Zones: North, East, West, South & Central
Two hubs from each zone and one additional North-East Zone
Ten spokes under each hub
The pre-requisite of a regional hub & spoke:
| Criterion | Regional hub | Spoke |
|---|---|---|
| Medical college or Hospital | Yes | Yes |
| Performing IFA for scrub typhus or other diseases (ANA, etc.,) | Yes | No |
| Performing PCR for scrub typhus or other diseases | Yes | Desirable |
| Performing ELISA for scrub typhus | Yes | Yes |
| Can collaborate with clinicians for establishing surveillance | Yes | Yes |
- The selected hubs & spokes will become part of the national program being set-up for rickettsial surveillance by the NRCRD under the ICMR Mandate.
- The hubs & spokes will also be provided with the necessary IQC materials for performing the assays (serology & molecular) leading to generation of robust national data.
- The hubs and spokes will be trained to perform rickettsial diagnostic assays so that comparable (normalized) data is generated.
- The hubs and spokes will initiate rickettsial disease surveillance as per the SOP designed for the same.
- All patients who report to the hub and spoke hospitals with AUFI will be tested for scrub typhus and spotted fever.
- A website and a mobile application is being developed by the NRCRD for real time capture of necessary data and periodic analysis (National Rickettsia Portal).
- The NRCRD will provide training and technical support for generation of data and data entry into the National Rickettsia Portal (NRP).
- Each site (Hub/spoke) will have a unique credential for data entry and surveillance.
- The data generated from this surveillance will be entered in the mobile application and the same will be stored in the NRP.
- The surveillance data from all the centres will be analyzed by the NRCRD and shared with the ICMR and the individual centers.
- The NRP will be initiated with ten hubs and then expanded by the hubs to the respective spokes with active support from the NRCRD.
- Hubs & spokes which are found eligible will be selected to participate in this national program.
- For each zone, 4 to 6 hubs will be shortlisted and visited by the PI & Co-PI for further assessment and final selection of the two hubs per zone.
- The selected hubs will be invited to the NRCRD for a ToT (Training of Trainers) program.
- The ToT will include information on the NRCRD program including initiation of the NRS & NRP, the role of the hubs and spokes, data entry procedure and hands on training of sample processing, ICT, ELISA, IFA, DNA extraction and PCR for rickettsioses.
- During the ToT, the spokes of each hub will be selected by the NRCRD with inputs from the respective hubs.
- The ToT will be conducted twice in the first year and annually thereafter so that all hubs become proficient in rickettsial diagnostics.
- The hubs will train the personnel from the spokes (n=10/hub). The NRCRD will provide logistic support.