NSTMT TEST MENU.Pdf

MINISTRY OF HEALTH

NATIONAL STANDARD TEST MENU, TECHNIQUES AND SUPPLIES LIST FOR LABORATORIES

March 2017

Uganda National Health Laboratoryi Services - UNHLS ii TABLE OF CONTENTS TABLEFOR OFEW CONTENTSORD...... v FOREWORD...... ACKNOWLEDGMENT ...... vii ACKNOWLEDGMENT...... LIST OF ABBREVIATIONS AND ACRONYMS ...... vii x LIST1.0 OF SECT ABBREVIATIONSION ONE: INTRO DANDUCT IOACRONYMS...... N...... x11

1.0 SECTION1.1 The Labo ONE:rator yINTRODUCTION Service Delivery and ...... Network in Uganda ...... 1 2

1.1 The1.2 J uLaboratorystification ...... Service Delivery...... and Network in Uganda...... 1 2

1.2 Justification1.3 Background ...... of Standardiszation ...... 2 2 1.3 Background of Standardiszation...... 2 1.4 Standardization of Laboratory Testing ...... 3 1.4 Standardization of Laboratory Testing...... 3 1.5 Objectives of the Guideline...... 3 1.5 Objectives of the Guideline...... 3 1.6 Target Audience ...... 4 1.6 Target Audience...... 4 1.7 Components Of The Guideline ...... 4 1.7 Components Of The Guideline...... 4 2.0 SECTION TWO: TEST MENUS ...... 5 2.0 SECTION TWO: TEST MENUS...... 5 2.1 Test Menus...... 15 2.1 Test Menus...... 5 2.2 Laboratory Service Delivery at the Various Levels of Healthcare ...... 15 2.2 Laboratory Service Delivery at the Various Levels of Healthcare...... 5 2.2.1 Health Centre III ...... 15 2.2.1 Health Centre III...... 5 2.2.22.2.2 Health Healt h CentreCentre IVIV...... 515

2.2.32.2.3 General Gener al HospitalHospital LaLaboratoriesboratories ...... 515

2.2.42.2.4 Regional Region aReferrall Referra l HospitalHospital LLaboratoriesaboratories (RRH (RRH))...... 616

2.2.52.2.5 National Nation al ReferralReferral HoHospitalsspitals...... 616

2.2.62.2.6 Laboratory Laborator y HHubsubs ...... 616

2.2.72.2.7 Testing Test ingbelow below Health Health CCentreentre II I...... III...... 616 2.3 NATIONAL SPECIALIZED LABORATORIES...... 6 2.3 NATIONAL SPECIALIZED LABORATORIES ...... 16 2.3.1 Uganda Heart Institute (UHI)...... 6 2.3.1 Uganda Heart Institute (UHI) ...... 16 2.3.2 Uganda Cancer Institute (UCI)...... 6 2.3.2 Uganda Cancer Institute (UCI) ...... 16 2.3.3 Central Public Health Laboratory (CPHL)...... 7 2.3.42.3.3 Uganda Centr al BloodPublic HeTransfusionalth Labora toServicery (CPH L)(UBTS) ...... 717

2.3.52.3.4 National Uganda BTuberculosislood Transfus ionReference Services (ULaboratoryBTS) ...... (NTRL)...... 717

2.3.62.3.5 Uganda Natio nalVirus Tub erResearchculosis Re feInstitituterence Lab or(UVRI)atory (N...... TRL) ...... 717

3.0 SECTION2.3.6 Uganda THREE: Virus R eTESTsearch ITECHNIQUESnstititute (UVRI) .AND ...... EQUIPMENT...... 27 17

3.1 Techniques3.0 SECTIO...... N THREE: TEST TECHNIQUES AND EQUIPMENT ...... 27 27 3.2 Equipment 3.1 Techniqu...... es ...... 27 27 3.3 Personnel...... 27 3.2 Equipment ...... 27 4.0 SECTION FOUR: LABORATORY SUPPLIES LIST AND VEN CLASSIFICATION..... 44 3.3 Personnel...... 27 4.1 Laboratory supply chain...... 44 4.0 SECTION FOUR: LABORATORY SUPPLIES LIST AND VEN CLASSIFICATION...... 44 4.2 VEN classification...... 44 4.1 Laboratory supply chain ...... 44

4.2 VEN classification ...... 44

iii FOREWORD

This guidelines document is a major milestone in the journey towards standardised, quality, TABLES TABLES responsive and cost effective laboratory services. A well developed laboratory system is a Table 1: List of Test Menu recommended per Level of Health Care ...... 8 fundamental and vital component of any health system. The health system in Uganda aims at Table 1: List of Test Menu recommended per Level of Health Care ...... 8 delivering quality and affordable health services with universal access for the Ugandan population. To TableT a2:bl eList 2: L ofist Testof Te menust menu for f orUganda Uganda Hearth Heart hinstitute institut e(UHI) (UHI )and and UgandaUganda CCancerancer IInstitutenstitute ( UC(UCI)...... I)...... 1018 achieve this, laboratory services must be accessible to all, well managed and standardized across all TableT a3:ble List3: L iofst ofTest Te stMenu Menu forfor UUgandaganda BBloodlood Tran Transfusionsfusion S erServisevise (UB (UBTS)TS) and andNati oNationalnal Tube rTuberclossiclossi healthcare delivery levels. Reference Laboratory (NTRL)...... 26 Reference Laboratory (NTRL)...... 26 Table 4: Minimum Equipment /Technology recommended according to capacity per level of care ...... 28 Quality laboratory service delivery has been hampered by many factors that include among others, Table 4: Minimum Equipment /Technology recommended according to capacity per level of care ...... 28 lack of standardized laboratory test menus,equipment, techniques and supplies list for the various TableT ab5:le 5:List Li stof of tthehe cucurrentrrent ha rharmonizedmonized an alanalyzersyzers ...... 29 levels of healthcare delivery. TableT a6:bl eList 6: L iofst ofStandardized Standardize dTest Test Techniques Techniques perper LevelLevel ofof HHealthealth C Careare ...... 29

TableT a 7:ble Classification7: Classification ooff l abolaboratoryratory sup psupplieslies using VusingEN cla s sVENifi ca classificationtion...... 45 45 In response to the Maputo Declaration (2008), Uganda in 2013 embarked on the process of TableT a8:bl eList 8: L i soft of SStandardizedtandardized Labo Laboratoryratory Supp Supplies...... lies...... 46 standardising the laboratory test menus and supplies for the various tiers of laboratories in the laboratory network. Standardization will increase access to high quality diagnostic tests for the care, treatment, prevention and surveillance of HIV/AIDS, tuberculosis (TB) and malaria amongst other infectious and non-infectious diseases.

From laboratory supply chain managment perspective, implementation of standardization will significantly contribute to the reduction in the number of commodities managed by the central warehouses.

Additionally, as Uganda targets to get laboratories accredited to International Standards, these guidelines will form a basis for selection of accreditation scopes by laboratories.

This standard Test menu, Techniques and Supplies List for Laboratories provides useful information on the diagnosis of infectious and non-infectious diseases in Uganda. It also provides a foundation for setting up an efficient procurement and supply system that will contribute to increasing the availability of safe, efficacious, quality lab commodities and supplies.

The guidelines were developed through consultative and inclusive workshops and meetings with relevant stakeholders at different levels to ensure that it addresses the needs at every level for provision of quality health services within the limited resources available for the laboratory sub- sector.

The VEN analysis concept was used to classify the selected reagents and other laboratory supplies to guide procurements. All parties procuring diagnostics, reagents and equipment in Uganda, including country programs, Implementing Partners, Private-Not-For-Profit organizations and donor funding agencies are encouraged to utilize this standard test menu, techniques and supplies list for laboratories.

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iv FOREWORD

This guidelines document is a major milestone in the journey towards standardised, quality, TABLES responsive and cost effective laboratory services. A well developed laboratory system is a Table 1: List of Test Menu recommended per Level of Health Care ...... 8 fundamental and vital component of any health system. The health system in Uganda aims at

Table 2: List of Test menu for Uganda Hearth institute (UHI) and Uganda Cancer Institute (UCI)...... 10 delivering quality and affordable health services with universal access for the Ugandan population. To achieve this, laboratory services must be accessible to all, well managed and standardized across all Table 3: List of Test Menu for Uganda Blood Transfusion Servise (UBTS) and National Tuberclossi healthcare delivery levels. Reference Laboratory (NTRL)...... 26

Table 4: Minimum Equipment /Technology recommended according to capacity per level of care ...... 28 Quality laboratory service delivery has been hampered by many factors that include among others,

Table 5: List of the current harmonized analyzers ...... 29 lack of standardized laboratory test menus,equipment, techniques and supplies list for the various levels of healthcare delivery. Table 6: List of Standardized Test Techniques per Level of Health Care ...... 29

Table 7: Classification of laboratory supplies using VEN classification...... 45 In response to the Maputo Declaration (2008), Uganda in 2013 embarked on the process of Table 8: List of Standardized Laboratory Supplies...... 46 standardising the laboratory test menus and supplies for the various tiers of laboratories in the laboratory network. Standardization will increase access to high quality diagnostic tests for the care, treatment, prevention and surveillance of HIV/AIDS, tuberculosis (TB) and malaria amongst other infectious and non-infectious diseases.

From laboratory supply chain managment perspective, implementation of standardization will significantly contribute to the reduction in the number of commodities managed by the central warehouses.

Additionally, as Uganda targets to get laboratories accredited to International Standards, these guidelines will form a basis for selection of accreditation scopes by laboratories.

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v ACKNOWLEDGMENT

The development and finalization of this Standard of the Test Menu, Technique and List of Supplies This standard test menu, techniques and supplies list for laboratories will be reviewed on a for Laboratories in Uganda is a result of contributions and dedicated efforts of the Ministry of Health regular basis to respond to the prevailing needs in health services delivery. (MOH), several stakeholders, health development partners and individuals. These parties have been engaged in series of meetings, workshops, and individual as well as institutional consultations to develop this guidelines and the MOH is grateful for all the support and sacrifice that has been invested . …………………………….. for its successful development. Dr. Diana Atwine Permanent Secretary - MOH Special acknowledgement is extended to PEPFAR through The United States Government’s Centers for Disease Control and Prevention (CDC- Uganda) and United States Agency for International Development (USAID); CHAI, UNICEF for funding laboratory systems strengthening in Uganda.

We would like specifically to appreciate PEPFAR-CDC funded A Global Healthcare Public Foundation and USAID-UHSC Project for their logistical and Technical support in the test menu development.

The Ministry of Health would also like to express its appreciation to all workshop participants for their dedication and technical input in the process of producing this document.

The following were workshop participants:

No Name Institution 1. Seru Morries MOH 2. Obua Thomas Ocwa MOH 3. Wilson Nyegenye MOH 4. Kyokushaba Judith MOH 5. Steven Aisu MOH 6. Aidarayaan Namakula MOH 7. Abdul Mutaka MOH 8. Guma Gaspard MOH 9. Philip Kasibante MOH 10. Bernard Baitwababo MOH 11. Geoffrey Taasi MOH 12. Nassimbwa Dianah MOH 13. Ocaka robert MOH 14. Yonah Muganzi MOH 15. Felix Muloya MOH 16. Dr. Miriam Murungi MOH 17. Christopher Okiira MOH 18. Dr. Simon Kalyesubula MOH 19. Dr.Hakim Sendangire MOH 20. Agnes Nakakawa MOH 21. Mugerwa Ibrahim MOH 22. Godfrey Mujuzi MOH 23. Rita N. Eragu MOH 24. Nakidde Rebbecca MOH 25. Denis Kyabagu MOH 26. Sunday Izidoro NMS 27. Peter Ayebare NMS 28. Derrick Kibirige JMS 29. Ms. Adunia Ann Mary DHO

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vi ACKNOWLEDGMENT

We would like specifically to appreciate PEPFAR-CDC funded A Global Healthcare Public Foundation and USAID-UHSC Project for their logistical and Technical support in the test menu development.

The Ministry of Health would also like to express its appreciation to all workshop participants for their dedication and technical input in the process of producing this document.

The following were workshop participants:

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vii

30. Dr. Anguzu Patrick DHO 31. Dr. Oundo G.B DHO We wish to thank the Equipment and Laboratory Supplies Technical Working Group that provided 32. Dr. Matovu John Bosco DHO leaderships and technical reviews. The TWG members include: Wilson Nyegegye, Steven Aisu, Judith 33. Dr. Ojok Samuel DHO Kyokushaba, Victor Bigira, Sam Acellam, Sunday lzidoro, Abdul Mutaka, Nantege Grace, Wasike 34. Dr.Onek A Paul DHO Samuel, Aidarayaan Namakula, Moses Lubale, Martha Pedun, Guma Gaspard, Derrick Kibirige, and 35. Dr. Rugonga Joseph DHO Clare Ashaba. 36. Dr. Bawine Julius DHO 37. Dr. Musisi Edrisa DHO 38. Dr. Mucunguzi William DHO 39. Dr. Musisi Stuart DHO Finally, we thank the taskforce secretariate namely Judith Kyokusaba, Wilson Nyegenye, and Pedun 40. Dr. Rutahigwa Elisa DHO Martha who worked tirelessly to ensure that the guidelines are produced. 41. Dr. Okadhi Charles Stephen DHO 42. Dr. Ongiera Sam Ajoga DHO 43. Dr. Jubille Facility in charge 44. Lt. Yonah B Muganzi Facility in charge 45. Dr. Ochor Thomas Facility in charge 46. Dr. Katongole Paul Facility in charge Dr. Susan Nabadda 47. Dr. Makaya Facility in charge 48. Dr. Alex Andema Facility in charge 49. Dr. Mukobi Peter Facility in charge Ag. Head, Laboratory Services - CPHL/MOH 50. Mule William DLFP 51. Kimera Deo DLFP 52. Isabirye Richard DLFP 53. Kalyesubula Edward DLFP 54. Mutesi Lydia DLFP 55. Mugabi Joel Sam DLFP 56. Babirye Yunia DLFP 57. Muloya Felix DLFP 58. Olak Patrick DLFP 59. Ejoku Bernard DLFP 60. Kebba John NRH & RRH 61. Gilbert Sunday NRH & RRH 62. Grace Otekat NRH & RRH 63. Nangosa Hamida NRH & RRH 64. Kadhumbula Silver NRH & RRH 65. Ntambi Samuel NRH & RRH 66. Moses Mukembo NRH & RRH 67. Jackson Were NRH & RRH 68. Stella Maiya NRH & RRH 69. Kasule Daniel NRH & RRH 70. Patrick Kakeeto NRH & RRH 71. Robert Ocakachon NRH & RRH 72. Sarah Namutebi NRH & RRH 73. Silver Mashate UHSC 74. Kyokushaba Judith UHSC 75. Edward Otim UHSC 76. Moses Lubale UHSC 77. Ankunda Philip UHSC 78. Macreen Mudoola UHSC 79. Samuel Balyejjusa UHSC 80. Dr. Victor Bigira CHAI 81. Acellam Samuel CHAI 82. Thomas Nsibambi CDC 83. Wasike Samuel CDC 84. Nantege Grace CDC 85. Ashaba Clare UNICEF 86. Prof. Kilian Songwe AGHPF 87. Dr. Peter M Tukei AGHPF 88. Maryanne Otieno AGHPF 89. Carol Asiimwe AGHPF 90. Martha Pedun AGHPF

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ix LIST OF ABBREVIATIONS AND ACRONYMS

ACHAP Africa Comprehensive HIV/AIDS Partnership

AGHPF A Global HealthCare Public Foundation AIDS Acquired Immunodeficiency Syndrome ART Antiretroviral Therapy ARV Antiretroviral (drugs)

CDC Centers for Disease Control and Prevention

CHAI Clinton Healthcare Access Initiative

CMS Central Medical Store

CPHL Central Public Health Laboratories

CSF Cerebrospinal fluid

DNA Deoxyribonucleic Acid, EID Early Infant Diagnosis EMTCT Elimination of Mother to Child Transmission

GH General Hospital

HC Health Centre

HIV Human Immunodeficiency Virus

HVS High Vaginal Swab

ICD International Classification of Disease

JMS Joint Medical Store

LMIS Laboratory Management Information System

MAUL Medical Access Uganda Limited

MoH Ministry of Health

NHL National Health Laboratory

NHLS National Health Laboratory Services

NMS National Medical Stores

NRH National Referral Hospital

NTRL National Tuberculosis Reference Laboratory

PCR Polymerase Chain Reaction

PD Pharmacy Department

PEPFAR President’s Emergency Plan for AIDS Relief

PFP Private for Profit

PITC Provider-Initiated Testing and Counseling

PLWHA People Living with HIV/AIDS

PMTCT Prevention of Mother-to-child Transmission

PNFP Private Not for Proffit

x POCT Point of Care Testing

RRH Regional Referral Hospital SOP Standard Operating Procedure TB Tuberculosis UBTS Uganda Blood Transfusion Service

UCG Uganda Clinical Guidelines UCI Uganda Cancer Institute UHI Uganda Heart Institute UHSC Uganda Health Supply Chain

UNMHCP Uganda National Mimimum Health Care Package USAID United States Agency for International Development UVRI Uganda Virus Research Insititute VCT Voluntary Counseling and Testing VEN Vital, Essentail and Non-Essentail VL Viral Load

xi 1.0 SECTION ONE: INTRODUCTION

1.1 THE LABORATORY SERVICE DELIVERY AND NETWORK IN UGANDA

The Health Sector Strategic and Investment Plan (HSSIP) 2015/16-2019/20 identifies laboratory services as a key driver for effective delivery of the Uganda National Minimum Health Care Package (UNMHCP) and as a critical component for effective disease control and prevention1. A well- functioning health laboratory service provides vital information needed for proper planning and utilization of health resources, which is particularly critical in resource-limited settings.

The National Health Policy, Health Sector Strategic Plan (HSSP) I and II and the Public Private Partnerships for Health (PPPH) policy are some of the key documents that guide laboratory services delivery. The Uganda National Laboratory Policy2 and Uganda National Laboratory Strategic Plan 2017-20213 sets direction in 13 key areas that are fundamental in attaining and sustaining quality laboratory services delivery in the country; these include: organization and management; delivery of the services; laboratory facilities, safety and biosecurity; laboratory equipment and supplies; human resources; quality management systems; information systems; research and development; point of care testing services; partnerships; regulatory and legal framework; monitoring and evaluation; and financing and accountability.

Uganda laboratory services are designed to support the UNMHCP at thevarious levels of healthcare, with the complexity of tests performed rising in accordance with the level of healthcare. The laboratory services function as a cascading network with linkages among the laboratories at different facility levels, which havealso been strengthened with the establishment of the hub system4.

The hub system functions as a network within the system that allows referral of specimen to the higher level if services are not available at the originating one. The hub system is currently being used for testing and or as a referral channel for Viral Load, DNA-PCR, CD4, chemistry, hematology, TB samples such as GeneXpert, culture and sensitivity specimen.

The range of laboratory services provided at the various levels range from basic services at Health Centre (HC) level III, through HC IV increasing in complexity in General Hospitals (GH), Regional Referral Hospital (RRH) Laboratories and to highly specialized testing at National Reference Hospital laboratories. The National Referral Hospital Laboratories include Mulago Hospital, Butabika Hospital, Uganda Heart Institute (UHI), and Uganda Cancer Institute (UCI). There are also national specialized laboratories such as Central Public Health Laboratories (CPHL),National Tuberculosis Reference Laboratory (NTRL), Uganda Virus Research Institute (UVRI) and Uganda Blood Transfusion Services (UBTS).

Laboratory service provision requires commodities, functioning equipment, trained personnel,information systems, and infrastructure. Standardised provision of laboratory testing services eases and fundamentally improves the efficiency and quality of services provided to the user.

Test menu, techniques, equipment and supply lists at the various levels of health care compose the building blocks of laboratory standardization5. These building blocks are used to review or create

1The Health Sector Strategic and Investment Plan (HSSIP) 2010/11-2015/16 2 Uganda National Laboratory Policy, (Second National Health Lab Policy Strategic Plan) 3 Uganda National Laboratory Strategic Plan 2017-2021 4Hub operation guidelines, 2016 5USAID | DELIVER PROJECT, 2010. Laboratory Standardization: Lessons Learned and Practical Approaches.

1 laboratory standard operating procedures (SOP) that outline the standard practices to be used throughout the national laboratory network in Uganda.

1.2 JUSTIFICATION

Over the past decade, there has been an increased demand for laboratory testing to manage infectious and non-infectious diseases including emerging and re-emrging diseases. In response to the increased demand for testing, new technologies have been developed in addition to the already highly diverse technology and testing platforms.

Medical laboratories in Uganda are a tiered network of testing facilities operating under common principles and procedures to enhance rational distribution of testing capacity.Laboratory networks require central management and direction setting through national laboratory policies, guidelines and regulatory oversight and coordination of operational functions such as supply chain, quality assurance to ensure more efficient operation and collective benefits across all laboratories.

The standardization of test menus, techniques,Equipment and supplies list across the network promotes an efficient and cost-effective operation and management of the laboratory network

This standard test menu, techniques and supplies list for laboratories will streamline services delivery across the laboratory network, manage and reduce operational costs without compromising quality of laboratory services. Other benefits that will accrue include; improved planning and resource allocation, improved efficiency of procurement and supply chain management, improved management of equipment service and maintenance contracts, improved implementation of EQA programmes and reduction in retraining of staff.

1.3 BACK GROUND OF STANDARDISATION

In January 2008, a team of experts, policy makers and major stakeholders held a meeting in Maputo, Mozambique to make recommendations on laboratory testing standardization and harmonization to address laboratory challenges that limit the scale–up of services for tuberculosis, malaria and HIV diagnosis and care6.

The purpose of the Maputo meeting was: a) To review and agree on a list of supplies and tests needed at each level of integrated tiered laboratory network. b) To develop a consensus to guide standardization of laboratory equipment at each level of the laboratory network. c) To develop a consensus on key considerations to guide maintenance and service contracts at various levels of the laboratory network.

A written declaration,‘The Maputo Declaration’, that established a global commitment to strengthening integrated national public health laboratory systems was developed and participating countries ratified the declaration7. Uganda was among the 33 countries that attended the meeting. In 2011, the Uganda Ministry of Health (MoH) and Central Public Health Laboratory (CPHL) developed the first set of standardized laboratory test menus, test techniques, supplies, and laboratory equipment

6 WHO Report, The Maputo Declaration on Strengthening of Laboratory Systems,2008 7Maputo declaration, 2008 12

2 for each type of test and each level in the health system8. These were revised in 2013 to reflect the changes in technologies and treatment guidelines9.

The following key milestones in standardization have been achieved to date:

a) Comprehensive laboratory test menu was compiled for the various levels of health care. b) Comprehensive list of lab techniques for each tests was compiled. c) A harmonized list of equipment was developed according to recommended techniques for CD4, 10 chemistry and hematology d) A supply list for all lab reagents and consumables was prepared and classified using VEN analysis to guide procurement. e) The test menu and supplies list were included in the Uganda Clinical Guidelines11 to improve the utilization of lab services by clinicians

1.4 STANDARDIZATION OF LABORATORY TESTING

Standardization is the process of harmonizing laboratory test menus, test techniques, supplies, operating procedures, and laboratory equipment for each type of test and for the different levels of health care12.

The benefits of standardization include:

a) Fewer products flowing through the supply chain enhances the efficiency and management of national laboratory logistics system. b) The use of the same kind of equipment to conduct the same menu of tests at same level facilities allows easy sharing/distribution in case of stock out and significantly reduces the risk of expiries in facilities. c) Enables rational decision making throughout the supply chain in product selection, forecasting, quantification, and procurement d) Increases affordability of commodities through economies of scale e) Enables comparison and interpretation of results from different laboratories contributing to reduction in the need for re-testing in-case of client transfers. f) Enhances efficiency in training and management of staff g) Eases the implementation of equipment maintenance program h) Enables development of a robust quality assurance program i) Allows rational allocation of limited resources j) Allows uniform and consistent case definition and management

1.5 OBJECTIVES OF THE GUIDELINE a. To provide test menus by each level of healthcare. b. To provide the most suitable technique and equipment by each level of care that fulfill test menus c. To provide an up-to-date list of supplies that corresponds to the agreed testing technique and equipment by level of care d. To provide a list of supplies that is VEN-classified to guide procurement by prioritizing vital commodities.

8Laboratory Building Blocks for Standardization report, 2011 9Laboratory building blocks for standardization report,2013 10Equipment standardization and hominization report, 2011 11UCG guideline, 2016 12USAID | DELIVER PROJECT, 2010. Laboratory Standardization: Lessons Learned and Practical Approaches 13

3 e. To guide the development of standard operating procedures (SOP) at diffirent levels of health care provision. f. Advocacy tool for increased uptake and utilization of lab services, and resource mobilization

1.6 TARGET AUDIENCE The primary audiences for these guidelines are:

a. All health service providers and users of laboratory services b. Procurement agents and central warehouses c. Development partners,Implementating Partners, Health Training insititution and curricula developers d. General Public

1.7 COMPONENTS OF THE GUIDELINE This guidline is made up of four sections,these include;

a) Section One: Introduction which gives backgroud of lab services, justification, objectives, and benefits of this guidiline. This section also describes the background on test menu and equipment stardandistion.

b) Section Two: It describes the minimum test menu package required at each level of health care and provides a list of test to be done at each level. Table 1,2 and 3 provide details of test menu for each level.

c) Section Three: It describes the recommended techniques per test in each level of health care. Table 4,5 and 6 shows a detailed list of techniques per test.

d) Section Four: It describes commodities needed to perform the test. The supplies were categorized according to VEN clarification. Table 7 provide a detailed list of supplies required per test at each level. The list will be used by national warehouses during procurement.

4 2.0 SECTION TWO: TEST MENUS

2.1 TEST MENUS

The test menu is defined as list of tests offered at a specific laboratory for diagnosis of a condition Uganda has a well- defined laboratory tiered network that is aligned with the public health service delivery.The test menu was developed to reflect the needs of patients and is consistent with the Uganda’s health service delivery standards for each level of the health. (Table 1,2 &3:List of test menus for the various levels of health care)

The purpose of the test menu is to facilitate effective diagnosis and management of various conditions at all levels of health care. This test menu was developed, reviewed and aligned to the ICD 10,UCG , standard treatment guidelines for HIV13, and TB14 to ensure that :

a. Laboratory personnel get a better appreciation of the utility of the tests performed in the laboratoriesthereby offering advisory services to clinicians b. Improvedparticipation of laboratorians and cliniciansin patient care c. Savings on the costs of testing and patient treatment d. Increased uptake of laboratory and utilization of laboratory services since clinicians will aware of the tests available at the various levels e. Effective utilization of available medical laboratory technologies f. Availability of information for decision making g. Test data from Ugandan laboratories is comparability with test data from other countries and International Health Organisations.

2.2 LABORATORY SERVICE DELIVERY AT THE VARIOUS LEVELS OF HEALTHCARE Laboratory services is Uganda are a tiered network of testing facilities that include both government- run and private laboratories. These guidlines clearly state the minimum testing services expected at the various levels in the tiered laboratory network (See table 1).

2.2.1 Health Centre III Laboratory services by policy start at this level of health care. Laboratories at this level shall perform basic tests in hematology, parasitology, serology, blood grouping, urine chemistry and immunology.

2.2.2 Health Centre IV Laboratories at this level shall perform selected clinical chemistry tests,hematology, Prothrombin time Test (PT) and blood compatibility testing in addition to all the tests done at HC IIIs. CSF, HVS and swab analysis shall also be performed at this level. Where applicable, laboratories at this level shall supervise HC III laboratories .

2.2.3 General Hospital Laboratories These laboratories perform specialized clinical chemistry tests that include lipid, cardiac profile, thyroid functional tests and fertility hormones, plasmin inhibitors, pancreatic and infectious disease tests in addition to all tests provided at HC IVs. Laboratories at this level, shall, where applicable supervise all the lower level testing facilities.

13 Consolidated guideline for prevention and treatment of HIV IN Uganda 14 TB care and treatemnet guidelines

5 2.2.4 Regional Referral Hospital (RRH) Laboratories RRH laboratories shall have more advanced and highly equipped laboratories to perform all functions of general hospital laboratories. In addition, RRH shall perform more specialized tests such as glycated Hb, Reticulocyte count, Hb electrophoresis, body fluids and swab analysis by performing microbiology culture and sensitivity; mycology and cytology (PAP smear and Biopsy), blood gas, and tumor markers tests.

RRH laboratories, shall, where applicable, supervise all the lower level laboratories . They shall also be used for training, scientific research and investigations for the control and prevention of epidemics and emerging diseases within the country to inform policy at national level.

2.2.5 National Referral Hospital Labomtones Laboratories in this category shall perform all functions of the regional referral in addition to providing highly specialized tests in cardiac profile, blood gas tests, metabolic tests, thyroid functional tests, fertility tests and tumor markers, Hb electrophoresis, coagulation tests and plasmin inhibitors. They shall also be referral centres for histology and mycology tests particularly culture and sensitivity.

2.2.6 Laboratory Hubs Laboratory hubs were established to increase access to quality laboratory services and improve accuracy and immediacy in disease diagnoses. Laboratory hubs provide services on-site or refer to a higher level facility that has capacity to perform the test. All facilities designated as hubs irrespective of level of care shall at minimum perform CD4, TB, chemistry and hematology test, in addition to providing services expected at its level of health care. They shall also function as referral centers through which samples for specilised tests such as EID,Viral Load, microbiology, histopathology, and outbreak investigations are sent to national reference laboratories.

2.2.7 Testing below Health Centre III By policy, there are no laboratory facilities below Health Centre III. However, point of care testing such as rapid HIV test, malaria, Heptitis B, Syphilis, pregnancy tests, and glucose is provided for below this level of healthcare. These sites should have the capacity to collect and refer samples to the next level for testing. Outreach testing commodities shall be accessed through HCIIIs, and therefore,all testing data for outreaches should be included in the HCIII reports.

2.3 NATIONAL SPECIALIZED LABORATORIES

2.3.1 Uganda Heart Institute (UHI)

The UHI serves as a center of excellence for the provision of comprehensive medical services to patients with cardiovascular and thoracic diseases and to offer opportunities for research and training. The UHI laboratory shall have capacity to perform all relavant tests for treatment and monitoring of patients with cardiovascular and thoracic diseases. In addition , they shall perform other tests as provided at national referral hospital laboratories.

2.3.2 Uganda Cancer Institute (UCI)

UCI is a cancer treatment, research and teaching insititution. The UCI laboratory shall perform all relavant tests for treatment and monitoring of cancers in patients. In addition , they shall perform other tests as provided at national referral hospital laboratories. See table 2 for detailed list of test menu for UHI and UCI

6 2.3.3 Central Public Health Laboratory (CPHL)

CPHL is consortium of national specialized testing laboratories that include:

a. Molecular laboratories such as EID, Viral Load, and sickle cell b. Microbiology laboratory that supports disease outbreak investigations, antimicrobial resistance testing and surveillance, and environmental and food handlers hygiene monitoring. c. Laboratories that support external quality assurance programs across the national laboratory test menu. d. Any other Laboratories that may be established for purposes of provding references testing and national level.

2.3.4 Uganda Blood Transfusion Services (UBTS)

UBTS laboratory shall perform all blood grouping and screening tests on donated blood to ensure the safety of the recipients. UBTS shall distribute and supervise the work of all Regional Blood Banks and the lower level laboratories providing blood transfusion services.

2.3.5 National Tuberculosis Reference Laboratory (NTRL)

NTRL shall perform the following tests: tuberculosis culture, identification of mycobacteria tuberculosis complex (MTC), drug susceptibility testing (DST) methods and GeneXpert MTB/RIF test. The laboratory shall also provide support supervision and mentorship to regional and district health facilities to perform Acid-Fast Bacilli (AFB) microscopy for both ZN and FM microscopy techniques according to the prevailing WHO policy guidance. NTRL assures quality TB testing, external profiency testing, capacity building through training and support supervision to all local and regional laboratories. See table 3 for detailed list of test menu for UBTS and NTRL

2.3.6 Uganda Virus Research Instititute (UVRI). UVRI is a national medical research institute that conducts research on both human and zoonotic communicable diseases with emphasis on viral etiologies. UVRI supports national specialized reference testing by providing capacity for those techniques not available in other reference laboratories. UVRI is a component of Uganda National Health Research Organization (UNHRO), an umbrella organization for health research within Uganda.

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of nationa is a Consortinum CPHL arise

26 3.0 SECTION THREE: TEST TECHNIQUES AND EQUIPMENT 3.1 Techniques Techniques are specific method used to carry out a test that is based on an established protocol. Laboratory tests have a large number of widely accepted techniques; for example, TB laboratory diagnosis can be by ZN microscopy, fluorescent microscopy, and GeneXpert. Laboratory personnel are best placed to decide on the most appropriate technique to adopt for the in-country setting.

During the development of this guideline, technical, environmental, infrastructural considerations and supply chain implications were considered in selecting techniques. Supply chain management conditions such as cold chain maintenance was a major consideration during the selection of techniques especially at lower health facilities. Consensus was based on having a balance in scientifically sound technology, appropriateness to the infrastructure and staff competencies at the various levels of healthcare. (Table 6: List of recommended techniques for each test for the various levels of health care)

3.2 Equipment The laboratory testing techniques are either manual or automated. The automed techiques use equipment as per testing categories. Each testing category has several platforms of equipment with diffirent capaicities by diffirent manufacturers. Minimum equipment capacity at each level of health care has been difined in Table 4 per level of health care.

In 2011, Ministry of Health harmonized equipment15for each level of care (See Table 5).The harmonization of equipment has guided the development of guidelines and has supported rationalization of laboratory supply chain with minimum commodities.

With the harmonization of equipment, the country has also been able to strengthen equipment maintenance both at central and regional centers across the country.

3.3 Personnel Laboratory staff is an important resource for delivery of lab services. In order to implement this guideline, the requirement staffing norms at each level of health care should match the complexity of testing services provided at that level.

15Equipment standardization and hominization report, 2011

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43 4.0 SECTION FOUR: LABORATORY SUPPLIES LIST AND VEN CLASSIFICATION In developing the national laboratory supplies list, other considerations were also used as part of the VEN 4.1 Laboratory supply chain classification: The management of laboratory supply chains is a challenging and complex undertaking because of the wide range of commodities required to conduct a single laboratory test and the plethora of tests that exist. a. To ensure that all commodities required to perform a given test are procured at the same time, the list has

grouped the commodities into kits. This will ensure continuity of testing and reduce wastage due to expiry There are three central warehouses that have a central role in procuring, storing and distributing of commodities procured incomplete to perform a test. laboratory supplies to Public, PNFP and PFP facilities, that is: National Medical Stores (NMS), Joint Medical b. The different levels use different commodities and different facilities have different platforms for Store (JMS) and Medical Access Uganda Limited (MAUL). performing the same test. The classification accounts for this and ensures that all facilities can access the These warehouses handle several laboratory commodities covering different testing areas which include commodities. However, the platforms considered are according to the MoH standardized equipment list. chemistry, hematology, immunology, virology, blood bank, microbiology, molecular biology, histology, c. Personal protective equipment and safety materials are considered Vital. This is to ensure the safety of the pathology and cytology. laboratory workers, users of the laboratory services and the community at large. All samples in the laboratory are considered potentially infectious. Therefore, availability of PPE and waste management The standardized supplies list will be shared across the warehouses to facilitate trading of stock between national commodities (color coded bins, liners) is very important. warehouses. d. HIV, TB and malaria are diseases of public health importance. Therefore commodities, reagents, kits for

the diagnosis of these diseases e.g. HIV test kits, CD4, VL, EID, TB and malaria reagents are grouped 4.2 VEN classification as vita VEN is an acronym where V stands for vital, E for essential and N for non-essential.Where funds for procurement are insufficient, first priority will be given to the procurement and supply of vital items. Ensuring the availability of vital items is primarily the responsibility of National warehouses.If funds are available after securing vital items, procurement of essential (E) list items will then be initiated.  Chemistry and hematology commodities are also considered vital as these have implications for the care, treatment and monitoring of HIV patients; however, further classification was made considering the number The VEN classification was used to priotitize and develop a list of laboratory commodities required for of platforms available in the country. performing tests at the various levels of health care as described in table 7. List of supplies classified according to VEN analysis per level of health care is in table 8.  All commodities associated with emergency medicine were considered vital. The medical Table 7: Classification of laboratory supplies using VEN classification emergencies include those requiring surgery with general anesthetic interventions, intensive care monitoring, meningitis, malaria, diabetic coma, renal and hepatic failure to name a few. These Category Classification criteria commodities include all stains for gram stains, malaria identification, and hemoglobin estimation, V-Vital items  Are required to perform the critical tests that support the implementation of LFT/RFT including electrolytes parameter, blood glucose estimation, and cryptococcal antigens. the mimimum health care package based on level of health care. These tests are mainly used at referral hospitals for monitoring patients in critical conditions.  All commodities related to blood transfusion services are considered vital inclusive of the hepatitis B  Are required for tests used to diagnose, treat or control disease of major and C antigen test kits public health and national health plan such as HIV, malaria, and TB  Microbiology supplies were classified as vital, necessary or non-essential depending on the technique used to  E-Essential items Are normally used to perform tests in the mimimum health care package perform the test. Syphilis tests were considered vital as these are critical for antenatal care and have however absence of the items does not necessary prevent the test from being implications for fetal viability and pregnancy outcomes. performed  Histology/cytology/mycology commodities are considered Vital based on the level of health care and Non-essential /Desirable  Are used for additional tests not classified as essential for delivering the basic techniques. These are mainly required at regional and national referral hospital laboratories. The health care package procurement of these commodities requires annual estimation by the end users who submit their

estimates to National Medical Stores for procurement.  Have a high cost and marginal therapeutic advantages

18 19

In developing the national laboratory supplies list, other considerations were also used as part of the VEN classification:

a. To ensure that all commodities required to perform a given test are procured at the same time, the list has grouped the commodities into kits. This will ensure continuity of testing and reduce wastage due to expiry of commodities procured incomplete to perform a test. b. The different levels use different commodities and different facilities have different platforms for performing the same test. The classification accounts for this and ensures that all facilities can access the commodities. However, the platforms considered are according to the MoH standardized equipment list. c. Personal protective equipment and safety materials are considered Vital. This is to ensure the safety of the laboratory workers, users of the laboratory services and the community at large. All samples in the laboratory are considered potentially infectious. Therefore, availability of PPE and waste management commodities (color coded bins, liners) is very important. d. HIV, TB and malaria are diseases of public health importance. Therefore commodities, reagents, kits for the diagnosis of these diseases e.g. HIV test kits, CD4, VL, EID, TB and malaria reagents are grouped as vita

 Chemistry and hematology commodities are also considered vital as these have implications for the care, treatment and monitoring of HIV patients; however, further classification was made considering the number of platforms available in the country.

 All commodities associated with emergency medicine were considered vital. The medical emergencies include those requiring surgery with general anesthetic interventions, intensive care monitoring, meningitis, malaria, diabetic coma, renal and hepatic failure to name a few. These commodities include all stains for gram stains, malaria identification, and hemoglobin estimation, LFT/RFT including electrolytes parameter, blood glucose estimation, and cryptococcal antigens. These tests are mainly used at referral hospitals for monitoring patients in critical conditions.  All commodities related to blood transfusion services are considered vital inclusive of the hepatitis B and C antigen test kits

 Microbiology supplies were classified as vital, necessary or non-essential depending on the technique used to perform the test. Syphilis tests were considered vital as these are critical for antenatal care and have implications for fetal viability and pregnancy outcomes.

 Histology/cytology/mycology commodities are considered Vital based on the level of health care and techniques. These are mainly required at regional and national referral hospital laboratories. The procurement of these commodities requires annual estimation by the end users who submit their estimates to National Medical Stores for procurement.

45 Table 8: List of Standardized Laboratory Supplies

ITEM DESCRIPTION UNIT LoC VEN HAEMATOLOGY Haematology reagents 2% Turks Solution (WBCT Count) 500 ml HC3 V Drabkin solution 500 ml HC3 V Cyanmethemoglobin Standard 10 ml HC3 V Micro Cuvettes 100 ml HC3 V 0.85% Sodium Chloride (Saline) 1000 ml HC3 V Phosphate buffers tablets 50 ml HC3 V ESR Tubes and Stand Each HC3 V Sickle cell supplies Sodium metabisulphite 500 g HC3 V Beckman Coulter AcT 3&5 diff Haematology, Beckman Coulter, AcT5 diff, Calibrator, 2 x 2 ml 4 ml HC IV V Haematology, Beckman Coulter, AcT 5diff, Control Plus, H, N, L, 6 x 2.3 ml 13.8 ml HC IV V Haematology, BeckmanCoulter, AcT 5diff, Diluent 20 L HC IV V Haematology, Beckman Coulter, AcT 5diff, Fix 1 L HC IV V Haematology, BeckmanCoulter, AcT 5diff, Rinse 1 L HC IV V Haematology, Beckman Coulter, AcT 5diff, WBC Lyse 1 L HC IV V Haematology, Beckman Coulter, AcT Rinse Shutdown Diluent, EEC 500 ml HC IV V Haematology, Beckman Coulter, AcT diff Pack, Reagent Kit, 15 L + 300 ml 300 ml HC IV V Haematology, Beckman Coulter, AcT5 diff, Hgb Lyse 400 ml HC IV V HumaCount 3&5 Diff Haematology, HumaCount, Cleaning Solution 1 L HC4 V Haematology, HumaCount, Cyanide Free Lyse Reagent 1 L HC4 V Haematology, HumaCount, Diluent 20 L HC4 V Haematology, HumaCount, Lyse Reagent for Basophils 1 L GH V Haematology, HumaCount, Lyse Reagent for Eosinophils 1 L GH V Haematology, HumaCount, Controls H, N, L 2 x 2.5 ml 5 ml HC4 V Haematology, HumaCount, Calibrators, 2 x 2.5 ml 10 ml HC4 V Haematology, HumaCount 5 L Controls 5 ml GH V Sysmex 3&5 Diff (Symex XN 450, XS1000i, XN1000) Haematology, Sysmex, Cell pack DCL 20 L RR E Haematology, Sysmex, Cell pack DFL 1.5 L RR E Haematology, Sysmex, Cell Clean 50 ml HC4 V Haematology, Sysmex, Cell pack 20 L HC4 V Haematology, Sysmex, Lyser cell WDF 4 L RR E Haematology, Sysmex, Lyser cell WNR 4 L RR E Haematology, Sysmex, Lyser cell WPC 12 ml RR E Haematology, Sysmex, Fluoro cell WDF 42 ml RR E Haematology, Sysmex, Fluoro cell WNR 82 ml RR E Haematology, Sysmex, Fluoro cell RET 12 ml RR E Haematology, Sysmex, Fluoro cell PLT 12 ml RR E Haematology, Sysmex, Fluoro cell WPC 12 ml RR E Haematology, Sysmex, Stromatolyser 4DL 5 L HC4 V Haematology, Sysmex, Stromatolyser 4DS, 3 x 42 ml 126 ml HC4 V Haematology, Sysmex, Stromatolyser SWH, 3 x 500 ml 1500 ml HC4 V

Table 8: List of Standardized Laboratory Supplies Haematology, Sysmex, Sulfolyser Haematology, Sysmex, Control E-Check (XS) High, 4 x 1.5 ml 6 ml HC4 V ITEM DESCRIPTION UNIT LoC VEN Haematology, Sysmex, Control E-Check (XS) Low, 4 x 1.5 ml 6 ml HC4 V HAEMATOLOGY Haematology, Sysmex, Control E-Check (XS) Normal, 4 x 1.5 ml 6 ml HC4 V Haematology reagents Haematology, Sysmex, Eightcheck -H, 1.5 x 12 ml vials 18 ml HC4 V 2% Turks Solution (WBCT Count) 500 ml HC3 V Haematology, Sysmex, Eightcheck -L, 1.5 x 12 ml vials 18 ml HC4 V Drabkin solution 500 ml HC3 V Haematology, Sysmex, Eightcheck -N, 1.5 x 12 ml vials 18 ml HC4 V Cyanmethemoglobin Standard 10 ml HC3 V Haematology, Sysmex, XN check -L1, 8 x 6 ml vials 48 ml RR E Micro Cuvettes 100 ml HC3 V Haematology, Sysmex, XN check -L2, 8 x 6 ml vials 48 ml RR E 0.85% Sodium Chloride (Saline) 1000 ml HC3 V Haematology, Sysmex, XN check -L3, 8 x 6 ml vials 48 ml RR E Phosphate buffers tablets 50 ml HC3 V Haematology, Sysmex, XN BF L1&L2, 4 x 6 ml vials 24 ml RR E ESR Tubes and Stand Each HC3 V Nihon Koden Coulter 3&5 Diff Sickle cell supplies Haematology, Coulter, Isotonac 3 Diluent 20 L HC4 V Sodium metabisulphite 500 g HC3 V Haematology, Coulter, Haemolynac 3N 1 ml HC4 V Beckman Coulter AcT 3&5 diff Haematology, Coulter, Haemolynac 5N 1 ml HC4 V Haematology, Beckman Coulter, AcT5 diff, Calibrator, 2 x 2 ml 4 ml HC IV V Haematology, Coulter, Cleanac (Normal) 5 ml HC4 V Haematology, Beckman Coulter, AcT 5diff, Control Plus, H, N, L, 6 x 2.3 ml 13.8 ml HC IV V Haematology, Coulter, Cleanac 3 (Strong) 5 ml HC4 V Haematology, BeckmanCoulter, AcT 5diff, Diluent 20 L HC IV V Haematology, Control, H, N, L (5ND) 2 ml HC4 V Haematology, Beckman Coulter, AcT 5diff, Fix 1 L HC IV V Haematology, Control, H, N, L (3DL) 2 ml HC4 V Haematology, BeckmanCoulter, AcT 5diff, Rinse 1 L HC IV V MINDRAY BC5600, BC 6800 Haematology, Beckman Coulter, AcT 5diff, WBC Lyse 1 L HC IV V Haematology, Mindray-58/56 cleanser 4 L HC4 V Haematology, Beckman Coulter, AcT Rinse Shutdown Diluent, EEC 500 ml HC IV V Haematology, Mindray-58/56 LEO (II) lyse reagent 2 L HC4 V Haematology, Beckman Coulter, AcT diff Pack, Reagent Kit, 15 L + 300 ml 300 ml HC IV V Haematology, Mindray-58/56 LH lyse reagent 2 L HC4 V Haematology, Beckman Coulter, AcT5 diff, Hgb Lyse 400 ml HC IV V Haematology, Mindray-58/56 LEO (I) lyse reagent 4 L HC4 V HumaCount 3&5 Diff Haematology, Mindray-58/56 LBA lyse reagent 4 L HC4 V Haematology, HumaCount, Cleaning Solution 1 L HC4 V Haematology, Mindray-58/56 D diluent 20 L HC4 V Haematology, HumaCount, Cyanide Free Lyse Reagent 1 L HC4 V Haematology, Mindray-68 DS diluent 20 L RR E Haematology, HumaCount, Diluent 20 L HC4 V Haematology, Mindray-68 LB lyse 1 L RR E Haematology, HumaCount, Lyse Reagent for Basophils 1 L GH V Haematology, Mindray-68 LH lyse 1 L RR E Haematology, HumaCount, Lyse Reagent for Eosinophils 1 L GH V Haematology, Mindray-68 LD Lyse 1 L RR E Haematology, HumaCount, Controls H, N, L 2 x 2.5 ml 5 ml HC4 V Haematology, Mindray-68 FD Dye 12 ml RR E Haematology, HumaCount, Calibrators, 2 x 2.5 ml 10 ml HC4 V Haematology, Mindray-68 DR Diluent 1 L RR E Haematology, HumaCount 5 L Controls 5 ml GH V Haematology, Mindray-68 FR Dye 12 ml RR E Sysmex 3&5 Diff (Symex XN 450, XS1000i, XN1000) Haematology, Mindray-68 LN Lyse 1 L RR E Haematology, Sysmex, Cell pack DCL 20 L RR E Haematology, Mindray-68 FN Dye 12 ml RR E Haematology, Sysmex, Cell pack DFL 1.5 L RR E Haematology, Mindray-68 Cleanser 50 ml RR E Haematology, Sysmex, Cell Clean 50 ml HC4 V Haematology, Mindray-68 Controls 6D (6 x 4.5 ml) 27 ml RR E Haematology, Sysmex, Cell pack 20 L HC4 V Haematology, Mindray-68 Controls 6Ret (6 x 4.5 ml) 27 ml RR E Haematology, Sysmex, Lyser cell WDF 4 L RR E Coagulation and plasmin inhibitor supplies Haematology, Sysmex, Lyser cell WNR 4 L RR E Sysmex CA 600 Haematology, Sysmex, Lyser cell WPC 12 ml RR E Haematology, Sysmex CA- Actin FS 4 ml NR V Haematology, Sysmex, Fluoro cell WDF 42 ml RR E Haematology, Sysmex CA- Dade Inovance 15 ml NR V Haematology, Sysmex, Fluoro cell WNR 82 ml RR E Haematology, Sysmex CA- Calcium chloride solution 15 ml NR V Haematology, Sysmex, Fluoro cell RET 12 ml RR E Haematology, Sysmex CA- Clean I 50 ml NR V Haematology, Sysmex, Fluoro cell PLT 12 ml RR E Haematology, Sysmex CA- Clean II 500 ml NR V Haematology, Sysmex, Fluoro cell WPC 12 ml RR E Haematology, Sysmex CA- IOV buffer 15 ml NR V Haematology, Sysmex, Stromatolyser 4DL 5 L HC4 V Haematology, Sysmex CA- Citrol 1 1 ml NR V Haematology, Sysmex, Stromatolyser 4DS, 3 x 42 ml 126 ml HC4 V Haematology, Sysmex CA- Citrol 2 1 ml NR V Haematology, Sysmex, Stromatolyser SWH, 3 x 500 ml 1500 ml HC4 V Haematology, Sysmex CA- TT reagent 5 ml RR V

20 21

Haematology, Sysmex CA- FIB reagent 1 ml RR V Haematology, Sysmex CA- P.T Mult-Calibrator 1 ml RR V Haematology, Sysmex CA- Normal control 1 ml RR V Haematology, Sysmex CA- Reaction tubes Piece RR V Haematology, Sysmex CA-Sample cups Piece RR V ACL Ellite Haematology, ACL-Ellite – Proclot - Coagulation Protein C Test NR V Haematology, ACL-Ellite – Proclot Diluent 100 ml NR V Haematology, ACL-Ellite - Pt-Fibrinogen Hs Plus H.V 45 ml NR V Haematology, ACL-Ellite – Sample Diluent 10 ml RR V Haematology, ACL-Ellite – Reference Emulsion 200 ml NR V Haematology, ACL-Ellite – Factor Diluent 10 ml NR V Haematology, ACL-Ellite -Thrombin Time Kit Test RR V Haematology, ACL-Ellite – Hepatocomplex Test NR V Haematology, ACL-Ellite – Cleaning Solution 500 ml NR V Haematology, ACL-Ellite – Cleaning Agent 80 ml NR V Haematology, ACL-Ellite –Emulsion Wash-R Acl 1 L NR V Haematology, ACL-Ellite – Von Willebrand Kit Ag 12 ml NR V Haematology, ACL-Ellite – Protein S Test NR V Haematology, ACL-Ellite – Pt Rgt Recomboplastin 45 ml NR V Haematology, ACL-Ellite – Pt Rgt Recomboplastin 105 ml NR V Haematology, ACL-Ellite – Von Willebrand Activity 9 ml NR V Haematology, ACL-Ellite - APPT – SP 45 ml RR V Haematology, ACL-Ellite – D-Dimer Test RR V Haematology, ACL-Ellite – Antithrombin Test NR V Haematology, ACL-Ellite – Plasminogen 9 ml NR V Haematology, ACL-Ellite – Plasmin Inhibitor 9 ml NR V Haematology, ACL-Ellite - Def.Plasma Factor XII 10 ml NR V Haematology, ACL-Ellite - Def.Plasma Factor XI 10 ml NR V Haematology, ACL-Ellite - Def.Plasma Factor V 10 ml NR V Haematology, ACL-Ellite - Def.Plasma Factor VII 10 ml NR V Haematology, ACL-Ellite - Def.Plasma Factor VIII 10 ml NR V Haematology, ACL-Ellite - Def.Plasma Factor IX 10 ml NR V Haematology, ACL-Ellite - Def.Plasma Factor II 10 ml NR V Haematology, ACL-Ellite - Def.Factor VIII (Chromogenic) Test NR V Haematology, ACL-Ellite – Protein C Test NR V Haematology, ACL-Ellite - Fib-C 20 ml NR V Haematology, ACL-Ellite – DRVVT Screen 20 ml NR V Haematology, ACL-Ellite – DRVVT Confirm 20 ml NR V Haematology, ACL-Ellite – Factor VIII ABN. Control 10 ml NR V Haematology, ACL-Ellite – Normal Control Plasma 10 ml NR V Haematology, ACL-Ellite - ABN. Control Plasma Low 10 ml NR V Haematology, ACL-Ellite - ABN. Control Plasma High 10 ml NR V Haematology, ACL-Ellite - Calibration Plasma 10 ml RR V Haematology, ACL-Ellite – Low Fibrinogen Control 10 ml RR V Haematology, ACL-Ellite – D-dimer Control 2 Level 10 ml RR V Haematology, ACL-Ellite – Special Control Test 1 10 ml NR V Haematology, ACL-Ellite – Special Control Test 2 10 ml NR V Haematology, ACL-Ellite –La Positive Control 10 ml RR V

Haematology, ACL-Ellite – La Negative Control 10 ml RR V Haematology, ACL-Ellite – Clear Sample Cup 0.5 ml 1 L RR V Haematology, ACL-Ellite – Rotors (20 Pos) Piece RR V Haematology, ACL-Ellite –Magnetic Stirrer Piece RR V Satellite Stago Haematology, Satellite Stago – STA Micro-container Piece NR V Haematology, Satellite Stago - Micro-cups Piece NR V Haematology, Satellite Stago - Max Reducer Piece NR V Haematology, Satellite Stago - Mini Reducer Piece NR V Haematology, Satellite Stago - White stirring magnet Piece NR V Haematology, Satellite Stago - STA Satellite Cuvettes Piece NR V Haematology, Satellite Stago – STA Neoplastin Cl +5 30 ml NR V Haematology, Satellite Stago - STA PTT Automate 5 60 ml NR V Haematology, Satellite Stago - STA CaCl 2 0.025 ml 360 ml NR V Haematology, Satellite Stago - STA Owren Koller 360 ml NR V Haematology, Satellite Stago - STA Coag Control N+P 24 ml NR V Haematology, Satellite Stago - Star Cleaner Solution 15 L NR V Haematology, Satellite Stago - STA Desorb U 360 ml NR V Minicap electrophoresis Haematology, Minicap – Hemoglobin 1.5 L NR V Haematology, Minicap – Serum protein 1.5 L NR V Haematology, Minicap – Urine protein 1.5 L NR V Haematology, Minicap – HbA1C 150 ml NR V Haematology, Minicap - Carbohydrate deficient transferrin (CDT) for Alcohol 200 ml NR V abuse) Haematology, Minicap - Hemoglobin controls 10 ml NR V Haematology, Minicap – Protein Controls 10 ml NR V Haematology, Minicap – HbA 1C controls 10 ml NR V Haematology, Minicap – CDT controls 10 ml NR V SEROLOGY Rapid testing HIV 1/2, Determine Complete HIV Kit, 100 Test Test HC2 V HIV 1/2, Stat-Pak Dipstick Assay Kit, 30 Test Test HC2 V HIV 1/2, Bioline 3.0 Kit, Complete 25 Test Test HC2 V HIV 1/2, HIV/Syphilis DOU HIV Kit, 25 Test Test HC2 V Syphilis, RPR Kit, 50 Test Test HC2 V Malaria Antigen P.f/Pan Kit, 25 Test dipstick Test HC2 V Hepatitis, HBsAg Screening Kit, 25 Test Test HC2 V Hepatitis, HCsAg Screening Kit, 25 Test Test HC3 V Latex Agglutination Test Kit, Cryptococcus, Antigen, 50 Test Test HC3 V Brucella abortus Ag 5 ml HC3 V HCG pregnancy test strips Test HC2 V Anti Streptolysin O-Test (ASOT) Test HC4 E Typhoid ag/antigen screening test Test HC3 V Rheumatoid factor screening test Test HC3 V Toxoplasma IgG and IgM Test HC4 E CMV IgG/IgM Test HC4 E CFlowytometry BD Fasc Calibur

Flow Cytometry, BD FACS, Clean Solution 5 L H V Flow Cytometry, BD FACS, FACSFlow Sheath Fluid, 20 L Test H V Flow Cytometry, BD FACS, Lysing Solution 10 x, 500 Test, 100 ml Test H V Flow Cytometry, BD FACS, MultiTest CD3/CD8/CD45/CD4 with Trucount Test H V Tubes, 50 Test Flow Cytometry, BD FACS, Rinse Solution 5 L H V Flow Cytometry, BD FACS, Trucount Controls, 30 Test 250 ml H V Flow Cytometry, BD FACSCalibur, Calibrite 3 Color Beads Kit, IVD, 25 Test Test H V Flow Cytometry, BD FACSCalibur, Calibrite APC Beads, 25 Test Test H V BD Presto Flow Cytometry, BD Presto Cartridges, 100 Test Test HC3 V Partec CyFlow Flow Cytometry, CyFlow, CD4% Easy Count Kit - dry, 100 Test 2.5 ml HC3 E Flow Cytometry, CyFlow, Cleaning Solution 250 ml HC3 E Flow Cytometry, CyFlow, CountCheck Beads, Green - dry, 50 Test Test HC3 E Flow Cytometry, CyFlow, Decontamination Solution 250 ml HC3 E Flow Cytometry, CyFlow, Sample Tubes, 3.5 ml, 500 PC Piece HC3 E Flow Cytometry, CyFlow, Sheath Fluid, 5 L 5 L HC3 E Flow Cytometry, CyFlow, Sodium Hypochlorite Solution, 0.5%, 250 ml 250 ml HC3 E Flow Cytometry, CyFlow, Thermal Paper, 5 Rolls Rolls HC3 E Pima CD4 Machine Flow Cytometry, Pima, Bead Standard, 1 Normal Cartridge,1 Low Cartridge Each HC3 V Flow Cytometry, Pima, CD4 Cartridge Kit, 100 Test Test HC3 V Flow Cytometry, Pima, Finger Stick Sample Collection Kit, 100 Units Test HC3 V Flow Cytometry, Pima, Printer with 1 Roll Thermal Paper Roll HC3 V BIOCHEMISTRY Urine biochemistry Glucometer, Test Strips, 50 pieces Test HC3 V Test Strips, Urinalysis Strips, 10 Parameters Test HC3 V Test Strips, Urinalysis Strips, 3 Parameters Test HC2 V Cobas CIII /Cobas 311/Integra 400/6000/Cobas H32/Cobas E411 Biochemistry, Cobas c111, ALP IFCC gen.2 Cobas c111 Test HC4 V Biochemistry, Cobas c111, ALT (Alanine aminotransferase) Test HC4 V Biochemistry, Cobas c111, AST (Aspartate aminotransferase) Test HC4 V Biochemistry, Cobas c111, Bilirubin direct Cobas c111 100 ml HC4 V Biochemistry, Cobas c111, Bilirubin total Gen.3 UN3316 36 ml HC4 V Biochemistry, Cobas c/Integra ALP IFCC gen.2 Test GH V Biochemistry, Cobas c/Integra ALT Test GH V Biochemistry, Cobas c/Integra amylase ver.2 Test GH V Biochemistry, Cobas c/Integra AST Test GH V Biochemistry, Cobas c/Integra Bilirubin Direct Gen.2 Test GH V Biochemistry, Cobas c/Integra bilirubin total Gen.3 UN3316 Test GH V Biochemistry, Cobas c/Integra Albumin BCG (ALB2) 4 x 100 Test Test GH V Biochemistry, Cobas c/Integra Y-Glutamyltransferase Ver2, GGT-2,200 test Test GH V Biochemistry, Cobas c/Integra Glucose HK Gen.3 Test GH V Biochemistry, Cobas c/Integra Total Protein Gen.2 UN1824 Test GH V Biochemistry, Cobas c111, Total Protein Gen.2 Cobas c111 UN1824 Test HC4 V Biochemistry, Cobas c111, Glucose HK Cobas c111 Test HC4 V Biochemistry, Cobas c/Integra Creatinine Jaffe gen.2 UN1814 Test GH V

Biochemistry, Cobas c111, Creatinine Jaffe Gen.2 Cobas c111 UN1814 700 ml HC4 V Biochemistry, Cobas c/Integra Urea/BUN test GH V Biochemistry, Cobas c/Integra Uric acid ver.2 Test GH V Biochemistry, Cobas c111, Urea/BUN (blood urea nitrogen) Cobas c111 500 ml GH V Biochemistry, Cobas c/Integra LDL Cholesterol gen2 Test GH V Biochemistry, Cobas c/Integra Cholesterol Gen.2 Test H V Biochemistry, Cobas c/Integra, HDL Cholesterol Test H V Biochemistry, Cobas c/Integra Triglycerides Test H V Biochemistry, Cobas c/Integra, ISE chloride (Cl) electrode Cobas c311 Each GH V Biochemistry, Cobas c/Integra, ISE potassium (K) electrode Cobas c311 Each GH V Biochemistry, Cobas c/Integra, ISE sodium (Na) electrode Cobas c311 Each GH V Biochemistry, Cobas c/Integra, ISE reference electrode Cobas c311 Each GH V Biochemistry, Cobas c111 ISE potassium (K) electrode Cobas c111 Each HC4 V Biochemistry, Cobas c111, ISE chloride (Cl) electrode Cobas c111 Each HC4 V Biochemistry, Cobas c111, ISE sodium (Na) electrode Cobas c111 Each HC4 V What Biochemistry, Cobas c111, ISE reference electrode Cobas c111 Each HC4 V Biochemistry, Cobas c111, ISE reference solution Cobas c111 1 ml HC4 V Biochemistry, Cobas c ISE standard high Each HC4 V Biochemistry, Cobas c ISE standard low Each HC4 V Biochemistry, COBAS c, C111, ISE Calib. Ind./Urine Each HC4 V Biochemistry, COBAS c, C111, ISE Calibration Kit Each HC4 V Biochemistry, Cobas c111, ISE deproteinizer Piece HC4 V Biochemistry, Cobas c111, ISE etcher Each HC4 V Biochemistry, Cobas c311/501 internal standard insert, ISE 22 ml GH N Biochemistry, Cobas c311/501 ISE diluent Gen.2 3.6 L GH V Biochemistry, Cobas c/integra/e411 -Magnesium Reagent Test RR E Biochemistry, Cobas c/integra/e411 -Lithium Reagent Test RR E Biochemistry, Cobas c/integra/e411 – Calcium Reagents 300 Test Test RR E Biochemistry, Cobas c/Integra, Lactate Dehydrogenase Reagent Test GH E Biochemistry, Cobas c/Integra Creatine Kinase Test GH E Biochemistry, Cobas c/Integra Creatine Kinase MB Test GH E Biochemistry, Cobas c/c-Reactive Protein Kit 300 ml GH E Biochemistry, Cobas H 232 Control Troponin T 2 ml NR V Biochemistry, Cobas H 232 T Assay | Strips Test NR V Biochemistry, Cobas H 232 PRO BNP assay | strips Test NR V Biochemistry, Cobas c/integra/H/e411, Pro Brain Natriuretic Peptide Test NR V Biochemistry, Cobas c/integra/H/e411, Procollagen Type 1 Intact N-Terminal Test NR V Peptide Reagent Biochemistry, Cobas c/integra/e411 –Troponin Test NR V Biochemistry, Cobas c/integra/e411 AFP 100 test Test GH E Biochemistry, Cobas c/integra/e411 - Spec- Chem-Ca19-9 Ag Reagent Test NR V Biochemistry, Cobas c/integra/e411 - Spec- Chem-CA 15-3 Ag Reagent Test NR V Biochemistry, Cobas c/integra/e411 - Spec- Chem-CA 72-4 Ag Reagent Test NR V Biochemistry, Cobas c/integra/e411 -Total Prostatic Specific Antigen(PSA) Test GH E Biochemistry, Cobas c/integra/e411 -Free Prostatic Surface Antigen Test GH E Biochemistry, Cobas c/integra/e411 -Carcino Embryonic Antigen Reagent Test NR V Biochemistry, Cobas c/integra/e411 -Carcinoma Antigen 125 Reagent Test NR V Biochemistry, Cobas c/integra/e411 -Beta Human Chorionic Gonadotrophic Test NR V Biochemistry, Cobas c/integra/e411,Neurone Specific Enolase Reagent Test NR V

Biochemistry, Cobas c/integra/e411 FT3 III 200 test Test GH E Biochemistry, Cobas c/integra/e411 FT4 II 200 test Test GH E Biochemistry, Cobas c/integra/e411, Free Tri-Iodo-Thyronine Reagent Test GH E Biochemistry, Cobas c/integra/e411,Total Tri-Iodo Thyronine Reagent Test GH E Biochemistry, Cobas c/integra/e411,Anti Thyroid Peroxidase Reagent Test GH E Biochemistry, Cobas c/integra/e411 TSH 200 test Test GH E Biochemistry, Cobas c/integra/e411 -Parathyroid Hormone Reagent Test RR E Biochemistry, Cobas c/integra/e411 Cortisol 100 test Test GH E Biochemistry, Cobas c/integra/e411 Estradiol II 100 test Test RR E Biochemistry, Cobas c/integra/e411 Ferritin 100 test Test RR E Biochemistry, Cobas c/integra/e411 FSH 100 test Test GH E Biochemistry, Cobas c/integra/e411 LH 100 test Test GH E Biochemistry, Cobas c/integra/e411 Progesterone II 100 test Test GH E Biochemistry, Cobas c/integra/e411 Prolactin II 100 test Test RR E Biochemistry, Cobasc/integra/e411 Testosterone II 100 test Test GH E Biochemistry, Cobas c/integra/e411, Pregnancy Associated Plasma Protein Test RR E Biochemistry, Cobas c/integra/e411s -Adreno Cortico Hormone Reagent Test NR V Biochemistry, Cobas c/integra/e411s -Adreno Cortico Trophic Hormone Test NR V Biochemistry, Cobas c/integra/e411, Cyclic Citrullinated Peptide Reagent Test NR V Biochemistry, Cobas c/integra/e411, Cytokeratin-21-1 Fragment Reagent Test NR V Biochemistry, Cobas c/integra/e411 -Toxoplasma Immunoglobulin M Test NR E Biochemistry, Cobas c/integra/e411 -Toxoplasma Immunoglobulin G Test NR E Biochemistry, Cobas c/integra/e411, Rubella Immunoglobulin G Reagent Test NR E Biochemistry, Cobas c/integra/e411, Rubella Immunoglobulin M Reagent Test NR E Biochemistry, Cobas c/integra/e411, Cytomegally Virus Immunoglobulin G Test NR E Biochemistry, Cobas c/integra/e411, Cytomegally Virus ImmunoglobulinM Test NR E Biochemistry, Cobas c/integra/e411, Hepatitis B Envelope Antigen Reagent Test NR V Biochemistry, Cobas c/integra/e411, Hepatitis B Virus Immunoglobulin M Test NR V 100 Test Biochemistry, Cobas c/integra/e411 -Hepatitis B Virus Core Immunoglobulin Test RR E G Biochemistry, Cobas c/integra/e411 -Bicarbonate Reagent (Ammonia) Test RR E Biochemistry, Cobas c/integra/e411 -Inorganic Phosphate Reagent Test RR E Biochemistry, Cobas c/Integra Lactate Test GH E Biochemistry, Cobas c/Integra Lipase Test GH E Biochemistry, Cobas c/integra/e411 -Ferritin Reagent Test RR E Biochemistry, Cobas c/integra/e411- Iron Reagent Test RR E Biochemistry, Cobas c/integra/e411-Hyper Glycated Hemoglobin Reagent Test RR E Biochemistry, Cobas c/integra/e411 CF HBA1C100 test Test RR E Biochemistry, Cobas c/integra/e411 Vitamin B12 100 test UN1824 Test RR E Biochemistry, Cobas c/integra/e411 Folate III 100tst UN1824 Test RR E Biochemistry, Cobas c/integra/e411,Interleukin 6 Test NR V Biochemistry, Cobas c/Integra, Calibrator for automated systems (Cfas) 24 ml HC4 V Biochemistry, Cobas c/Integra, preci control ClinChem multi 1 20 ml HC4 V Biochemistry, Cobas c/Integra, preci control ClinChem multi 2 20 ml HC4 V Biochemistry, Cobas -Preci control varia (Normal & High) 4 ml GH E Biochemistry, Cobas -Ammonia (Bicarbonate) control (Normal & High) 4 ml RR E Biochemistry, Cobas -Preci Control Universal (Normal & High) 4 ml HC4 V Biochemistry, Cobas -Toxo IgM, Hep B Core IgM, Toxo IgG, HepBsAg 2 ml RR E

Calset Calibrators Biochemistry, Cobas c Cfas lipids, 3 x 1 ml 2 ml HC4 V Biochemistry, Cobas -CF HBA1C 3 ml RR E Biochemistry, Cobas c Cfas CK-MB, 3 x 1 ml 3 ml RR E Biochemistry, Cobas c Cfas proteins, 5 x 1 ml 2 ml HC4 V Biochemistry, Cobas -Ammonia (Bicarbonate) Calibrator 2 ml RR E Biochemistry, Cobas -Total Thyroxine Calset Calibrator 2 ml GH E Biochemistry, Cobas -Free Thyroxine Calset Calibrator 2 ml GH E Biochemistry, Cobas -Tri-iodo Thyroxine Calset Calibrator 2 ml GH E Biochemistry, Cobas -Follicle Stimulating Hormone Calset Calibrator 2 ml GH E Biochemistry, Cobas -Luteinizing Hormone Calset Calibrator 2 ml GH E Biochemistry, Cobas -Thyroid Stimulating Hormone Calset Calibrator 2 ml GH E Biochemistry, Cobas -Prolactin Calset Calibrator 2 ml RR E Biochemistry, Cobas -Alpha Feto Protein Calset Calibrator 2 ml GH E Biochemistry, Cobas -Estradiol Calset Calibrator 2 ml RR E Biochemistry, Cobas -Progesterone Calset Calibrator 2 ml GH E Biochemistry, Cobas -Human Chorionic Gonadotropic Calset Calibrator 2 ml RR E Biochemistry, Cobas -Testosterone Calset Calibrator 2 ml GH E Biochemistry, Cobas -Carcino Embryonic Antigen Calset Calibrator 2 ml RR E Biochemistry, Cobas -Carcinoma Antigen 125 Calset Calibrator 2 ml RR E Biochemistry, Cobas -Troponin Calset Calibrator 2 ml NR E Biochemistry, Cobas -Total Prostatic Specific Antigen Calset Calibrator 2 ml RR E Biochemistry, Cobas -Parathyroid Hormone Calset Calibrator 2 ml RR E Biochemistry, Cobas -Adreno-Cortico Hormone Calset Calibrator 2 ml RR E Biochemistry, Cobas -Cortisol Calset Calibrator 2 ml GH E Biochemistry, Cobas -C reactive protein Calibrator 2 ml GH E Biochemistry, Cobas -CFAS CKMB Calibrator 2 ml GH E Biochemistry, Cobas -Preci Control Tumour makers 2 ml GH E Biochemistry, Cobas -Preci Control Cardiac Each GH E Biochemistry, Cobas -Preci control Infectious disease Each GH E Biochemistry, Cobas c/Integra activator 108 ml HC4 V Biochemistry, Cobas c/Integra, Lamp halogen 12V/50W for Cobas c311 Kit HC4 V Biochemistry, Cobas c/Integra, sample cups, 2 ml Piece HC4 V Biochemistry, Cobas c cell wash solution I / NaOH-D UN1824 Kit HC4 V Biochemistry, Cobas c cell wash solution II / Acid Wash Kit HC4 V Biochemistry, Cobas c111,Cleaner UN1824 30 ml HC4 V Biochemistry, Cobas c111, Diluent NaCl 9% 6*23 ml 39.2 ml HC4 V Biochemistry, Cobas c111, Lamp halogen 12V/20W for Cobas c111 Piece HC4 V Biochemistry, Cobas c111, Micro cuvette segment 1680PC Piece HC4 V Biochemistry, Cobas c111, Probe, set of 2 pieces Piece HC4 V Biochemistry, Cobas c111, Reagent disc, 27 slots Piece HC4 V Biochemistry, Cobas c111, Thermal printer paper Piece HC4 V Biochemistry, Cobas c311reaction cell set 48 ml HC4 V Biochemistry, Cobas c311/501 detergent NaOH-D UN1824 230 ml HC4 V Biochemistry, Cobas c311/501 sample cleaner 1 UN1824 100 ml HC4 V Biochemistry, Cobas c311/501 wash reagent SMS UN1789 Kit HC4 V Biochemistry, Cobas c/Integra, cleaner UN1789 Kit HC4 V Biochemistry, Cobas c311/501/502 diluent NaCl 9% Kit HC4 V Biochemistry, Cobas/Elecsys cleaning solution (SysClean) UN1824 Kit HC4 V

Biochemistry, Cobas c/integra/e411 system solution (ProCell) 50 ml GH V Biochemistry, Cobas c/integra/e411 SysWash 3 L GH V Biochemistry, Cobas c/Integra, c311 Ecotergent Test GH V Blood Gas Analyser Biochemistry, Paper, Thermal, Printer Roll Opticca -Ts2 Rolls RR E Biochemistry, Capillary Tubes, Glass Heparinised 200 µl 250 Per Box Piece RR E Biochemistry, Control S, Cvc 123, Linearity,4 Amp/5levels, Opticca, Opticca- 2 ml RR E Ts, Opti R, Opti Lion, Optic Ca-Ts2 Controls, Opti-Check, Ph/Bg/Elec/Glu, Tri-Level, 10 amp/Level, Opticca, 2 ml RR E Opticca-Ts, Opti Cca-Ts2 Biochemistry, Controls, Opti-Check Plus, Ph/Bg/Elec/Glu, Tri-Level, 10 2 ml RR E amp/Level, Opticca, Opticca-Ts, Opti Cca-Ts2 Biochemistry, Cassette, Calibration, Opti Cca-Ts2 2 ml RR E Biochemistry, Cassette, Standard Reference (Src) –Multi-Level, Opticca-Ts2 Piece RR E Biochemistry, Cassette, E-Cl, 25 Per Box, Opti R Bp 7162 Bottle, Gas, Low Test RR E Pressure, Opti Cca-T Biochemistry, Comfort Sampler, Bulk Pack With Needle & Protector, 240 µl, Piece RR E 300 Per Box Biochemistry, Pump Piece RR E Electrophoresis Machine Pretty Biochemistry, Serum Protein Electrophoresis Kit 6 Samples Per Gel 60 Test Test NR V Biochemistry, Agarose Gel Plate 10 Per Kit Kit NR V Biochemistry, Buffered Sponges 2 Pieces Per Pack Piece NR V Biochemistry, Acid Blue bottle 500 ml NR V Biochemistry, Disposable Sample Plates 10 Pieces Per Pack Piece NR V Biochemistry, Blotters A 10 X 10 Size 10 Pieces Per Pack Piece NR V Biochemistry, Destain Solution 6 x 100 ml Per Pack 600 ml NR V Biochemistry, Normal Serum Control 6 vials Per Pack Vial NR V Biochemistry, Abnormal Serum Control 3 Vials Per Pack Vial NR V Biochemistry, Stain Bottle Per Pack Filters 30 Pieces Piece NR V Biochemistry, Alkaline Hb-Electrophoresis Kit 6 Test Per Gel Test NR V Biochemistry, haemoglobin Control Afsa 2 0.5 ml Per Vial 20.5 ml NR V Biochemistry, haemoglobin Control Solution Afsc 0.5 ml Per Vial 0.5 ml NR V Humastar 80/100/200 /600 & Humalyte Plus Biochemistry, Human, GOT (ASAT) IFCC modified LiquiUV Kit, 10 x 10 ml 100 ml HC4 V Biochemistry, Human, GPT (ALAT) IFCC modified LiquiUV Kit, 10 x 10 ml 100 ml HC4 V Biochemistry, Human, Alkaline Phosphatase Liquicolor Kit, 10 x 10 ml 100 ml HC4 V Biochemistry, Human, Gamma-GT Liquicolor, 8 x 50 ml 400 ml GH V Biochemistry, Human, Total Protein Liquicolor, 4 x 100 ml 400 ml HC4 V Biochemistry, Human, Albumin Liquicolor, 4 x 100 ml 400 ml GH V Biochemistry, Human, Alpha-Amylase Liquicolor Kit, 6 x 50 ml 300 ml HC4 V Biochemistry, Human, Bilirubin Direct, 375 ml 375 ml HC4 V Biochemistry, Human, Bilirubin Direct/Total Liquicolor Complete Kit, 2 x 200 ml HC4 V 100 ml Biochemistry, Human, Glucose Liquicolor Enzymatic Colorimetric Test, 400 ml HC4 V Complete Kit, 4 x 100 ml Biochemistry, Human, Urea Liquicolor Enzymatic Colorimetric Test, 200 ml HC4 V Complete Kit, 200 ml Biochemistry, Human, Creatinine Liquicolor Colorimetric Test, Complete Kit, 200 ml HC4 V

200 ml Biochemistry, Human, Uric Acid Liquicolor, 4 x 100 ml 400 ml HC4 N Biochemistry, Human, Auto-Creatinine Liquicolor Kit, 2 x 100 ml + 50 ml 300 ml HC4 V Biochemistry, Human, LDH SCE mod. liquiUV Modified SCE method, 100 ml GH V Complete Kit, 10 x 10 ml Biochemistry, Human, LDL Cholesterol Liquicolor Colorimetric Test, 200 ml GH V Complete Kit, 200 ml Biochemistry, Human, Cholesterol Liquicolor, Complete Kit, 4 x 100 ml 400 ml GH V Biochemistry, Human, Triglycerides Liquicolor Mono, Complete Kit,4 x 100 400 ml GH V ml Biochemistry, Human, CK NAC activated liquiUV, 10 x 10 ml 100 ml GH E Biochemistry, Human, Creatinine Kinase-MB, Complete Kit, 20 x 3 ml 60 ml GH E Biochemistry, Human, Iron Liquicolor, 2 x 30 ml 60 ml GH E Biochemistry, Human, Lactate Test GH E Biochemistry, Human, Lipase Test GH E Biochemistry, Human, Ferritin Reagent Test GH E Biochemistry, Human HbA1C 100 test Test GH E Biochemistry, Human, K Electrode Each HC4 V Biochemistry, Human, Na Electrode Each HC4 V Biochemistry, Human, Cl Electrode Each HC4 V Biochemistry, Human, Ref. Electrode Each HC4 V Biochemistry, Human, ISE Standard Pack 710 ml HC4 V Biochemistry, Human, Humalyte Na/pH Condition Solution 100 ml 100 ml HC4 V Biochemistry, Human, Humalyte Urine Diluent 250 ml HC4 V Biochemistry, Human, Humalyte, Ca Filling Solution 100 ml HC4 V Biochemistry, Human, Humalyte, Daily Cleaning Solution 100 ml HC4 V Biochemistry, Human, Humalyte,K Filling Solution 100 ml HC4 V Biochemistry, Human, Humalyte, Na Conditioner 100 ml HC4 V Biochemistry, Human, Humalyte, Na/Cl Filling Solution 100 ml HC4 V Biochemistry, Human, Humalyte, QC Solution 100 ml HC4 V Biochemistry, Human, Humalyte, Ref. Filling Solution 100 ml HC4 V Biochemistry, Human, ISE Cleaner6 x 20 ml 120 ml HC4 V Biochemistry, Human, ISE Urine Diluent 4 x 20 ml 80 ml HC4 V Biochemistry, Human, Calcium Liquicolor, 3*430 Test RR E Biochemistry, Human, Magnesium Liquicolor, 4*60 Test RR E Biochemistry, Human, Phosphorus Liquirapid, 4*60 Test HC4 N Biochemistry, Human, Control Sera, Autocal Kit, 4 x 5 ml 20 ml HC4 V Biochemistry, Human, Control Sera, HumaTrol N Kit, 6 x 5 ml 30 ml HC4 V Biochemistry, Human, Control Sera, HumaTrol P Kit, 6 x 5 ml 30 ml HC4 V Biochemistry, Human, Humastar 600 Serodos 12 ml HC4 V Biochemistry, Human, Humastar 600 Serodos plus 12 ml HC4 V Biochemistry, Human, Humalyte Cleaning Solution 50 ml 50 ml HC4 V Biochemistry, MultiCal 1, Serum Protein Multi-Calibrator, 5 x 2 ml 10 ml HC4 V Biochemistry, Multical, HDL and LDL, Lyophilized, 5 x 5 ml 25 ml HC4 V Biochemistry, Multitrol Normal, Lyophilized, 10 x 5 ml 50 ml HC4 V Biochemistry, Multitrol Pathological, Lyophilized, 10 x 5 ml 50 ml HC4 V Biochemistry, Humalyser, Exatrol Normal, 10 x 5 ml 50 ml HC4 V Biochemistry, Human, ISE Tri-Level QC kit 3 x 10 ml 30 ml HC4 V Biochemistry, Human, CK-MB Control 4 x 2 ml 12 ml GH E

Biochemistry, Human, CK-MB Calibrator 2 x 1 ml 2 ml GH E Biochemistry, Humalyzer 2000 Cuvettes, 1000 Pc Piece HC4 V Biochemistry, Humalyzer 2000/3000 Lamp Each HC4 V Biochemistry, Humalyzer, Flow Cell Cleaner 100 ml HC4 V Biochemistry, Human, Humalyte, Sample Cups, 2ml, 500 pc Piece HC4 V Biochemistry, Human, Humalyte, Thermal Paper, White, 57 x 50 x 11 mm, 5 Roll GH V Rolls Biochemistry, Human, Humalyte, Weekly Cleaning Solution, 100 ml 100 ml GH V Biochemistry, Human, Humalyte, Reagent Pack, 1000 ml 1 L GH V Biochemistry, Human, Humalyte Solution Reagent Pack Complete Each GH V Biochemistry, Human, Humastar 600 Diluent 20 L GH V Biochemistry, Human, Humastar 600 Reactive cuvettes Piece GH V Biochemistry, Human, Humastar 600 Tip cleaning kit H 600 Piece GH V Biochemistry, Human, Humalyte Plus 3 Thermal printer paper Rolls GH V Biochemistry, Human, Humastar 600 Wash additive 1 L GH V Mindray BS480 Biochemistry, Mindray BS-480, Aspartate Aminotransferase Kit Test NR V Biochemistry, Mindray BS-480, Albumin Kit Test NR V Biochemistry, Mindray BS-480, Alkaline Phosphatase Kit Test NR V Biochemistry, Mindray BS-480, Alanine Aminotransferase Kit Test NR V Biochemistry, Mindray BS-480, Bilirubin Direct Kit Test NR V Biochemistry, Mindray BS-480, Bilirubin Total Kit Test NR V Biochemistry, Mindray BS-480, α-Amylase Kit Test NR V Biochemistry, Mindray BS-480, Gamma–Glutamyltransferase Kit Test NR V Biochemistry, Mindray BS-480, Glucose Kit Test NR V Biochemistry, Mindray BS-480, Prealbumin Kit Test NR V Biochemistry, Mindray BS-480, Total Bile Acids Kit Test NR V Biochemistry, Mindray BS-480, Total Protein Kit Test NR V Biochemistry, Mindray BS-480, Microalbumin*C) Test NR V Biochemistry, Mindray BS-480, Creatinine Kit Test NR V Biochemistry, Mindray BS-480, Uric Acid Kit Test NR V Biochemistry, Mindray BS-480, Urea Kit Test NR V Biochemistry, Mindray BS-480, Cystatine – C Test NR V Biochemistry, Mindray BS-480, Total Cholesterol Kit Test NR V Biochemistry, Mindray BS-480, Triglycerides Kit Test NR V Biochemistry, Mindray BS-480, HDL-Cholesterol Kit Test NR V Biochemistry, Mindray BS-480, LDL-Cholesterol Kit Test NR V Biochemistry, Mindray BS-480, Lipoprotein (A) Kit Test NR V Biochemistry, Mindray BS-480, Complement C3 Kit Test NR V Biochemistry, Mindray BS-480, Complement C4 Kit Test NR V Biochemistry, Mindray BS-480, Apolipoprotein A1 Kit Test NR V Biochemistry, Mindray BS-480, Apolipoprotein B Kit Test NR V Biochemistry, Mindray BS-480, Creatine Kinase Kit Test NR V Biochemistry, Mindray BS-480, Creatine Kinase-MB Kit Test NR V Biochemistry, Mindray BS-480, Lactate Dehydrogenase Kit Test NR V Biochemistry, Mindray BS-480, C-Reactive Protein Kit Test NR V Biochemistry, Mindray BS-480, Myoglobine (C ) Test NR V Biochemistry, Mindray BS-480, High Sensitivity CRP (C And Q) Test NR V Biochemistry, Mindray BS-480, Antistreptolysin O (C And Q) Test NR V

Biochemistry, Human, CK-MB Calibrator 2 x 1 ml 2 ml GH E Biochemistry, Mindray BS-480, Immunoglobulin E (C ) Test NR V Biochemistry, Humalyzer 2000 Cuvettes, 1000 Pc Piece HC4 V Biochemistry, Mindray BS-480, Immunoglobulin A Kit Test NR V Biochemistry, Humalyzer 2000/3000 Lamp Each HC4 V Biochemistry, Mindray BS-480, Immunoglobulin G Kit Test NR V Biochemistry, Humalyzer, Flow Cell Cleaner 100 ml HC4 V Biochemistry, Mindray BS-480, Immunoglobulin M Kit Test NR V Biochemistry, Human, Humalyte, Sample Cups, 2ml, 500 pc Piece HC4 V Biochemistry, Mindray BS-480, β2-Microglobuline Test NR V Biochemistry, Human, Humalyte, Thermal Paper, White, 57 x 50 x 11 mm, 5 Roll GH V Biochemistry, Mindray BS-480, Haemoglobin A1c (C And Q) Test NR V Rolls Biochemistry, Mindray BS-480, Homocysteine (C And Q) Test NR V Biochemistry, Human, Humalyte, Weekly Cleaning Solution, 100 ml 100 ml GH V Biochemistry, Mindray BS-480, Lipase (C And Q) Test NR V Biochemistry, Human, Humalyte, Reagent Pack, 1000 ml 1 L GH V Biochemistry, Mindray BS-480, Iron (C And Q) Test NR V Biochemistry, Human, Humalyte Solution Reagent Pack Complete Each GH V Biochemistry, Mindray BS-480, Transferrin (C ) Test NR V Biochemistry, Human, Humastar 600 Diluent 20 L GH V Biochemistry, Mindray BS-480, Ferritin (C ) Test NR V Biochemistry, Human, Humastar 600 Reactive cuvettes Piece GH V Biochemistry, Mindray BS-480, α--Hydroxybutyrate Dehydrogenase Kit Test NR V Biochemistry, Human, Humastar 600 Tip cleaning kit H 600 Piece GH V Biochemistry, Mindray BS-480, Calcium Kit Test NR V Biochemistry, Human, Humalyte Plus 3 Thermal printer paper Rolls GH V Biochemistry, Mindray BS-480, Magnesium Kit Test NR V Biochemistry, Human, Humastar 600 Wash additive 1 L GH V Biochemistry, Mindray BS-480, Phosphorus Kit Test NR V Mindray BS480 Biochemistry, Mindray BS-480, Bicarbonates (C And Q) Test NR V Biochemistry, Mindray BS-480, Aspartate Aminotransferase Kit Test NR V Biochemistry, Mindray BS-480, 5’-Nucleotidase Test NR V Biochemistry, Mindray BS-480, Albumin Kit Test NR V Biochemistry, Mindray BS-480, Adenosine Deaminase Test NR V Biochemistry, Mindray BS-480, Alkaline Phosphatase Kit Test NR V Biochemistry, Mindray BS-480, Angiotensin Converting Enzyme (C ) Test NR V Biochemistry, Mindray BS-480, Alanine Aminotransferase Kit Test NR V Biochemistry, Mindray BS-480,Beta Hydroxybutyrate (C ) Test NR V Biochemistry, Mindray BS-480, Bilirubin Direct Kit Test NR V Biochemistry, Mindray BS-480, Cholinesterase (C And Q) Test NR V Biochemistry, Mindray BS-480, Bilirubin Total Kit Test NR V Biochemistry, Mindray BS-480,D-Dimer (C ) Test NR V Biochemistry, Mindray BS-480, α-Amylase Kit Test NR V Biochemistry, Mindray BS-480, Fructosamine (C And Q) Test NR V Biochemistry, Mindray BS-480, Gamma–Glutamyltransferase Kit Test NR V Biochemistry, Mindray BS-480, Retinol Binding Protein (C ) Test NR V Biochemistry, Mindray BS-480, Glucose Kit Test NR V Biochemistry, Mindray BS-480, Rheumatoid Factor (C And Q) Test NR V Biochemistry, Mindray BS-480, Prealbumin Kit Test NR V Biochemistry, Mindray BS-480, Unsaturated Iron Binding Capacity (C ) Test NR V Biochemistry, Mindray BS-480, Total Bile Acids Kit Test NR V Biochemistry, Mindray BS-480, α-L-Fucosidase Test NR V Biochemistry, Mindray BS-480, Total Protein Kit Test NR V Biochemistry, Mindray BS-480, Multi Control Sera P 50 ml NR V Biochemistry, Mindray BS-480, Microalbumin*C) Test NR V Biochemistry, Mindray BS-480, Multi Control Sera N 50 ml NR V Biochemistry, Mindray BS-480, Creatinine Kit Test NR V Biochemistry, Mindray BS-480, Specific Proteins Control N 5 ml NR V Biochemistry, Mindray BS-480, Uric Acid Kit Test NR V Biochemistry, Mindray BS-480, Prealbumin Control N&P 6 ml NR V Biochemistry, Mindray BS-480, Urea Kit Test NR V Biochemistry, Mindray BS-480, Lipids Control N 18 ml NR V Biochemistry, Mindray BS-480, Cystatine – C Test NR V Biochemistry, Mindray BS-480, Ck-MB Control N 12 ml NR V Biochemistry, Mindray BS-480, Total Cholesterol Kit Test NR V Biochemistry, Mindray BS-480, HCY Control N 3 ml NR V Biochemistry, Mindray BS-480, Triglycerides Kit Test NR V Biochemistry, Mindray BS-480, Lipoprotein(A) Control 3 ml NR V Biochemistry, Mindray BS-480, HDL-Cholesterol Kit Test NR V Biochemistry, Mindray BS-480, Co2 Control N 15 ml NR V Biochemistry, Mindray BS-480, LDL-Cholesterol Kit Test NR V Biochemistry, Mindray BS-480, D-Dimer Control 3 ml NR V Biochemistry, Mindray BS-480, Lipoprotein (A) Kit Test NR V Biochemistry, Mindray BS-480, Multimmun Control 6 ml NR V Biochemistry, Mindray BS-480, Complement C3 Kit Test NR V Biochemistry, Mindray BS-480, RBP Control 6 ml NR V Biochemistry, Mindray BS-480, Complement C4 Kit Test NR V Biochemistry, Mindray BS-480, UIBC Control 1 ml NR V Biochemistry, Mindray BS-480, Apolipoprotein A1 Kit Test NR V Biochemistry, Mindray BS-480, G6PD Control 5 ml NR V Biochemistry, Mindray BS-480, Apolipoprotein B Kit Test NR V Biochemistry, Mindray BS-480,ACE Control 2 ml NR V Biochemistry, Mindray BS-480, Creatine Kinase Kit Test NR V Biochemistry, Mindray BS-480, MALB Control 2 ml NR V Biochemistry, Mindray BS-480, Creatine Kinase-MB Kit Test NR V Biochemistry, Mindray BS-480, TRF Control 2 ml NR V Biochemistry, Mindray BS-480, Lactate Dehydrogenase Kit Test NR V Biochemistry, Mindray BS-480,β2-HB Control 2 ml NR V Biochemistry, Mindray BS-480, C-Reactive Protein Kit Test NR V Biochemistry, Mindray BS-480, CYSC Control (L&H) 10 ml NR V Biochemistry, Mindray BS-480, Myoglobine (C ) Test NR V Biochemistry, Mindray BS-480,β2-Mg Control (L) 2 ml NR V Biochemistry, Mindray BS-480, High Sensitivity CRP (C And Q) Test NR V Biochemistry, Mindray BS-480, 5’-Nt Control (L) 1 ml NR V Biochemistry, Mindray BS-480, Antistreptolysin O (C And Q) Test NR V Biochemistry, Mindray BS-480, TBA Control (L) 1 ml NR V

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Biochemistry, Mindray BS-480, ADA Control (L) 5 ml NR V Biochemistry, Mindray BS-480,AFU Control(L&H) 1 ml NR V Idvia Centaur CP Biochemistry, Idvia Centaur CP, FT4 Test NR V Biochemistry, Idvia Centaur CP,TSH Test NR V Biochemistry, Idvia Centaur CP,FT3 Test NR V Biochemistry, Idvia Centaur CP, Total PSA Test NR V Biochemistry, Idvia Centaur CP, Tripoint Liquiimune Control Lev 1 30 ml NR V Biochemistry, Idvia Centaur CP, Tripoint Liquiimune Control Lev 2 30 ml NR V Biochemistry, Idvia Centaur CP, Tripoint Liquiimune Control Lev 2 30 ml NR V Biochemistry, Idvia Centaur CP, R1 & R2 Test NR V Biochemistry, Idvia Centaur CP, Cleaning Solution Bottle NR V Biochemistry, Idvia Centaur CP, Sample Cuvettes Piece NR V Biochemistry, Idvia Centaur CP, Sample cups Piece NR V Biochemistry, Idvia Centaur CP, Wash-1 (2 x 1500 ml) Test NR V Biochemistry, Idvia Centaur CP, Disposable Tips Piece NR V Biochemistry, Idvia Centaur CP, Calibrator A (FT3,FT4,TT3,TT4,) L&H 20 ml NR V Biochemistry, Idvia Centaur CP, Calibrator B Piece NR V Biochemistry, Idvia Centaur CP, Calibrator Q Piece NR V I-chroma Biochemistry, i-chroma D Test NR V Biochemistry, i-Chroma TSH-25T Test NR V Biochemistry, i-Chroma T3-25T Test NR V Biochemistry, i-Chroma T4-25T Test NR V Biochemistry, i-Chroma Troponin I-25T Test NR V Biochemistry, i-Chroma hsCRP-25T Test NR V Biochemistry, i-Chroma CRP-25T Test NR V Biochemistry, i-Chroma D-Dimer-25T Test NR V Biochemistry, i-Chroma RF IgM-25T Test NR V Biochemistry, i-Chroma ASOT-25T Test NR V Biochemistry, i-Chroma Pro BNP-25 T Test NR V Biochemistry, i-Chroma BNP-25T Test NR V Biochemistry, i-Chroma ASO-25T Test NR V Biochemistry, i-Chroma PSA-25T Test NR V Biochemistry, i-Chroma HbA1C-0.5 ml Test NR V Biochemistry, i-Chroma HbA1C 25T Test NR V Biochemistry, i-Chroma Universal control-1.0 ml 1 ml NR V Biochemistry, i-Chroma D-Dimer Control-0.5 ml 0.5 ml NR V Biochemistry, i-Chroma CRP Controls-0.5 ml 0.5 ml NR V Biochemistry, i-Chroma BNP Controls -0.5 ml 0.5 ml NR V Biochemistry, i-Chroma RF Controls -0.5 ml 0.5 ml NR V Biochemistry, i-Chroma hsCRP Controls-0.5 ml 0.5 ml NR V Biochemistry, i-Chroma ASO-Controls-0.5 ml 0.5 ml NR V Biochemistry, i-Chroma Troponin I-controls-0.5 ml 0.5 ml NR V Biochemistry, i-Chroma Pro BNP Controls -0.5 ml 0.5 ml NR V Biochemistry, i-Chroma D-Dimer-0.5 ml 0.5 ml NR V Selectra analyzers Biochemistry, Selectra, ALT/GPT 4+1 SL 2 x 62.5 ml 125 ml HC4 V Biochemistry, Selectra, AST /GOT4+1 SL 2 x 6.2 ml 125 ml HC4 V

Biochemistry, Selectra, Albumin 2 x 125 ml 250 ml HC4 V Biochemistry, Selectra, ALP(DEA) S l2 x 62.5 ml 125 ml HC4 V Biochemistry, Selectra, Amylase S l6 x 50 ml 300 ml GH V Biochemistry, Selectra, Bilirubin T&D 4+1 x 125 ml 500 ml HC4 V Biochemistry, Selectra, Gamma-Gt Plus S l2 x 62.5 ml 125 ml GH V Biochemistry, Selectra, Glucose Pap SL 6 x 100 ml 600 ml HC4 V Biochemistry, Selectra, Total Protein Plus 2 x 125 ml 250 ml HC4 V Biochemistry, Selectra, Creatinine Jaffe 2 x 125 ml 250 ml HC4 V Biochemistry, Selectra, Urea UV SL 4 x 62.5 ml 250 ml HC4 V Biochemistry, Selectra, Uric Acid Mono SL 6 x 50 ml 300 ml GH V Biochemistry, Selectra, Trigl Mono SL New 6 x 50 ml 300 ml GH V Biochemistry, Selectra, Cholesterol HDL sl2g 1 x 80 ml 80 ml GH V Biochemistry, Selectra, Cholesterol SL 6 x 100 ml 600 ml GH V Biochemistry, Selectra, LDH-L SL 2 x 62.5 ml 125 ml GH V Biochemistry, Selectra, CK NAC S l2 x 62.5 ml 125 ml GH E Biochemistry, Selectra, CRP Reagent 100 ml GH E Biochemistry, Selectra,HbA1c 1 x 32 ml 32 ml GH E Biochemistry, Selectra, haemoglobin 1 x 50 ml 50 ml GH E Biochemistry, Selectra, Iron Ferrozine 2 x 125 ml 250 ml GH E Biochemistry, Selectra, Magnesium Calmagite 2 x 125 ml 250 ml GH E Biochemistry, Selectra, Phosphorus 2 x 125 ml 250 ml GH E Biochemistry, Selectra, Calcium Arsenazo 2 x 125 ml 250 ml GH E Biochemistry, Selectra, Iron Tibc 50 Test Test GH E Biochemistry, Selectra, Lactate 10 X 10 ml 100 ml GH E Biochemistry, Selectra, Lipase SL 4 X 9.2 ml Vtl 36.8 ml GH E Biochemistry, Selectra, Micro Albumin IP 5 ml + 2 x 25 ml 55 ml NR E Biochemistry, Selectra, Orosomucoid IP 5 ml + 2 x 25 ml 55 ml NR E Biochemistry, Selectra, Prealbumin IP 5 ml + 2 x 25 ml 55 ml GH E Biochemistry, Selectra, Protein IP Cal Set 5 lev x 1 ml 5 ml HC4 V Biochemistry, Selectra, Microprotein Plus 12 x 20 ml Vtl 240 ml RR E Biochemistry, Selectra, Transferrin IP 5 ml + 5 x 25 ml 130 ml RR E Biochemistry, Selectra, IGA IP 5 ml + 2 x 25 ml 55 ml NR E Biochemistry, Selectra, IGG IP 5 ml + 2 x 25 ml 55 ml NR E Biochemistry, Selectra, IGM IP 5 ml + 2 x 25 ml 55 ml GH E Biochemistry, Selectra, ELICAL 2-4 x 3 ml 24 ml GH E Biochemistry, Selectra, Haptoglobin IP 5 ml + 2 x 25 ml 55 ml GH E Biochemistry, Selectra, Acid Solution 1 ml HC4 V Biochemistry, Selectra, Cleaner 6 x 8 ml 48 ml HC4 V Biochemistry, Selectra, Conditioner 3 x 253 x 25 759 ml HC4 V Biochemistry, Selectra, ISE Diluent 12 x 25 ml 300 ml HC4 V Biochemistry, Selectra, ISE Reference Solution 1 x 500 ml 500 ml HC4 V Biochemistry, Selectra, EE System Cleaning Solution 1 ml HC4 V Biochemistry, Selectra, System Solution 1 ml HC4 V Biochemistry, Selectra, ISE Control I 10 x 5 ml 50 ml HC4 V Biochemistry, Selectra, ISE ControlIi 10 x 5 ml 50 ml HC4 V Biochemistry, Selectra, Elitrol I 10 x 5 ml 50 ml HC4 V Biochemistry, Selectra, Elitrol II 10 x 5 ml 50 ml HC4 V Biochemistry, Selectra, CK-Mb Control 4 x 3 ml 13 ml GH E Biochemistry, Selectra, Cholest. LDL2g Calibr. 4 x 1 ml 5 ml GH E

Biochemistry, Selectra, CRP IP Calibrator Set 5lev x 1 ml 5 ml GH E Biochemistry, Selectra, HbA1c Calibrator Set 4 x 0.5 ml 2 ml GH E Biochemistry, Selectra, HbA1c Controls L+H 4 x 0.5 ml 2 ml GH E Biochemistry, Selectra, ISE Calibrator (6 x 20 ml + 6 x 20 ml) 240 ml HC4 V Biochemistry, Selectra, ECS Empty Vial + Caps 10 x 10 ml 100 ml GH E Biochemistry, Selectra, ECS Empty Vials+Caps 30 x 25 ml 750ml GH E Biochemistry, Selectra, Cholest.HDL2g Calibr. 4 x 1 ml 4 ml GH E PARASITOLOGY Peripheral blood smear- Reconstituted laboratory reagents Fields A Stain solution 1 L HC3 V Fields B Stain solution 1 L HC3 V Giemsa Stain 1 L HC3 V Leishman's Stain 1 L HC3 E 2% Crystal Violet 1 L HC3 V Gram's Iodine Solution 1 L HC3 V 50% Acetone Alcohol 1 L HC3 V 0.1% Neutral Red 1 L HC3 V Lens Cleaning, Paper Tissues, 10 x 15cm (4 x 6 in), 50 Sheets Piece HC3 V Immersion Oil, Type FF, 4oz x 1 Bottle 100 ml HC3 V Slide Box, Standard, Plastic, Hinged Lid, 100 Slides, White, Each Piece HC3 V Slide Rack, Slide Staining, Polyactetal, for 25 Slides, Each Piece HC3 V Microscope Slide Cover Glass, Rectangular, For Counting Chamber, 8 x 1 in, Piece HC3 V 1 Pack x 12 PC Microscope Slide Cover Glass, Square, No. 2, 18 mm, and 25 mm, Oz Pack Piece HC3 E Microscope Slide Cover Slip, Plastic, Square, 22 mm, 1000 PC Piece HC3 V Microscope Slide, 25 x 75 mm, Plain Glass, 100 PC Piece HC3 E Microscope Slide, 25 x 76 mm, Frosted, 100 PC Piece HC3 V Couplin Jars Each NR V BIOMERIEUX, VITEK (Vitek Identification System) Biomerieux, Vitek 2 GN Kit Piece RR V Biomerieux, Vitek 2 GP Kit Piece RR V Biomerieux, Vitek 2, AST ST01 Piece RR V Biomerieux, Vitek 2, AST P580 Piece RR V Biomerieux, Vitek 2, AST GN 84 Piece RR V Biomerieux, Vitek 2, AST GN 86 Piece RR V Biomerieux, Vitek 2, AST GP 67 Piece RR V Biomerieux, Vitek 2, YST cards Piece RR V Biomerieux, Vitek 2, AST YST O7 Piece RR V Biomerieux, Vitek 2, NH cards Piece RR V Biomerieux, Vitek 2, AST P 576 Piece RR V Biomerieux, Vitek 2, ANC cards Piece RR V Biomerieux, Vitek 2, BCL cards Piece RR V Biomerieux, Vitek 2, Sterile swabs Piece RR V Biomerieux, Vitek 2, McFarland standards for Vitek2 Piece RR V Biomerieux, Vitek 2 Polystyrene tube Piece RR V BACTEC FX BD BACTECTM PLUS - Aerobic/F medium Vial RR V BD BACTECTM PLUS - Anaerobic Lytic Vial RR V BD BACTECTM PLUS - Myco Lytic Vial RR V

BD BACTECTM PLUS - Mycosis/IC Vial RR V BD BACTECTM PLUS - Ped plus Vial RR V BD BACTECTM PLUS - Standard Aerobic Vial RR V BD BACTECTM PLUS - Standard Anaerobic Vial RR V Culture and sensitivity Media, dehydrated powder Blood agar base 500 g H E Media, Columbia Blood Agar Base 500 g H E Media, MacConkey Agar 500 g H E Media, Dehydrated powder TCBS agar 500 g H E Media, dehydrated powder XLD agar 500 g H E Media, dehydrated powder DCA agar 500 g H E Media, dehydrated powder CLED Medium single indicator agar 500 g H E Media, dehydrated powder Muller Hinton Agar 500 g H E Media, dehydrated powder Nutrient Agar 500 g H E Media, dehydrated powder MacConkey sorbitol agar 500 g H E Media, dehydrated powder Selenite F broth 500 g H E Media, dehydrated powder Brain Heart infusion broth 500 g H E Media, saboraud Dextrose agar 500 g H E Media, IsoVitaleX Enrichment, 2 ml lyophilized, with 2 mL Diluent, 5 PC 500 g H E Media, Simmons Citrate Agar, Dehydrated 500 g H E Media, Triple Sugar Iron Agar (TSI) 500 g H E Media, Vitox Supplement, 2 x 5 vials, for 500 ml medium, 5 PC 500 g H E Media, dehydrated powder Hemoglobin powder agar 500 g H E Media, dehydrated powder Alkaline peptone water agar 500 g H E Media, dehydrated powder SIM agar 500 g H E Media, dehydrated powder Urea agar 500 g H E Media, dehydrated powder Heamophilus sensitivity agar 500 g H E Media, dehydrated powder Carry-blair agar 500 g H E Media, dehydrated powder Amies medium 500 g H E Media, dehydrated powder Stuart medium 500 g H E Media, cooked meet medium 500 g H E Media, GC Base agar 500 g H E Media, skimmed Milk 500 g H E Media, phenyl alanine 500 g H E Media, tryptone soya broth base 500 g H E Media, bile aesculin agar 500 g H E Media, kligler iron agar 500 g H E Media, Salmonella/Shigella Agar (SSA) 500 g H E Media, Campylobacter isolation medium 500 g H E Media, Mannitol salt 500 g H E Antimicrobial sensitivity discs kits Amikacin 30 μg Piece H E Ampicillin 25 μg Piece H E Augmentin 30 μg Piece H E Aztreonam 30 μg Piece H E Bacitracin Piece H E Cefepime Piece H E Cefixime Piece H E Ceftazidime 30 μg Piece H E

Ceftriaxone µg Piece H E Cefuroxime Sodium 30 μg Piece H E Cephalotin Piece H E Chloramphenicol 10µg Piece H E Ciprofloxacin 5 μg Piece H E Clindamycin 2 μg Piece H E Cotrimoxazole 25 μg Piece H E Erythomycin 5µg Piece H E Gentamycin 10 μg Piece H E Imipenem 10 μg Piece H E Linezolid Piece H E Meropenem 10 μg Piece H E Methicillin 10 μg Piece H E Metronidazole Piece H E Mezoloxacillin 10 μg Piece H E Minocycline Piece H E Nalidixic Acid 30µg Piece H E Nitrofurantoin 50 μg Piece H E Norfloxacin Piece H E Optochin 5 μg Piece H E Oxacillin 1.0 μg Piece H E Penicillin G 10µg Piece H E Piperacillin Piece H E Rifampicin 5 μg Piece H E Spectinomycin Piece H E Tazobactam Piece H E Teicoplanin 30 μg Piece H E Tetracycline 30 μg Piece H E Vancomycin 30 μg Piece H E Identification biochemical E-strip test Piece H E Optochin Piece H E Factor X Piece H E Factor V Piece H E Factor X+V Piece H E Iso vitalex Piece H E Slidex latex rapid Kit for cholera Piece H E Pastorex Rapid Kit for meningitis Piece H E Yersinia pestis Rapid kit Piece H E Triple Sugar Iron Agar 500 g H E Urea Agar Base 500 g H E Urea solution 40% 500 g H E Lysine Iron Agar (LIA) 500 g H E Motility Indole Ornithine (MIO) 500 g H E Bile Aesculin Agar 500 g H E Glucose Ar 500 g H E Lactose Ar 500 g H E Maltose Ar 500 g H E Sucrose Ar 500 g H E

Ceftriaxone µg Piece H E Tetramethyl-p-phenylenediamine dihydrochloride 100 g 500 g H E Cefuroxime Sodium 30 μg Piece H E 4-Dimethylaminobenzaldehyde 100 g 500 g H E Cephalotin Piece H E Amyl alcohol 500 ml 500 g H E Chloramphenicol 10µg Piece H E Simmons Citrate Agar 500 g H E Ciprofloxacin 5 μg Piece H E Gram Negative Id Plate Box/10 Plates Piece H E Clindamycin 2 μg Piece H E Gram Positive Id Panel Box/10 Plates Piece H E Cotrimoxazole 25 μg Piece H E Gram Negative Urinary Isolate BP/MIC (SIW) Piece H E Erythomycin 5µg Piece H E Gram Positive Mic Plates (SIW+) 10 Plates Piece H E Gentamycin 10 μg Piece H E Sterile Distilled Water 100 Tubes6 Boxes Piece H E Imipenem 10 μg Piece H E Cation Adjusted Mueller-Hinton Broth (5 ml) 100 tubes Piece H E Linezolid Piece H E Typing sera Meropenem 10 μg Piece H E Salmonella monovalent H gm 2 ml H E Methicillin 10 μg Piece H E Salmonella monovalent Hd 2 ml H E Metronidazole Piece H E Salmonella monovalent vi 2 ml H E Mezoloxacillin 10 μg Piece H E Salmonella monovalent 09 2 ml H E Minocycline Piece H E Salmonella polyvalent A-S 2 ml H E Nalidixic Acid 30µg Piece H E Entero-invasive Escherichia coli 0157 2 ml H E Nitrofurantoin 50 μg Piece H E Shigella dysenteriae monovalent type 1 2 ml H E Norfloxacin Piece H E Shigella dysenteriae polyvalent 1-10 2 ml H E Optochin 5 μg Piece H E Shigella sonnei Phase 1&2 2 ml H E Oxacillin 1.0 μg Piece H E Shigella boydii 2 ml H E Penicillin G 10µg Piece H E Vibrio cholerae 01 monovalent Inaba 2 ml H E Piperacillin Piece H E Vibrio cholerae 01 monovalent ogawa 2 ml H E Rifampicin 5 μg Piece H E Vibrio cholerae 01 & 0139 Rapid test 2 ml H E Spectinomycin Piece H E Vibrio cholerae 01 polyvalent ogawa, Inaba 2 ml H E Tazobactam Piece H E Neisseria meningitidis monovalent A 2 ml H E Teicoplanin 30 μg Piece H E Neisseria meningitidis polyvalent A-D 2 ml H E Tetracycline 30 μg Piece H E Neisseria meningitidis monovalent W135 2 ml H E Vancomycin 30 μg Piece H E Neisseria meningitidesmonovalent B 2 ml H E Identification biochemical Neisseria meningitidis monovalent C 2 ml H E E-strip test Piece H E Neisseria meningitidis monovalent D 2 ml H E Optochin Piece H E Neisseria meningitidis monovalent X 2 ml H E Factor X Piece H E Neisseria meningitidis monovalent Y 2 ml H E Factor V Piece H E Neisseria meningitidis monovalent Z 2 ml H E Factor X+V Piece H E Escherichia Coli polyvalent A 2 ml H E Iso vitalex Piece H E Escherichia Coli polyvalent B 2 ml H E Slidex latex rapid Kit for cholera Piece H E Escherichia Coli polyvalent C 2 ml H E Pastorex Rapid Kit for meningitis Piece H E Escherichia Coli polyvalent 0157 2 ml H E Yersinia pestis Rapid kit Piece H E Transport Swab, Sterile, with Transport Media, 500 swabs 2 ml H E Triple Sugar Iron Agar 500 g H E Incubator, Standard Lab, 2.5 cu. ft Capacity, each 2 ml H E Urea Agar Base 500 g H E Haemophillus influenzae type A 2 ml H E Urea solution 40% 500 g H E Haemophillus influenzae type B 2 ml H E Lysine Iron Agar (LIA) 500 g H E Haemophillus influenzae type C 2 ml H E Motility Indole Ornithine (MIO) 500 g H E Haemophillus influenzae type D 2 ml H E Bile Aesculin Agar 500 g H E Haemophillus influenzae type E 2 ml H E Glucose Ar 500 g H E Haemophillus influenzae type F 2 ml H E Lactose Ar 500 g H E Chemicals Maltose Ar 500 g H E Bleach, Sodium Hypochlorite Solution, NaOCl, 4-6% 1 L HC3 V Sucrose Ar 500 g H E Chemical, Phenol, Crystal 500 g H V

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Chemical, Acetic Acid, C.P., 2.5 L Pieces Piece H V Chemical, Acid Ethanol, 3%, 5 x 250 ml 1.25 L HC3 V Chemical, Alcohol, 70% 1 L HC3 V Chemical, Bleach, Teepol, 4% available chlorine 5 L HC2 V Chemical, Ethanol, Absolute 2.5 L HC3 V Chemical, Formalin 500 ml H V Chemical, Glycerol 1 L H V Chemical, Hydrochloric Acid 1 L HC3 V Chemical, Hydrogen Peroxide 3%, amber glass 500 ml H V Chemical, Methanol 5 L H V IMMUNOLOGY/ MOLECULAR Emerging Infectious diseases (EID) testing Molecular, COBAS AMPLIPREP K-tips, 12 racks x 36 Piece NR V Molecular, KIT CAP-G/CTM WASH RGT 5.1 L IVD, 5.1 L (100 Test) 5 L NR V Molecular, KIT CAP-G/CTM HIV-1 QUAL 48T RUO, 48 Test Test NR V Molecular, COBAS AMPLIPREP Flapless SPU, 12 racks x 24 Piece NR V Molecular, Cobas Ampliprep S tubes (input), 12 racks x 24 Piece NR V Molecular, KIT CAP-G/CTM SPECIMEN PRE-EXTRACT RUO, 5 x 7 5ml 350 ml NR V (350) Test) Molecular, Cobas TaqMan K Tubes, 12 x 96 Piece NR V Molecular, CAP-CTM Lab Consumable Bundle Piece NR V Molecular, DBS Sample collection Bandles (50) Test single use Test NR V Viral load testing Roche Machines Molecular, COBAS AMPLIPREP K-tips, 12 racks x 36 Piece NR V Molecular, KIT CAP-G/CTM WASH RGT 5.1 L IVD 5.1 L (100 Test) 5 L NR V Molecular, KIT CAP-G/CTM HIV-1 V2.0 EXPT-IVD 48 Test Test NR V Molecular, COBAS AMPLIPREP Flapless SPU 12 racks x 24 Piece NR V Molecular, Cobas Ampliprep S tubes (input) 12 racks x 24 Piece NR V Molecular, Cobas TaqMan K Tubes 12 x 96 Piece NR V Molecular, HIV Viral Load CAP-CTM Lab Consumable Bundle Piece NR V Roche 8800 Molecular, Cobas omni Specimen Diluent 4 L NR V Molecular, Cobas omni Lysis Reagent 4 L NR V Molecular, Cobas omni Wash Reagent 1 L NR V Molecular, Cobas omni Pipette Tips Test NR V Molecular, Cobas omni Processing Plate Piece NR V Molecular, Cobas® NHP Negative Control Kit Test NR V Molecular, Cobas omni MGP Reagent Test NR V Molecular, Cobas omni Amplification Plate Test NR V Molecular, KIT COBAS 6800/8800 HIV 96T CE-IVD Test NR V Molecular, KIT COBAS 6800/8800 H x V RMC CE-IVD Runs NR V Molecular, Solid Waste Bag Set of 200 Piece NR V Molecular, SS Tubes Piece NR V Molecular, PBS Buffer Piece NR V Abbot Machines Molecular, Abbott Real Time HIV-1 Amplification Reagent Kit, 1 pack with 4 Test NR V boxes x 24 Test Molecular, Abbott Real-time HIV-1 Control Kit ,1 pack with 8 Neg, 8 Pos, Test NR V

Chemical, Acetic Acid, C.P., 2.5 L Pieces Piece H V and 8 low-controls Chemical, Acid Ethanol, 3%, 5 x 250 ml 1.25 L HC3 V Molecular, Abbott Real-time HIV-1 Calibrator Kit Piece NR V Chemical, Alcohol, 70% 1 L HC3 V Molecular, Abbott mSample Preparation System DNA, 1 box of 4 x 24 preps Piece NR V Chemical, Bleach, Teepol, 4% available chlorine 5 L HC2 V Molecular, Bulk mLysis DNA Buffer (for DBS processing only), 210 ml 210 ml NR V Chemical, Ethanol, Absolute 2.5 L HC3 V bottle Chemical, Formalin 500 ml H V Molecular, 200 ml Reagent Vessels Piece NR V Chemical, Glycerol 1 L H V Molecular, Abbott Optical Adhesive Covers Piece NR V Chemical, Hydrochloric Acid 1 L HC3 V Molecular, Abbott 96-Deep-Well Plate Piece NR V Chemical, Hydrogen Peroxide 3%, amber glass 500 ml H V Molecular, Abbott 96-Well Optical Reaction Plate Piece NR V Chemical, Methanol 5 L H V Molecular, Saarstedt Master Mix Tube Piece NR V IMMUNOLOGY/ MOLECULAR Molecular, Saarstedt 5 ml Reaction Vessels Piece NR V Emerging Infectious diseases (EID) testing Molecular, 1000 µl Tecan Disposable Tips, Pack with 12 boxes, 96 tips per Piece NR V Molecular, COBAS AMPLIPREP K-tips, 12 racks x 36 Piece NR V box Molecular, KIT CAP-G/CTM WASH RGT 5.1 L IVD, 5.1 L (100 Test) 5 L NR V Molecular, 200 µl Tecan Disposable Tips, Pack with 12 boxes, 96 tips per box Piece NR V Molecular, KIT CAP-G/CTM HIV-1 QUAL 48T RUO, 48 Test Test NR V Molecular, Molecular, m2000 Real time PCR, Biohazard bag, 32 x 34 in, Piece NR V Molecular, COBAS AMPLIPREP Flapless SPU, 12 racks x 24 Piece NR V Orange, 27 Gallon, 50 PC Molecular, Cobas Ampliprep S tubes (input), 12 racks x 24 Piece NR V Molecular, DBS collect kit VL W-stickers, 50 Test Single use Test NR V Molecular, KIT CAP-G/CTM SPECIMEN PRE-EXTRACT RUO, 5 x 7 5ml 350 ml NR V Molecular, Laboratory Consumables Bundle for Automated Assay (Abbot) Piece NR V (350) Test) Molecular, Absolute ethanol, bottle 2 L NR V Molecular, Cobas TaqMan K Tubes, 12 x 96 Piece NR V HIV testing Molecular, CAP-CTM Lab Consumable Bundle Piece NR V SAMBA II Molecular, DBS Sample collection Bandles (50) Test single use Test NR V HIV- 1 Test Kit, 12 Tests per kit (Complete kit) Test HC3 V Viral load testing HIV- 1 Amplification Kit (Complete kit) Test HC3 V Roche Machines AlereQ Molecular, COBAS AMPLIPREP K-tips, 12 racks x 36 Piece NR V Alere™ q HIV-1/2 Detect (50 Cartridges) Test HC3 V Molecular, KIT CAP-G/CTM WASH RGT 5.1 L IVD 5.1 L (100 Test) 5 L NR V Finger Stick Sample Collection Kit (100) Piece HC3 V Molecular, KIT CAP-G/CTM HIV-1 V2.0 EXPT-IVD 48 Test Test NR V Printer Paper I Rolls HC3 V Molecular, COBAS AMPLIPREP Flapless SPU 12 racks x 24 Piece NR V GeneXpert Molecular, Cobas Ampliprep S tubes (input) 12 racks x 24 Piece NR V Xpert® HIV-1 Qual Cartridges Test HC3 V Molecular, Cobas TaqMan K Tubes 12 x 96 Piece NR V Xpert HIV-1 Viral Load, Cartridges Test HC3 V Molecular, HIV Viral Load CAP-CTM Lab Consumable Bundle Piece NR V Hepatitis B testing Roche 8800 Selexon Hepatitis B testing Molecular, Cobas omni Specimen Diluent 4 L NR V Selexon Hepatitis surface antigen (HBSAg) test kit Test HC3 N Molecular, Cobas omni Lysis Reagent 4 L NR V Selexon Hepatitis B e antigen(HBeAg) test kit Test HC3 N Molecular, Cobas omni Wash Reagent 1 L NR V Selexon AFP antigen(AFP) test kit Test HC3 N Molecular, Cobas omni Pipette Tips Test NR V TB TESTING Molecular, Cobas omni Processing Plate Piece NR V Xpert MTB/RIF kit of 50 Test Test HC4 V Molecular, Cobas® NHP Negative Control Kit Test NR V GeneXpert Warranty extension 1 year - GXIV-4 (4 modules system) Piece HC4 V Molecular, Cobas omni MGP Reagent Test NR V Xpert Check kits (Calibration Kit) Piece HC4 V Molecular, Cobas omni Amplification Plate Test NR V Sample containers (sterile screw capped containers) Piece HC3 V Molecular, KIT COBAS 6800/8800 HIV 96T CE-IVD Test NR V Alere Determine™ TB LAM Ag Test Test HC3 V Molecular, KIT COBAS 6800/8800 H x V RMC CE-IVD Runs NR V Strong carbol fuchsin 100 g HC3 V Molecular, Solid Waste Bag Set of 200 Piece NR V Methylene blue powder (g) 25 g HC3 V Molecular, SS Tubes Piece NR V 25% Suplhuric Acid ( ZN decolouriser ) in Liters 2.5 L HC3 V Molecular, PBS Buffer Piece NR V Phenol for ZN (g) 100 g HC3 V Abbot Machines Phenol for FM (g) 100 g HC4 V Molecular, Abbott Real Time HIV-1 Amplification Reagent Kit, 1 pack with 4 Test NR V Ethanol 95% (L) 2.5 L HC4 V boxes x 24 Test Hydrochloric acid, fuming (37%) (L) 2.5 L HC4 V Molecular, Abbott Real-time HIV-1 Control Kit ,1 pack with 8 Neg, 8 Pos, Test NR V Auramine O (g) 50 g HC4 V

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Potassium permanganate (g) 250 g HC4 V Mycobacteria Growth Indicator Tube PP-tubes for centrifuge, sterile, 50 ml, MGIT culture tubes (pack of 100) Boxes NTRL V BACTEC MGIT 960 Supplement Kit (100 Test, PANTA and OADC Boxes NTRL V combined) BACTEC™ MGIT™ 960 SIRE kit, One kit is sufficient for 40 test Boxes NTRL V BBL MGIT Tubes for use in Bactec MGIT 960 (7ml) - 100 tubes/pkg Boxes NTRL V Single use plastic Pasteur-pipettes sterile pack by 10 Boxes NTRL V TB Culture and Sensitivity / LPA Potassium dihydrogen phosphate (g) 500 g NTRL V Di-Sodium hydrogen phosphate (g) 500 g NTRL V Magnesium sulphate (g) 500 g NTRL V Tri-Sodium citrate 500 g NTRL V L-Asparagine (g) 2.5 g NTRL V Glycerol (ml) 2.5 L NTRL V Malachite green (g) 100 g NTRL V OADC supplement (ml) 100 ml NTRL V Sodium hydroxide, NaOH (g) 500 g NTRL V N-acetyl-L-cysteine (NALC) 5 g NTRL V PNB (g) 5 g NTRL V 7H9 Middle brook Media (g) 5 g NTRL V DST- 1st Line (Solid) Antibiotics INH 5 g NTRL V RMP 1 g NTRL V EMB 100 g NTRL V SM 5 g NTRL V DST- 2nd Line (Solid) Antibiotics OFX 10 g NTRL V KM 5 g NTRL V AK 5 g NTRL V CM 1 g NTRL V MF 1 g NTRL V Water molecular biology grade 1 L NTRL V GenoType MTBDR plus V2 - 30496AM : 30496A GenoType MTBDRplus Test NTRL V Version 2.0 and 51610 GenoLyse Tag polymerase 1.5 ml NTRL V Khan tubeS Piece NTRL V

Standard reaction tubes 2 ml Piece NTRL NTR L Tubes PCR Piece NTRL NTR L BLOOD TYPING AND BLOOD TRANSFUSION Routine blood typing antisera (antibodies) ANTI-A (human IgM monoclonal antibody) 100 ml HC3 V ANTI-B (human IgM monoclonal antibody) 100 ml HC3 V ANTI-AB (human IgM monoclonal antibody) 100 ml HC3 V ANTI-D (human IgM monoclonal anti body) 100 ml HC3 V ANTI-A1B (IgM antibody) 100 ml NR E

ANTI-A1 Lectin (IgM antibody) 50 ml NR E ANTI-H Lectin (IgM antibody) 10 ml NR E Anti-Human globulin (Polyclonal)- C3-complement and IgG antibody 10 ml NR E Anti-Human globulin (monoclonal) - C3 10 ml NR E ANTI-Human globulin (monoclonal) IgG antibody 10 ml NR E Red cell phenotyping antisera (antibodies) ANTI-D human IgG monoclonal anti body 10 ml HC3 V ANTI C 10 ml NR E ANTI E 10 ml NR E ANTI K 10 ml NR E ANTI K (cellano), IgG 10 ml NR E ANTI Fya, IgG antibodies 10 ml NR E ANTI Fyb, IgG antibodies 10 ml NR E ANTI JKa, IgG antibodies 10 ml NR E ANTI JKb, IgG antibodies 10 ml NR E ANTI Lea, IgM antibodies 10 ml NR E ANTI Leb, IgM antibodies 10 ml NR E ANTI P1, IgM antibodies 10 ml NR E ANTI M, IgG antibodies 10 ml NR E ANTI N, IgM antibodies 10 ml NR E ANTI S, IgG antibodies 10 ml NR E ANTI Lu a, Both IgM / IgA anti body 10 ml NR E ANTI Lu b, Both IgM / IgA anti body 10 ml NR E ANTI- I, IgM anti body 10 ml NR E Reverse typing antisera (serum typing) A1- standard cells 5 ml NR E B- standard cells 5 ml NR E O- standard cells 5 ml NR E A2- standard cells 5 ml NR E Antibody processing cells (for antibody detection test) Group O cells- antigen phenotyped RBCs 10 ml NR E Panel cells for anti-body identification- antigen phenotyped RBCs (i.e. kell, 50 ml NR E kid etc.) Enhancement / potentiating media Low Ionic Strength Saline (LISS) 10 ml NR E Polyethylene Glycol (Peg) 10 ml NR E Albumin Enzymes 10 ml NR E UBTS UBTS-Blood Collection Bags (Single) 450 ml Piece UBTS V UBTS-Blood Collection Bags (Quadruple; Primary) 45 Piece UBTS V Plaster Adhesive Zinc Oxide, 75 mm x 5 m Piece UBTS V Haemo Cue Cuvettes Test UBTS V UBTS-Copper Sulphate Analar Test UBTS V 1st Line Testing Parameter and Back Up UBTS-HIV Architect Screening kit (CMIA) 2000 test Test UBTS V UBTS-HBS Ag/Ab Architect Screening Kit (CMIA) 2000 test Test UBTS V UBTS-HCV Architect Screening Kit (CMIA) 2000 test Test UBTS V UBTS-Syphilis Architect Screening Kit (CMIA) 2000 test Test UBTS V UBTS-Architech Hbsag Reagent 100 test Test UBTS V

UBTS-Architect HIV Combo Reagent 100 test Test UBTS V UBTS-Architech Anti HCV Reagent 100 test Test UBTS V UBTS-Architech Syphilis Reagent 100 test Test UBTS V Controls and Calibrators UBTS-Architech Syphilis Control Test UBTS V UBTS-Architech Syphilis Calibrator Test UBTS V UBTS-Architech HIV Ag Control Test UBTS V UBTS-Architech HIV Ag/Ab Combo Cal Test UBTS V UBTS-Architech Hbsag Control Test UBTS V UBTS-Architech Hbsag Calibrator Test UBTS V UBTS-Architech HCV Control Test UBTS V UBTS-Architech HCV Calibrator Test UBTS V Accessories UBTS-Architech Trigger Solution 1 L Test UBTS V UBTS-Architech Pre Triger Solution 1 L Test UBTS V UBTS-Architech Reaction Vessels Test UBTS V UBTSError! Bookmark not defined.-Architech Conc Wash Buffer1 L Test UBTS V UBTS-Architec Septums 1 L Test UBTS V UBTS-Architec Probe Cleaning Solution 25 ml Test UBTS V UBTS-Architech Closure Green 100 Test UBTS V UBTSError! Bookmark not defined.-Architech Sample Cups 4 x 500 Test UBTS V UBTS-Microplate U Bottom Shaped, 96 Wells Test UBTS V UBTS-Microplate V Bottom Shaped, 96 Wells Test UBTS V 2nd Line Testing Parameter UBTS-HIV, Ag/Ab Combo Micro Plate Elisa 480t Test UBTS V UBTS-Hbs, Ag/Ab Combo Micro Plate V3 480t Test UBTS V UBTS-HCV Screening Test Micro Plate Elisa 480t Test UBTS V UBTS- Ice-Syphilis Micro Plate Elisa Screening Kit 480t Test UBTS V Pippete Tips Automated Elisa 1100 µl Test UBTS V Pippete Tips Automated Elisa 300 µl Test UBTS V Nat (PCR) Test For HIV, HBV, HCV & Zika Test UBTS V Regional Testing UBTS - Galileo ABD Fwd. And Reverse [ABD Full2] Test UBTS V UBTS - Galileo Antibody Screening With Pulled Cells 2 Test UBTS V UBTS - Galileo Weak D[Weak D2] Test UBTS V UBTS - Galileo Abo IgM High Titer Test UBTS V UBTS - Galileo TPHA Combo Kit 100 Test Immocor Automation Test UBTS V Malaria Screening Test For Low PCV And Platelet Counts Test UBTS V RPR Test Strips 100 Strips Test UBTS V UBTS - Galileo TPHA Combo Kit 100 Test Immocor Automation Test UBTS V Treponema Test Strips 100 Test Test UBTS V CONSUMABLES Sample Collection Consumables BD Vacutainer® Pre-attached Safety Devices - Pre-attached Eclipse™ 21G x Piece HC2 V 1.25 - Green Blood Collection Tube, K2-EDTA + PPT Polymer Gel, 5 ml, Plastic, Pearl Piece HC3 V White Top, Sterile, 100 PC Blood Collection Tube, K2-EDTA, 4 ml, Plastic, Lavender Top, 100 PC Piece HC2 V Blood Collection Tube, Paediatric, K2-EDTA, Lavender Top, 0.5 ml, 100 PC Piece HC2 V

Blood Collection Tube, Plasma, Lithium Heparin, 4 ml, Plastic, Green Top, Piece HC4 V 100 PC Blood Collection Tube, SST II Gel, Clot Activator, 4 ml, Plastic, Gold Top, Piece HC4 V 100 PC Blood Collection Tube, Vacutainer containers-Sodium citrate Piece HC4 V Capillary Tubes (Microhaematocrit), Heparin, 70 µl, 75 mm, Red, 200 PC Piece HC3 V Tourniquet, Latex Free, Disposable Pre-cut bands, 100 PC Piece HC2 V Cotton Roll, Absorbent, Non-Sterile, 500 g x 1 Roll 500 g HC2 V Lancet, Safety, High Flow, 21G x 1.8 mm, 200 PC Piece HC2 V Vial, Cryogenic, 2/5.0 ml, Self-Standing, Round Bottom, 500 PC Piece HC2 V Box, Cryogenic Storage, Plastic, 9 x 9 Place, for 1-2 ml Vials, 4 PC Piece HC4 V Blood Lancet, Spring Loaded Test HC3 V Alcohol Swabs-Isopropyl Contents 70% Piece HC2 V Infection Control and Prevention Commodities Sharps Container, Plastic, 32 L, Red, Each Each HC2 V Sharps Container, Plastic, 26 L (7G), Red, Each Each HC2 V Sharps Container, Plastic, 22 L, Yellow, Each Each HC2 V Sharps Container, Plastic, 5 L, Yellow, Wide Mouth Each HC2 V Sharps Container, Paperboard, 5 L, Each Piece HC2 V Biohazard bag 91 x 61 cm Piece HC2 V Waste Disposal bags (red) Piece HC2 V Waste Disposal bags (black) Piece HC2 V Gloves, Exam, Latex, Powdered, Non-Sterile, Med, ASTM Standard, 100 PC Piece HC2 V Gloves, Exam, Latex, Powdered, Non-Sterile, Sm, ASTM Standard, 100 PC Piece HC2 V Examination Gloves powder free, Nitrile Medium Piece NTRL V Examination Gloves powder free, Nitrile Large Piece NTRL V Disposable lab gowns medium Piece GH E Disposable lab gowns large Piece GH E Lab Coat, Basic, White, Lg, 25 PC Piece HC2 V Lab Coat, Basic, White, Med, 25 PC Piece HC2 V Lab Coat, Basic, White, Sm, 25 PC Piece HC2 V Goggles, Safety, Chemical Splash, Vented, Each Each HC3 V Cleaner, Hand sanitizer, No-Rinse Skin Sanitizer, 16oz Oz HC2 V Eyewash Station, Wall Mounted 16oz Double, Sterile, Saline Solution, Each Each HC3 V Face Masks, Surgical, With Ties, 50 PC Piece HC3 V First Aid Kit, 36 Units, Each Each HC3 V Specimen transport bag with pouch 160*165 (20*100), 1 Piece NR V Goggles Each NR V Other required consumables Absorbent paper Piece HC2 V Alcohol 95% Not Denatured 20 L Piece HC3 V Bag, autoclave Piece GH V Burning spirit (L) 2.5 L HC3 V Centrifuge Tube, 15 ml, Plastic, Conical Bottom, Plug Seal, Sterile, 500 PC Piece NR V Centrifuge Tube, 5mL, Glass, Conical Bottom, no cap, 12 PC Piece NR V Rack, Centrifuge Tube, Plastic, 8 Place, 50mL Tubes, Each Each NR V Diamond/Lead Pencils (piece) Fine Tip, Black, 10 PC Piece HC3 V De-ionized water (L) 20 L HC4 V Disinfectants (5% Lysol, 70% ethanol) 5 L HC3 V

Filter paper circular (pieces) Piece HC3 V Humidity Indicator Card, 1000 PC Piece GH V Loop, disposable 10 µl Piece HC3 V Measuring cylinders– 50 ml- 100 ml graduated Piece HC3 V Pipet Tips, Blue, 100-1000 µl, Sterile, Rack, 1000 PC Piece HC3 V Pipet Tips, Standard, Yellow, Sterile, Non-Filtered, 10-200 µl, 1000 PC Piece HC3 V Pipet, Transfer, 3.0 ml Draw, 4 ml Capacity, Non-Sterile, 500 PC Piece HC2 V Pipette tips -1000-5000 µl-white, Sterile, Non-Filtered Piece NRTL V Pipette tips PE, 0.1-2.5 µl, DNAse-free Piece NRTL V Pipette tips PE, 100- 1000 µl DNAse-free Piece NRTL V Pipette tips PE, 2.0-20 µl DNAse-free Piece NRTL V Pipette tips PE, 20-200 DNAse-free Piece NRTL V Pipetter Stand, Plastic, 6 Place, each Each HC3 V Pipetter, Electronic, Adjustable Volume, 100-500 µl, each Each HC3 V Pipetter, Electronic, Adjustable Volume, 500-1000 µl, each Each HC3 V Pipetter, Electronic, Adjustable Volume, 5-50 µl, each Each HC3 V Rack for tubes Piece HC3 V Shoe Covers Piece RR E Sterile Gauze Swab Piece RR E Sterile glass beads, diameter 3 mm Piece RR E Tape, sterilization indicator, for autoclaves Piece GH E Test Tube, Glass, 13 x 100mm, Round Bottom, Plain end, 250 PC Piece HC3 V Test Tube, Plastic, 12 x 75mm, Round Bottom, Falcon Type, Non-Sterile, No Piece HC3 V Cap, 1000 PC Thermometer, Refrigerator/Freezer (water bath, heating blocks, incubators), Each HC3 V Digital, -99 to 199 C, Universal bottle for cultures, 28 ml Piece HC3 V Weighing boat Piece GH E Xylene (L) 2.5 L HC3 V Hair Cover Piece NR E Additional items -Glass ware Spare bulb (pieces) Piece HC3 E Spare objective (pieces) Piece HC3 E Spare Mirror Piece HC3 E Spare Eyepiece Piece HC3 E Power supply boards (pieces) Piece HC3 E Funnel (pieces) Piece HC3 E Measuring Cylinder (500 ml) Plastic Piece HC3 E Erlenmeyer flasks-1000- 2000 ml Piece HC3 E Erlenmeyer flasks- 500-1000 ml Piece HC3 E Erlenmeyer flasks- 100-500 ml Piece HC3 E Erlenmeyer flasks- 50-100 ml Piece HC3 E Measuring cylinders- 500-1000 ml - 0.5 ml graduated Piece HC3 E Measuring cylinders- 100-500 ml - 2.5 ml graduated Piece HC3 E Measuring cylinders –0-100 ml - 0.5 ml graduated Piece HC3 E Thick-walled glass flask - 2500 ml Piece HC3 E Thick-walled glass flask - 2000 ml Piece HC3 E Thick-walled glass flask - 1000 ml Piece HC3 E Thick-walled glass flask - 500 ml Piece HC3 E

Filter paper circular (pieces) Piece HC3 V Laboratory beaker, low form with graduation and spout, 100 ml Piece HC3 E Humidity Indicator Card, 1000 PC Piece GH V Volumetric flasks 500-1000 ml Piece HC3 E Loop, disposable 10 µl Piece HC3 V Volumetric flasks 50-500 ml Piece HC3 E Measuring cylinders– 50 ml- 100 ml graduated Piece HC3 V Funnel, soda lime glass, plain, short stem, d = 75 mm Piece HC3 E Pipet Tips, Blue, 100-1000 µl, Sterile, Rack, 1000 PC Piece HC3 V Funnel, soda lime glass, plain, short stem, d = 125 mm Piece HC3 E Pipet Tips, Standard, Yellow, Sterile, Non-Filtered, 10-200 µl, 1000 PC Piece HC3 V Powder funnel , diameter 100 mm Piece HC3 E Pipet, Transfer, 3.0 ml Draw, 4 ml Capacity, Non-Sterile, 500 PC Piece HC2 V Histopathology reagents Pipette tips -1000-5000 µl-white, Sterile, Non-Filtered Piece NRTL V Harris Heamatoxyllin Powder 500 g NR E Pipette tips PE, 0.1-2.5 µl, DNAse-free Piece NRTL V Eosin Y Powder 500 g NR E Pipette tips PE, 100- 1000 µl DNAse-free Piece NRTL V Red Mercuric Oxide Powder 400 g NR E Pipette tips PE, 2.0-20 µl DNAse-free Piece NRTL V Sodium Iodate Salt 400 g NR E Pipette tips PE, 20-200 DNAse-free Piece NRTL V Ammonium Alum 10 kg NR E Pipetter Stand, Plastic, 6 Place, each Each HC3 V Xylene- In A Drum Of 200l 4 drums NR E Pipetter, Electronic, Adjustable Volume, 100-500 µl, each Each HC3 V Isopropyle Alcohol (Absolute – 99.9%) – In A 200 L Drum 4 drums NR E Pipetter, Electronic, Adjustable Volume, 500-1000 µl, each Each HC3 V Paraffin Wax Pellets 50 boxes NR E Pipetter, Electronic, Adjustable Volume, 5-50 µl, each Each HC3 V Histo Tissue Casettes With Covers (1000 Per Pack) 40 packs NR E Rack for tubes Piece HC3 V Diff Quick Staining Kit 4 NR E Shoe Covers Piece RR E Pap Stain Ea50 Powder 400 g NR E Sterile Gauze Swab Piece RR E Pap Stain Og6 Powder 400 g NR E Sterile glass beads, diameter 3 mm Piece RR E Analytical Sodium Chloride – 500g Pack 40 packs NR E Tape, sterilization indicator, for autoclaves Piece GH E Diamond Pencils 12 NR E Test Tube, Glass, 13 x 100mm, Round Bottom, Plain end, 250 PC Piece HC3 V Slide Trays (20 Slides) 50 NR E Test Tube, Plastic, 12 x 75mm, Round Bottom, Falcon Type, Non-Sterile, No Piece HC3 V Moutant (Dpx) Solution 2 L NR E Cap, 1000 PC Disposable Microtome Blades – Parks Of 50 40 packs NR E Thermometer, Refrigerator/Freezer (water bath, heating blocks, incubators), Each HC3 V Trisodium Citrate 4 Kg NR E Digital, -99 to 199 C, Manson Trichrome Stain 100 g NR E Universal bottle for cultures, 28 ml Piece HC3 V Reticulin Stain 100 g NR E Weighing boat Piece GH E Oil Red O Stain 100 g NR E Xylene (L) 2.5 L HC3 V Sudan Black Stain 100 g NR E Hair Cover Piece NR E Congo Red Stain 100 g NR E Additional items -Glass ware Periodic Acid Schiff Stain 100 g NR E Spare bulb (pieces) Piece HC3 E Mucicarmin Stain 100 g NR E Spare objective (pieces) Piece HC3 E Alcian Blue Stain 100 g NR E Spare Mirror Piece HC3 E Phosphotungstain Heamatoxylin 100 g NR E Spare Eyepiece Piece HC3 E Zn Stain 100 g NR E Power supply boards (pieces) Piece HC3 E Gram Stain 100 g NR E Funnel (pieces) Piece HC3 E Auramine Stain 100 g NR E Measuring Cylinder (500 ml) Plastic Piece HC3 E Formic Acid 10 L NR E Erlenmeyer flasks-1000- 2000 ml Piece HC3 E Mollifix 10 L NR E Erlenmeyer flasks- 500-1000 ml Piece HC3 E Formaldehyde (40%) 100 L NR E Erlenmeyer flasks- 100-500 ml Piece HC3 E Ream Of Papers 100 NR E Erlenmeyer flasks- 50-100 ml Piece HC3 E Ink Cartriges 20 NR E Measuring cylinders- 500-1000 ml - 0.5 ml graduated Piece HC3 E Box Of Stapples 10 NR E Measuring cylinders- 100-500 ml - 2.5 ml graduated Piece HC3 E Box Files 40 NR E Measuring cylinders –0-100 ml - 0.5 ml graduated Piece HC3 E Folder Files 40 NR E Thick-walled glass flask - 2500 ml Piece HC3 E Box Of 50 Frosted End Slides 500 NR E Thick-walled glass flask - 2000 ml Piece HC3 E Box Of 50 Cover Slips (24 X 24 Mm) 500 NR E Thick-walled glass flask - 1000 ml Piece HC3 E Box Of 50 Cover Slips (22 X 22 Mm) 500 NR E Thick-walled glass flask - 500 ml Piece HC3 E

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MISSION: Modeling Quality and Sustainable prevention, care & treatment of HIV and other health priorities using a family centred approach; to gether with training, education and research.

VISION: Commmunities equipped to effectively respond to HIV & other priority health issues.

Strategic Objectives

a). To provide test menus by each level of healthcare.

b). To provide the most suitable technique and equipment by each level of care that fulfill test menus

c). To provide an up-to-date list of supplies that corresponds to the agreed testing technique and equipment by level of care

d). To provide a list of supplies that is VEN-classified to guide procurement by prioritizing vital commodities.

UNHLS Ministry of 73Health Uganda P.O. Box 7272 Kampala