Experience and
response of Suriname’s
National Public Health
Laboratory to
ChikungunyaMarina Sew-Atjon
Acting Head Bacteriology & Virology / Project
Coordinator
Central Laboratory
Bureau for Public Health
Suriname
Types of tests done in Suriname
PCR – in house test based on SYBR Green – Academic
Hospital Laboratory
Commercial PCR – Medical Research Institute (MWI)
Euroimmun IgM Immunofluorescence assay (IFA) –
Academic Hospital Laboratory
CTK Biotech OnSite IgM Combo Rapid test Cassette –
Private Laboratories
Types of tests Central Laboratory
Euroimmun IgM and IgG Immunofluorescence assay (IFA)
Training, validation and quality control by ERASMUS MC Virology
Laboratory
First positive case
6/6/2014 Confirmed first positive case
45 year old male travel history to
Date of onset 28/04/2014, sample taken 06/05/2015, tested 06/06/2014
Symptoms: fever, myalgia, malaise. Note no arthralgia
Family members (2) also tested positive by IgG IFA in June 2014
Local transmission confirmed mere weeks later.
Suspected that Chikungunya entered Suriname via various routes
Coastal areas Regional Health Service care areas
View of cases in coastal areas
880
1004
770
709
535
452
338
224
317 310
257
157183
331
273244
0
200
400
600
800
1000
1200
40 41 42 43 44 45 46 47 48 49 50 51 52 1 2 3
RGD 2014 & 2015 Surveillance Fever & Arthritis
Epidemiological week
Remote interior areas Medical Mission care area
View of cases in remote areas
126 8 5 2 0 0 0 2
11 9
19
66
92
211
221
238
111
147
165
101106 103 103
54
26
66
54
2935
31
1621
0
50
100
150
200
250
28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 51 1 2 3 4 5 6 7 8
Medical Mission 2014 & 2015 Surveillance Fever & Arthritis
Epidemiological week
Dissemination of Chikungunya -
Fight mosquito populations
Follows a similar pattern as the Dengue epidemics.
Chikungunya is concentrated in several problem coastal
areas (Albina, Groot Henar, Zanderij, 5e Rijweg) and
neighbourhoods (Latour, Geyersvlijt) in Paramaribo.
Rapid spread in remote interior areas
Entomology department of BOG tracks mosquito
populations by placing ovitraps in hospitals, care homes,
schools and neighbourhood areas. They work closely with
Environmental Health of BOG to reduce these populations
by providing areas that need to be cleaned and fogged.
Challenges at Central Laboratory
Acquiring IFA & PCR test kits
Training personnel
Overload of test requests
PCR at AZP
IFA is labour intensive and subjective
Quality of whole blood samples sent from remote areas
Validation of rapid tests for other labs highlighted the insensitivity of these.
CTK Biotech OnSite Duo Dengue IgG/IgM-CHIK IgM Rapid test
CTK Biotech OnSite IgM Combo Rapid test - Cassette
Modification of testing algorithm
Three weeks after confirmation of the first positive case
the testing algorithm at Central Lab was modified to
include only:
Severely ill hospitalized patients
Patients with other chronic health issues
Pregnant women
Young children
Current situation at Central Laboratory
As of 26/02/2015:
334 samples analyzed
228 positives
73 negatives
22 not tested
7 to be tested
Receive approximately 10 test requests per week currently
* Central Laboratory only analyzes data from tests received at Central Laboratory. National and
International data is analyzed by the Epidemiology department of BOG
Future outlook
CHIKV PCR at the Central Laboratory
Follow up research in patients 3-, 6-, and 9 months post
positive diagnosis with IgM IFA
Thank you for listening
Marina Sew-Atjon
Acting Head Bacteriology & Virology / Project Coordinator
Central Laboratory
Bureau of Public Health
Ministry of Health
Paramaribo, Suriname
(00597) 8580170
