests that are rejected due to out-of-range control values may likely be
attributed to true systematic error. However, if a dramatic shift Is noted in the
external control value when changing lot numbers, the manufacturer should be
notified to resolve the problem. A second external control can be run in parallel to
determine if the change is significant enough to affect both external controls.

E. PREVENTIVE MAINTENANCE AND CALIBRATION


Individualized maintenance schedules should be set up for each laboratory depending on
the equipment utilized. Preventive maintenance schedules should be included in the operating
instructions of laboratory instruments for use of ELISA readers and washers. Maintenance and
calibration procedures should be done regularly for optimal performance of equipment.
Performance ofscheduled maintenance activities should be documented for future reference.

VII. GUIDELINES ON EXTERNAL QUALITY ASSESSEMENT SCHEME (EQAS)


It is an external evaluation of laboratory performance that relies on incorporating
proficiency panels ofwell characterized sera into the testing routine. The NRL-SACCUSLH shall
conduct external quality assessment to all accredited HIV testing laboratories once a year to
determine the quality ofresults delivered.
External quality assurance shall be diligently practiced to be able to meet the need and
expectations of the medical community by producing highly reliable results. The NRLSACCUSLH shall conduct the External Quality Assessment Scheme (EQAS) on HIV as well
as other STls such as Hepatitis B, Hepatitis C and SyphiDs in support to the National AIDS
Prevention and Control Program ofthe Department ofHealth. EQAS Participation ofother blood
borne Sexually Transmitted Infections (STls) shall depend on the service capabilities ofa certain
HIV testing laboratory.
A. Participation to EQAS
A.1. Requirements fortheparticipation
a. Duly accomplished application form to register for participation in EQAS which (a
prototype of the referral forms are posted at the DOH website
www.doh.gov.ph/saccl). Application fee to defray the cost of preparation and freight
ofsending unknown samples.
A.2. Procedurefortbe.&QAS participation
a. EQAS participants shall accomplish application forms proVided by the NRLSACCUSLH for the EQAS ;
b. Qualified participants shall receive the EQAS panels after application fee
has been paid directly to San Lazaro Hospital.
c. Participants shall PE1rform the test in their respective facilities within 7
working days upon receiving ofthe panel as part oftheir daily routine ofHIV
testing as well as HBV and HCV. Report forms are provided by the NRLSACCUSLH.
d. Submission ofEQAS original results must be done within 30 days.
e. Unknown panels must be kept in freezer until results ofEQAS are released.
In cases ofdiscordant results, the panels will be retested by the participants
during the monltonng process.
f. Summary of EQAS results on nationwide coverage will be disseminated to
all participants after the analysis ofthe results.
B.Conditions of satisfactory and Unsatisfactory Results
a. Participants obtaining satisfactorv results in all HIV. HBV and HCV testing win
be considered as garnering apassing score of100% !lnd will receive acertificate
ofqUalification. .
b. Participants obtaining an unsatisfactory result below 100% to HIV panels

will be subject for supervisory visit. Any discordant results obtained on the said
panels will be monitored by repeattesllng orwill be given another set ofpanels
as the case may be.
e. Certificate ofparticipation shall be granted to participants obtaining
unsatisfactory results after the supervisory visit. A recommendation to BHFS
shall be forwarded to address the problem for further evaluation and appropriate
action.
VIII. TRAINING.
All HIV testing laboratories are dependent on the quality ofwork generated as part of the
Quality Assurance Program by the proficiency of the medical technologist. HIV proficiency
training of medical technologist shall be provided by the NRLSACCUSLH to maintain Ihe
effectiveness ofthe quality assurance and for accreditation purposes.
A. Requirements of initial HIV proficiency training
a. Accomplished application form provided by the NRL-SACCUSLH (a prototype of the
application forms are posted atthe DOH website www.doh.gov.ph/saccl ).
b. Photocopy ofPRC ID;
c. Letter of endorsement from the pathologist or head of agency and certification that
he/she is a practicing technologist inlaboratory work;
d. Registration fee 10 be paid directly to San Lazaro Hsopilal to defray the cost of the
training materials. reagents and serum panel preparations.
B. Scope of the Proficiency training
a. Laboratory safety and precautions and waste management
b. Laboratory screening methods for HIV and HCV antibody, HBsAg and Syphilis including
principles inVOlved, methodology and technical trouble shooting, QC/QA Program
c. Nature ofHIV Infection, Epidemiology, clinical manifestation and laboratory diagnosis
Social, ethical and legal aspects of HiV infecllon
d. Pre-post donalion/tesl'counseling
.
e. HIVaccreditation for clinical laboratory
.C. HIV Proficiency Training shall bebased Inthefollowing:
a.
b.
c.
d.
e.

Lectures/discussion
Practicum/hands-on
Demonstration
Discussion ofproblem cases
Pre and post written exams, quizzes and practical examinations

D. Duration of HIV proficiency training


The training shall be conducted in a maximum of7 working days.

E. Requirements for renewal of HIV Proficiency Certificate atthe NRLSACCUSLH.


a. Accomplished application form for the renewal of HIV proficiency certificate. provided by
the NRLSACCIISLH (a prototype ofthe application forms are posted atthe DOH website
www.doh.gov.ph/saccl ) and such must be signed by the pathologist of the sending
agency;
b. Photocopy ofprevious HIV proficiency certificate;
c. Quarterly census form for HIV and other blood-borne infections;
d. Certificate ofperformance signed by pathologist orchief medical technologist;
e.' Certificate oftraining. seminar orconvention (related to HIV and other blood-borne
infection);
f. 2 copies of2x2 colored ID picture with while background;
g. Renewal fee (depending on the category ofthe applicant) to be paid directly at the San
Lazaro Hospital.
F. Exemptions for Non-Renewal of HIV Proficiency Certificate.
Any three (3) of the following will be qualified for the exemption In the renewal of HIV
proficiency certificate:
a. Those who are consistently practicing HIV testing serology certified by the current head
ofthe laboratory;
b. Trainers of HIV proficiency workshops;
c. Those HIV proficient medical technologist currently in the service of any NRLs
designated by the DOH
d. HIV Proficient Medical Technologists who have been engaged in research involving HIV,
Hepatitis B& Cand Syphilis.
Anybody who qualifies for exemption are required to submit the minimum requirements as
stated in section Eexcept for the renewal fee.
G. Categories of Proficient Medical Technologist requiring renewal of certificate
a. Cateoorv I - Medical technologists performing HIV test with proficiency certificate
acquired after year CY 2001 shall undergo training seminar update.
b. Category II - Medical technologists perlorming HIV test with proficiency certificate
acquired before CY 2000 shall undergo refresher course.
c. Category III - Non-performing HIV proficient medical technologist and those with
expired proficiency certificates shall undergo initial HIV proficiency training for
reinstatement.

10

Issuance and content of certificate of proficiency and EQAS qualification


a. The initial HIV proficiency certificate shall stale the name ofthe medicallechnologist
the name of the laboratory he/she is currently connected, certificate number and
validity period ofthe certificate.
b. The certificate for renewal ofHIV proficiency shall state the name ofthe medical
technologist, name of the laboratories he/she is connected, certificate number and
validity period ofthe certificate.
c. Issuance of certificate ofqualification signed by the head ofthe NRL-SACCUSLH
will be given after the laboratory has complied with the necessary requirements for
EQAS participation stating the name ofthe participating laboratory, saflsfactory result
and validity period.
d. Issuance ofthe certificate ofparticipation will be given after the iaboratory has
.compiled with the necessary requirements for EQAS participation after supervisory
visit/monitoring activities stating the name ofthe participating laboratory.
I. Limitation and the use of proficiency certificate in handling HIV testing laboratories:
In order to sustain the qUality performance of a proficient medical technologist, hislher
services must be limited into two (2) HIV testing laboratories only. Any necessary amendments
concerning the content of the proficiency certificate for HIV, Hepatitis and STI shall be reviewed
and amended by the NRL-SACCUSLH.
IX. Monitoring
Monitoring of EQAS participants shall be conducted to facilities who obtain unsatisfactory
results. Participants will be subjected to strict observation during the performance of test panels.
The spontaneous monitoring shall document the overall quality performance of the laboratory
tests and shall recommend proper resolution of errors observed during monitoring by the NRLSACCUSLH.
X. validity
1. EQAS certificate ofparticipation shall be valid only for one (1) year;
2. EQAS certificate of qualification shall be valid for two (2) years, provided that the
participant obtained two consecutive satisfactory EQAS results;
3. Hlv proficiency certificate shall be valid only for three (3) years.

1I

XI. Grounds for non Issuance of certificate of participation

The following violations shall be grounds for non issuance ofcertificate ofparticipation:
1. The use ofunregistered lor expired certificate ofproduct registration for HIV test kits
and reagenls;
2. Performance ofHIV testing without valid proficiency training certificate;
3. Unauthorized use of proficiency Certificate by non proficient medical technologist
performing the test.
4. Switching of EQAS panels to and from other HIV facilities;
5. Falsification ofdocumenls pertinent to EQAS results.
XII. Separability! Repealing Clause
In the event that any section, paragraph, sentence, clause or word of this order is
declared invalid for whatever, any reason, other provisions thereof shall not be affected thereby.
These guidelines shall repeal and supercede all administrative orders and previous
issuances inconsistent thereof.
XIII. Effectivity
These guidelines shall 'take effect fifteen (15) days after its pUblication in a newspaper of
general circulation.

12

ANNEX 1
National Relercn,:" ..',horatory lor HIV, Hepatitis and other STis

STD/AIDS Cooperative Central laboratory


San Lazaro Hospital Compound, Quiricada St.. Sla. Cruz. Manila
Tel Nos: 309-9528129 Telefax: 7114117 email:saccl@compass.com.ph

TESTING ALGORITHM FOR HIV POSITIVE CONFIRMATORY TEST

,sam
__..ole lested

r-r

PA + Ag-Ab EIA methods


(tested induplicates)

...-------.~
Both Methods
Nonreactive

Ref.:rral s~;;~les Irom

private and gov~mment


HIVaccredlted
laboratories

::---==:._-_.-

DiscoIdanl or inconclusive

Both Methods
Readive

linmunoflourescent
Test OF)

Immunoflourescent
Test (IF)

Report as
Negative

Western Blot

Negative

Report as negative to
Anti-HIV

Indeterminate

Report as Indeterminate
(repeal blood test after 3-6
months)

Report as
Posilive

Positive

Report as positive to
AntiHIV

ANNEX2a
National Reference Laboratory for HIV, Hepatitis, and other STls
STO I AIDS COOPERATIVE CENTRAL LABORATORY
San LazaroHospitalCompound. Quiricada St., Sta. Cruz, Manila
Tel Nos: 3099528/29 Telelax: 711-4117 e-mail: sacd@compaos.com.ph

HIV confirmatory request / referral form


(print or type)

Nama of Referring Agency/ LaboretDIY:


Address:
TelNos: _'. __

Fax Number:

PatientName/ Code:
Age: __ Sex: _.

Blrthdate:
CivllStatlls:

Occupation:

History of trevel(Indicete dete andpiece)

Nationality:
Date bloodcollected:

type of specimen (please check):

serum

SCREENING TESTIS PERFORMED

n~P!.o!!~~

bloodun;/

(if ELISA WeS used)

Interpretation

Test 1

plasma

0.0.

C.O.V.

date tested

__ _____________________ .

--------.-------.

I -----------------

--------------------------------- ----------------.

I -----------------

I .----------------

.....
---- .. ------._-------._----______________________________

Lg!~

Tesl2
n~!_o!!i!~

_________________________

~!!__ ._------------_._-----_ .. --Test 3


~~~_q~kp"

I
____________________ .____

._----------_._----------------_.______________________________ -----------------

~9t~

~ fOR STRICTCOMPLIANCE.
SpacimenMUST NOT be HEMOLYZED or LIPEMIC. A minimumvoIuma of et LEAST500ulis required.
Preferably use PLASTICcontainers(I.e. cryovials). DO NOT use GLASSlubes for transport.
Submitsample together with PROPERLY fdJed up mimi! and ~ reporting form. HIV ConfirmalDIY Is FREE of CHARGE.
Storein freezer if there'sdelay.

--------..,..,..-::-"'7'::---:-...,......
RMT
MedicalTeChnologist
(signature overptintetllM1Tle)

HIV prorlCi6ncy Cartificate Number:

_ _ _ _ _ _ _ _ _ _ _ _ _ .MD
PathologiSt
(signature over printed name)

ANNEX2b
INFORMED CONSENT AND PRETEST COUNSELING DETAILS
FOR LABORATORY RETROVIRAL DISEASE TESTING
A. Explanation about tiletest
1. What isHIV antibody testing?
HIV antibody is a blood test. It will show if you have antibodies 10 HIV. the virus
that causes AIDS. ASAMPLE OF BLOOD WILL BE TAKEN FROM YOUR ARM. Ifthe first
rest (screening) shows a positive reaction. another lest (oonfirmatory) will be done to make
sure thai the flfSl lest is really positive. A positive anlibody test means you have been
infected with HIV. A negative test means you are probably not infecled. Bul i1tal<es time for
the body 10 produce antibodies, so if you have been exposed recently, you need to be
retested after several months to make sure you are not infecled.

2. What are the benefits oftaking the lest?


If you are test negative, you can learn how to protecl yourself ~om getting infected
by practicing sale sex (e.g. monogamous relationship, condom use).
If you test positive, you can learn how toavoid transmitting the virus to others liJ(e
your partner or child and how to take good care ofyour health properly byadhering 10 your
doctor's advice. You can also seek assistance from SLH (San Lazaro Hospilal) or RITM
(Research Institute for Tropical Medicine) fro proper medical evaluation and care.

'3. Voluntary testing

.
Taking an HIV antibody test isvoluntary. Ifyou do not want to be tested, you have
the right to refuse the lest. Ifyou want tohave the test but don't want toreveal your identity,
you can use acode narne.

4. Confidentiality ofTest Results


Your lest results are oonfidential. Itwill only be given to you personalty or 10 those
authorized toknow aboutlhe result.
B. HIV Risk status

l.History of, travel abroad: () yes (fitlup below)


ciiViCoU;;ii~ .

( ) None

Inclusive Dale

2. Major Risk Faclors: () yes, specify

() No

( ) Haterosexual with mumple sex partners


( ) Heterosexual partner ofa HIV infected
( ) Homosexual wimultiple sex partner
( ) Homosexual partner of aHIV infected
() Bisexual
( ) InlJ'avenous drug user
( ) Blood transfusion
( ) Perinatal
( ) Others, specify

Puroose

3. Purpose ofHIV testing:


( )High risk activity
( ) Employment requirement: ( ) local () abroad
( ) History ofSTD inthe past, specify dateJs
() Others, please specify

_
_

4. Have vou been lested inother laboratories for HIV? (l Yes ( No


Where
When

Result

My questions about testing have been answered. I, therefore, agree to lake the HIV
antibody lest and olher tests as deemed necessary.
Date:
Name/Code: __.
Address:

Signature:
AgeJsex:' __.._ .

__

_
..

I have explained the HIV antibody test, how it isdone, the meaning ofthe results and the possible
consequence ofdisclosure.
Name of Physician/Counselor:
Designation:
Date:

Prepared an~ Dis~ibuted by:

_
_

---,::::----.,._ _---,---.,.,--_,(Signature over printed name)


Agency/Hospilal
_

National Reference Laboralory for STDs, HIV an~ Hepatitis


STD/AIDS COOPERATIVE CENTRAL LABORATORY
San Lazaro Hospital Compound, Sta. Cruz, Manila
Tel: 30995-28129; Telefax: 711-4117

ANNEX 3

SPECIMEN TRANSPORT FOR REFERRAL TO NRLSACCUSLH

Steps of packaging and sending ofsamples:

1. Dispense at least 500 ul ofserum specimen to a screw cap (1.0 ml) cryovial.

2. Clearly label specimen with patient's name orcode with water proof cryo marker
pen.

3. Seaied the cryovial with paraffin film and wrap with tissue orabsorbent paper!
material.

4. Tie with rubber band around the absorbent tissue orpaper material.

5.

Place in are-sealable plastic bag

6. Positioned the cryovial in a small canister orwide mouth container undisturbed.


7. Transport specimen in asealed styrobox with enough cold dog orrefrigerants
inside.
8. Label the styrobox as potentially infectious.

9. Write the name ofthe sender orthe Pathologist and the name/address ofthe
HIV accredited laboratory.

10. Include in the package all pertinent documents sealed in plastic envelope such
as:
a. Filled up request form;
b. Inform consent and pre-test counseling details;
c. Laboratory test results ofthe particular specimen to be transported.
11. Send specimen package to the:
National Reference Laboratory for HIV, Hepatitis and Blood Borne STis
STD/AIDS Cooperative Central Laboratory
5an Lazaro Hospital Compound, DOH
Sta. Cruz, Manila 1003

PREVENTIVE MAINTENANCE AND CALIBRATION WORKSHEET


Name of Equipment

nemlNo.

Brand

Work Done
Maintenance I Calibration

Location

Jan.

Feb.

Date Performed
Apr.
Mar.

Remarks
May June

:z
:z

I
I
I

m
X

I
I

I
I
I
Name ofTechnician:

Name of Companies performing the calibration & maintenance:

Annex K
Department Order No. 393 - E s. 2000

62

RepublJcof the Philippines


Deportment of Health
OFfICE Of THE SECRETARY

November 14, ~OOO


. DEPARTMjONT ORDER

No.

3'3-G

8.2000

SUBJECT:

pESIGNATION OF NATIONAL REFERENCE LABORATORIES ANp


TBANSFER

OF

SUPpLIES,

PECIMENS,

CORRESpONplNG

RECORp

EQUIPMENT,

FROM

THE

INSTRUMENTS,

BUREAU OF

RESEARCH AND LABORATORIES 10 THE DESIGNATEQ NAIIONAl


REFERENCE LABORATORIES

As part of the Department of Health's goal of streamlining the Central Office In line with
devolution and decentralization of functions to improve the qualny of health services and establish
an effectlve pUblic health laboratory network In the countrY, the following Instnutions, In addition to
their regUlar responsibililles, are hereby designated as National Reference Laboratories (HRLs)
effective November 1, 2000.
Research Institute for Tropical Medicine - National Reference Laboratory for Dengue,
Influenza, Tuberculosis and other Mycobaeleria, Malaria and other parasltes, Baelerial enteric
diseases, Measles and other viral exanthems, Mycology, Enteroviruses, Antimicrobial resistance
and Emerging Diseases; NRL for confirmatory testing of blood donors and blood units.
Sa(i Lazaro Hospital National Reference LaboratOlY for HIV/AIDS, Hepatitis; and SexuallyTransmitted Diseases.

East Avenue Medical Center - National Reference Laboratory for Environmental and'
.
Occupallonal Health; Toxicology and Micronutrient Assay..
National Kidney and Transplant Institute National Reference Laboratory for Hematology
including Immunohematology (consistent with previously issued D.O. 301-1 s. 1999).
Lung Center of the Philippines - National Reference Laboratory for Anatomic Pathology arid
Biochemistry.
.
The above institutions should develop their capabilities to fulfill the following functions as
National Reference Laboratories:
a. To providelaboratory referral services, e.g. for confirmatory testing, surveillance,
research.
b. To train laboratory personnel.
c. To maintain a qualityassurance program for laboratory tests - in coordination with the
Bureau of HealthFacilities and Services, DOH.
d. To evaluate test kits and reagents - In coordination with the Bureau of Food and Drugs
and the Bureau of Health Devices and Technology, DOH.

The Bureau of. Research and laboratories (BRL) Is hereby ordered to endorse all
equipment, Instruments/devices, IUpplieS, apecimens and relevant records of Its various
laboratories to the corresponding designated National Reference laboratories.
To facilitate the smooth tum-over of the laboratory functions of BRL to the designated
National Reference laboratories, the following task forces are created to develop the transition
plan for each NRL and oversee the Implementation of transition plan upon approval of the DOH
Executive Committee.
A. RITM National Reference Laboratory:
Chairperson:
Dr. Socorro Luplsan Head. Laboratory Research Division, RtTM
Members:
Dr. Veronica cnan- Consultant. BRL
Dr. FemJuliaPaladin Head, Virology Dept., RITM
Ms. Ellen Castillo Head. TB SectJon, RITM
Ms. Lydia Sombrero Head, Gen. Bacteriology Section, RITM
Ms. Nenlta Canafranca ChiefMed. Tech., Bacteriology SectJon. BRL
Dr. Cielo Pasay Head, ParasItology Dept., RITM
Ms. Angelita Jimenez, ChiefMed. Tech, Parasitology Section, BRL
Dr. Rose Capedlng Head, Bacteriology Dept., RITM
Dr. Daria Manalo - Veterinary Reaearch Dept., RITM
Dr. MaryElizabeth Miranda Veterinary research Dept., RITM
Dr. cella Carlos - Program Director, Antimicrobial Resistance and
SUNeUlance Program. RITM
Or. Rosita de Leon - Chief, Laboretory Division I, BRL
B. San Lezaro Hospital National Reference Laboratory:
Chairperson:
Dr. Dorothy Agdamag - Medical Specialist III, San Lezaro HaSp.
Members:
Mrs. Myrna Reyes ChiefMad. Tech., Immunology Section, BRL
Or. Fem JuliaPaladin - Head. Virology Dept., RITM
C. East Avenue Medical CenterNational Reference Laboratory:
Chairperson:
Or. Socorro Yanez - Head, Dept. of laboratories, EAMC
Members:
Or. Marilyn Barza - Medical OfficerVII, East Avenue Medical center
Mrs,. Celina Pacls ChiefChemist. Environmental Health Examination
SectJon, BRL
D. NKTI National Reference Laboratory:
Chairperson: Or. Juanlto Blllote - Deputy Director, NKTI
Members:
Or. Jane Baylon Chairman, Stem Cell and CryopreseNatlon Dept. NKTI
Or. Januarlo VeioBO Head, Hematology & Transfusion Division, NKTI
Ms. Cecille Cuerde>- ChiefMad. Tech,lmmunohematology Section, BRL
Ms. Annarlssa Bumanlag- ChiefMed. Tech., Hematology Section, BRL

E. Lung Center of llie PhUlpplnea (LCP) National Reference Laboretory:


Chalrperaon:
.
Dr. Nelle Tan-Uu Head, Department of Pathology, LCP
Membera:
. Dr. Grace Ramos MS III (Acting Div. Chief, Leboretory Division II), BRL
Dr. Ma. Teresa Barzaga - MS III, Dept. of Pathology, LCP
Dr. Cannela Tan oMS II, Dept. of Pathology, LCP
0

A Management Team Is also hereby created to overaee the Implementation of the


trenaition plana to set-up the different designated NRLs. TheTeam shall be composed of:
Chairperaon: Undersecretary Ma. Margarita M. Galon
OffIce for Standards andRegulallon
Membera:
. Dr. Ma. Concepcion Rocea Director IV, Nallonal Epidemiology Center
Dr. Criselda Abesamia Director IV, Nafl Center for Health Facility Development .
Dr. Enrique Tayag Director III. Nallonal Center for Disease Prev.n & Control
.Dr. Remlglo Olveda Execullve Director, RITM
Dr. Benito Arce Medical Center Chief, San Lazaro Hospital
Dr. Ortando Pua Medical Center Chief, EastAvenue Medical Center
Dr. Enrtque Ona Executlve Director, Nallonal Kidney & Transplant Institute
Dr. Femando Melendrea Executive Director, Lung Centerof the Philipplnea
0

Transfer of alliaboretory functions of BRL to the designated NRLs ahould be completed on


or before December 31, 2000.

Annex L
Administrative Order No. 55-A s. 1989

63

Repu~ic cfthe Philippines


DeparC~I~ent ,of, He a l t h
M,;,r:llcr.

Aciffiinistr~tive

Crder
series --.,/9tf

;r-f:-It

No.

'January 2, 1989

RULES AND REGULATIONS GOVERNING Trill ACCREDITATION OF


LABORATORIES PERFORMING HIV TESTING
Sec.
tile

1 -

Title:

"RULES

These Rules

and

Regulations shall be known

R~GULATIONS GOVERNING

AND

rRE~~DrATION'

Or

LAE.OJCATCP,ES PERFO?HING HIV TZSTlNG".

.t n

accordance

s:.

a.s.

to

,4688,

(BLc od Bank Law)

1.517

(Clinical

Laboratory

E.O.

cons i s t ent with

to

:; - Purpose:

protect

and

the performance,

-'

and

b Lood

These rules and regulations are p~',omU'lil.at'ed',

promote
an(~,

banks

and

(;~eo"g8nization

119

Act of the Miniscry of "eill tn).

Sec.

Law)

the

health

of

assuring the quality of

licensed

according

to

by, reg~18ting

the

?eople

mv

testing in laJ;lOratories

the

implementing Rules

and

Regulati,c'<1$ of R.A. 463e and R.A. 1517.


Sec. I, -, Scope:
4.1

'The

regulations

embodied

herein

".

pe rso n ,

corporacion~

bank

or

in

performing
che

Pha Li pp i.ne s

for

determination
antigen/protein,

of
viral

to

the

or pub l i c he'a l t h 'purposes.

?r

blood

perrormRlV' testing

public

for, d i ag no st f c

t~$ting

EIV
he

:.

l abo r a t or y-:'

seeking

:0 any

shan "apply,

pr e senc e

particles

in

shall incluce
of

ant i.body ,

cl Ln i c e l

specimen 'indicating infection, by Human Irnrsunode f ic Lency


Virus' (RIV).
Sec.
Tpsting
scal1
of

Regulatory

Authority:

Lebo;cat,ories/Blood ,Eanits

be -exe r c t se d by

Research

and

unde r

The
t

Accreditation

he se . ru l e s

of'

uiv

and r egu I ar.Lon s

the 'Department of" Hea 1th ';:hrough' the' Eurea,u

Laboratories

in

'Office

fo~

Stendarcs

anG

Regu La t'i On.

Sec. 6 ..:
6.1

Lab~:CCl_~L Pr'oce9ure~ ;{eouiring


Any

of

the

f911~wing

Ac c r e'd i t a t i.o n :

1sbo=etory

proce4ures

shall

I?

Admt n Ls t ret Lve 0'r.'"cer

Page 2
.=============~======

require ~ccreciitation as a lilV Testing Laboratory:


Screening tests for HIV antibody

1)

Enzyme Inrrnunoassay (EIA)

1.1

1.2

Particle Agglutination (PA)

1.3
2)

3)

Others

Supplemental (Confirmatory) Tests for lilV Antibody

2.1

Western Blot (WB)

2.2

lmmunoflourescence (IF)

2.3

Radioimmuno Precipitation Assay. (RlPA)

2.4

Others
laboratory'

Other

procedures

such

as

test ing

for XIV antigen, culture of HlV, etc.


6.2

No Laboratory shall be allowed to perform lilV testing


without

accreditation

by

the

Department

of

Health'

through the Bureau of Research and Laboratories.

6.3

No

lilV

by

the

clearance' certificate shall be authenticated.


DOli

unless

the

laboratory

procedure

has

been performed by a laboratory accredited in accordance


to these rules and regulations.
Sec. 7. - Accreditation Requirements for a lilV Testing "Laboratory:
(Technical Standards)
7 .1

. All

clinical
requireci

be

f o Ll owf ng

laboratories
to

or

demonstrate

Technical

blood

banks

sha l l

compiiance' with

Standards

the

a . requirement

as

to accreditation:
1)

The
be

clinical
du ly

laboratory

licensed

by

or

the

blood
Bureau

bank
of

shall'

Research

and LaLoratories.

2)

The

laboratory

shall

be

headed

by

and

under

the direction and supervision 'of a duly licensed


physician

who

is

certified

by

the

Philippine

Board of Pathology or Philippine Board of HematologY


and Blood Transfusion.
3)

The
t

laboratory.

ecbnc l ogI s t s

of

Medical

shall

duly

be

staffed

registered

Technology,

who

"ith
have

by
the

medi ca l

Board

,undergone

acceptable training in HIV Testing duly certified

Administrative Order
Page 3
====================

by a training laboratory.
,4)

The

physical

plant

and

ventilated,
be

be hous ed in well-lighted

dust-free

areas

with

an

adequate

The space appropriately furnished,

supply of water.
should

shall

sufficient

to

accomodate' the

activities

needed for HIV Testing.


5)

Equipment, glassware and supplies:


The HIV Testing Laboratory shall have the appropriate
glassware

equipment,

and

supplies

other

needed

for HIV testing.


6)

Reagents:
The

laboratory

ut i l ize

shall

reagents,

such

as

HIV kits, which have been registered wi t h the Bur,eau


of Food and Drugs (BFAD).
7)

Report

objective

report

The

forms
and

indicate

the

forms

should

be, clear;

type of HIV kit

(brand/

manufacturer) utilized.
7.2

The

Bureau

compliance
to

of

Research

with

such

and

Laboratories shall evaluate

technical

standards

in

accordance

requirements as may be promulgated' unde r these Rules

and Regulations.
Sec. 8 - Reporting:
Each
tests, done,

HIV

testing

laboratory

shall

report

monthly

the

number of

results and referrals of seroreactive samples in accordance

with the format

prescribed by the Bureau of Resea r ch and Laboratories.

The report shall be accompanied by xerox copies of invoices of purchases


of HIV kits the previous month.
Sec. 9 - Referral of Seroreactive Serum Samples:

9.1

All
or

serum

PA)

by

samples

reactive

in

private

laboratories

sc reen t ng

shall

be

tests
referred

(EIA
to

the Research Institute of Tropical Medicine for confirmation.


9.2

All
or

serum

PA)

by

samples

reactive

government

in

screening

laboratories

shall

tests
be

(EIA

referred

to the Bureau of Research and Laboratories for confirmation.


9.3

The
to

names,
be

age,

sex and addresses of persons

seropositive

(by

WB/IF/RIPA)

shall

be

confirmed
reported

Administrat<.ve. :~er
Page 4
====================

to

AIDS

Registrar,

accordance

to

Health

Department

Intelligence' Service,

Circular

No.

11,

s.

DOH

1987

in

dated

March 11, 1987.


9.4

Such
a

person

shall

be

informed

seropositive test and the

of

the

implications

of

requirement of a confidential

report to the AIDS Registry.


Sec.

10

Quality

Control

Tests:

The

Direc.tor

of

the

Bureau

of Res ea rch and Laboratories or his representative is hereby authorized


to concuct such quality control tests as he deems appropriate or necessary.
-f or the administration of these regulations, for the control of operations

and as criteria for the renewal of certificates.

ill

Sec.
records

Inspection:

HIV

testing

laboratory

facilities

and

shall be subject to regular inspections to determine compLi.ance

with the above regulations.


11.1 The
or

Director
his

of

duly

reasonable

the

Bureau

authorized

time

and

of

Research

and

representative(s)

opportunity

to

Laboratories

shall

inspect

be

the

given

premises

and facilities wherein the HIV testing is being performed.


1102 Each
of

laboratory
the

Bureau

authorized

shall
of

make

available

Research

representative

and

all

to . the

Director

Labor at or Les or. his


records

kepr" pursuant

duly
to

these regulations for inspection.


11.3 The
or

Director
his

of

the

Bureau

of

representative. may be

Research

assisted

and

Laboratories

by duly designated

experts from professional associations in such inspections.


11.4 Directors
and

of

Regional

Health

Health

Officers

'Bureau

of

Municipal

report

to

existence
any

the
of

private

are

HIV

performing

and
test

'directed

Laboratories

testing

such

~ity

Provincial,

hereby

Research

unaccredited
party

Offices,

laboratories
without

to
the
or

proper

accreditation certificate.
Sec.
or

12

corporation

Bureau

of

desiring

Research

the prescribed
1)

Basic
and

Accreditation
to

Requirements:

perform' HIV

Laboratories,

testing
sworn

Any
shall

person,
submit

to

firm
the

petition/application on

form and containing among others, the following data:

Name,

citizenship

Testing Laboratory.

and

domicile

of

the

head

of

the

HIV

........-----

Administrativ~ OrGer

Page 5
====================

established.
3)

Name of the establishment.

4~

Name, citizenship and domicile of the owner;

5')

Copy of

a valid permit to, operate a clinical laboratory

or blood bank from the Department of ilealth, and;


6)

Scope of the nature of work to be undertaken.

Sec. 13 - Application for Accreditation:


,13.1

An
a

application
form

for'

accreditation

"Application

performing

HIV

for

shall

Accreditation

testing" with

be

of

the Office

filed

in

Laboratories
of

the Bureau

of Research and Laboratories for screening and approval.


13.2

Each application shall be signed under oath or affirmation


by

the

applicant

or

person

duly

authorized

to

act'

for and on his behalf.


13.3

Within 60 days after receipt of said application together


With the accreditation fee, an inspector from the Bureau
of Research and Laboratories shall inspect the establishment
and

verify

the

if

applicant

has

complied

r equd r ement s prescribed in these r egu Ia t i ons


,

13.4

Any

material

failure

false

statement

to comply with

in

the

v
-,'

with

the

'

application

requirements may servE! .as

or

basis

of the Director of the Bureau of Research and Laboratories


to

refuse

recommending

the

issuance

of

certificate

of accreditation.
Sec. 14 - Accreditation Fees:
14.1

A non-refundable fee shall be charged for every application


for an accreditation certificate issued for the performance
of HIV Testing for government and private laboratories.

14.2

A non-refundable fee is charged on application of renewal


if filed at least sixty (60) days before the accreditation
expires.

14.3

All

fees

shall

be

payable

to

the Bureau

of Research

and Laboratories in accordance with the following schedule:

14.4,

For New Certificates:

P 500.00

For Renewal of Certificates:

P 250.00

A penalty of P 200.0,0 for late renewal shall be charged


in addition to the renewal
(;..{)\

....I ......

~c

.. _.

fee when filed Within sixty

Administrativ~

Order

Page 6

14.5

Sixty

'unrenewed
and

days

(60)

after

expiration

certificates
cer~~fica~e

new

shall

be

shall

have

accreditation,

'0.

considered
to

be

lapsed,

applied

for.

Sec. 15 - Issuance and Exhibition of Certificate of Accreditation:


15.1

The

certificate

Undersecretary
the

if

will

of

be

issued, and

Health

application

for

signed

Standards

is found

and

by

the

Regulation

to be meritorious and

the

fees duly paid; otherwise the same shall not be approved.


15.2

The

accreditation

conspicuous
the

rules

certificate

place
and

within

should

the

regulations

be

placed

laboratory'.

shall

be

in

A copy

readily

a
of

available

for the gUidance of the staff in the laboratory.


Sec. 16 - Terms and Conditions of Accreditation:
16.1

The

certificate

the

certificate

transferred
16.2

party

The

owner

desiring
the

within

herein granted

shall

directly
or

to

shOUld
.1

be

to

right' unde r

any

assigned

indirectly
of

transfer
of

the

new place

fifteen

(15)

or

an

.oche rwt s e

unauthorized

HIV

another
and

and

of

after

laboratory

place, shall

Labo r a to r'Les
site

days

testing

such

in

inform
writ ing,

the" .es t ab Ld shment;


transfer.

The

shall be subject' to re-inspection before

antibody
notify

any

to

Research

it can resume operation

Any HIV

or

manager

new facilities
16.3

not

or

... >

Bureau

stating

as

laboratory

the

Bureau

desiring to stop operation

of

Research

and

Laboratories

"I

stating the said date of termination.


16.4

Any

pathologist

who

decides

transfer supervision shou ld


and

Laboratories

within

to

terminate'

services

or

inform the Bureau of Research

fifteen

(15)

days

after

such

termination or transfer.

16.5

Fai lure to report in writing within 15 days any change


in conditions of Accreditation will be cause for suspension
or

revocation

of

the

certificate

of

Accreditation

of

the laboratory.

. . . /7

Administrative- Order

Page 7
==========~==~======

Sec. 17 - Expiration of Accreditation Certificate:


a~creditation

Each
the

date

certificate

shall

expire

one

year

after

of approva I of the certificate such date being indicated in

the upper right hand corner of the certificate.


Sec. 18 - Renewal:

Application for renewal of certificates shall

be filed at least Sixty (60) days before the expiration of the certificate
in

accordance

shall

to

Sec.

14.

The

process applications for

Research

and Laboratories

renewal immediately upon receipt thereof

to

however,

that such IlIV testing laboratory may continue operation pending


their

the Director,

upon

of

subject

action. on

inspection

Bureau

the

application,

discretion

unless

of

the

otherwise

Director;

advised

provided'

or ordered by

Bureau of Research and Laboratories or his representative

to cease operation.

Sec. 19 - Publication of List of Accredited Laboratories:


19.1

A list

of

laboratories

HIV

testing

be

published

under

and

these

blood

rules

periodically

and

banks accredited for


and

regulations

be

made

shall

available

to

any person, agency or organization for legitimate purposes.


19.2

The

results

of

quality

control

testing ,shall

likewise

be published.
Sec. 20 - Modification and Revocation of Certificates:
T\le terms and conditions of each certificate shall be subject
to amendment or modification !,ly means of amendments to these regulations
as

the Secretary

willful,

of

Health may

deem necessary.

Except

in cases of

or repeated violations hereof, or where publ i c health Lnt.ere s t

or safety'requires otherwise, no certificate shall be modified, suspended


or

revoked

unless

prior

notice

has

been made

and

the

corresponding

investigation conducted,

Sec. 21 - Violations:
21.1

The

certificate

perform

HIV

of

testing

accreditation
shall

be

of

suspended

laboratory
or

revoked

to
by

the Under s ec r e t a ry of Health for Standards and Regulation


for any

violation of

these Rules and Regulations, which

may include among others:

, . . . /8

Admi n i s t ra t i.ve, Order


Page 8

1)

Operating an HIV Testing Laboratory without a qualified


pathologist or hematologist
material

false

or medical

2)

Any

3)

Utilizing unregistered HIV testing kits.

4)

Repeated

failure

statement

to

submit

in

accompanying xerox copies of

technologist.

the

application.

monthly

report

with

invoices to the Bureau

of Research and Laboratories.


Failure to submit seroreactive samples for supplemental

5)

(confirmatory)
of

testing

Tropical

to

Medicine

the

or

Research

Bureau

of

Institute

Research

and

Laboratories.
to

Failure

6)

seropositive

confirmed

report

cases

to the AIDS Registry, HIS, DOH.


7)

Refusal

to

allow

persons

authorized

inspection
by

the

of

the

Bureau

laboratory

by

Research

and

of

Laboratories during reasonable hours.


8)

Refusal

to perform tests on quality control samples

required by the Bureau of Research and Laboratories.


9)

Failure
time

to

correct

after

due

deficiencies with1.n a reasonable

notice

from

the

Bure'au of' Research

and Laboratories.
21.2

Any

HIV

Testing

and

regu lat ions

Laboratory
shall

Laboratory

Law

1517)

suffer

and

and
the

Revised

to such law.
including

(R.A.

be
4688)

penalties
Rules

and

that

violates

1iab l e

under

or

Blood

provided
Regulations

these
the

Bank
for

Clinical
LaW

in

rules
(R.A.

the law

issued. pur-suant;

Such violations shall be basis for sanctions

suspension

or

revocation

of

the

license

to

operate the Clincal Laboratory or Blood Bank.


Sec.

22

effect fifteen

EffectiVity:
(15)

These rules and

regulations shall

take

days after its publication in the Official Gazette

or in a newspaper of general circulation.

Annex M
Memorandum Circular No. 2006 0075

64

25 October 2006
MEMORANDUM CIRCULAR
No. .100<;- OO"'t5

TO:

ALL CENTER FOR HEALTH DEVELOPMENT


DIRECTORS, PROVINCIAL HEALTH OFFICERS, CITY
HEALTH OFFICERS, MUNICIPAL HEALTH OFFICERS,
HEADS OF LABORATORIES AND BLOOD BANKS,
HOSPITAL DIRECTORS AND GOVERNMENT AND
PRIVATE PHYSICIANS

SUBJECT:

MANUAL OF OPERATIONS FOR THE NATIONAL


HIV/AIDS REGISTRY

The passage of Republic Act 8504 otherwise known as the


Philippine AIDS Prevention and Control Act of 1998 ushered in the
establishment of a comprehensive HIV/AIDS Monitoring Program or
AIDSWATCH in the Department of Health. Upon the effectivity of the
Implementing Rules and Regulations of RA 8504, AIDSWATCH integrated
unto itself the NHSSS and the AIDS Registry.
The National HIV/AIDS Registry is the official record of the
number of HIV positive and AIDS cases and deaths confinmed by the two
National Reference Laboratories: STD/AIDS Cooperative Central Laboratory
(SACCL) and by the Research Institute for Tropical Medicine (RITM). Reports
of all confirmed HIV positive cases will be sent monthly to the National
Epidemiology Center for analysis and publication through the National
HIV/AIDS Registry.
This memorandum circular hereby directs all Center for Health
Development Directors, Provincial Health Officers, City Health Officers,
Municipal Health Officers, Heads of Laboratories and Blood Banks, Hospital
Directors and government and private physicians to use the National
HIV/AIDS Registry Manual of Operations for guidance.
This memorandum circular shall take effect immediately.

DOH Centrallibrory

I~I~ i/I ~1I111 illlli


D1321

H7.45 N385 2006 I The National HIV and AIDS registry