Speakers for UBD-Snibe 2026

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Immunoassays are indispensable analytical tools in modern laboratory medicine, underpinning the diagnosis and monitoring of endocrine, cardiac, oncologic, infectious, and autoimmune diseases. Despite continuous methodological refinement, immunoassays remain susceptible to a broad spectrum of interferences that can produce clinically misleading results, prompt unnecessary investigations, delay appropriate treatment, and erode confidence in laboratory data. This lecture provides a structured overview of the principal interference mechanisms encountered in routine and specialized immunoassay practice and offers a practical framework for their recognition, investigation, and mitigation.

Interferences are broadly classified into endogenous and exogenous categories. Endogenous interferences include heterophile antibodies, human anti-animal antibodies (notably HAMA), rheumatoid factor, autoantibodies, paraproteins, complement activation, and macro-analyte complexes such as macroprolactin, macro-TSH, and macro-CK. Sample-related interferents — hemolysis, lipemia, and icterus — alter optical signals and analyte stability and remain among the most frequently encountered preanalytical problems. Exogenous interferences encompass high-dose biotin supplementation (a well-recognized cause of erroneous thyroid and troponin results in streptavidin–biotin platforms), therapeutic monoclonal antibodies, anti-drug antibodies, and contaminants introduced during specimen collection or handling. Analytical phenomena such as the high-dose hook effect, cross-reactivity with structurally related molecules, and matrix effects further compound the diagnostic challenge.

The clinical consequences of unrecognized interference can be substantial, ranging from spurious tumor marker elevations and falsely suppressed or elevated hormone values to misclassification of cardiac injury. Detection strategies include critical correlation with clinical presentation, serial dilution and linearity testing, alternative-platform reanalysis, polyethylene glycol precipitation, heterophile-blocking reagents, and inter-method comparison. Effective management requires close communication between the clinical laboratory and the requesting clinician, supported by robust internal quality control, awareness of platform-specific vulnerabilities, and adherence to international guidance.

This presentation will integrate mechanistic explanations with illustrative case-based examples and propose a stepwise diagnostic algorithm for the investigation of suspected interference. Emphasis will be placed on emerging challenges, including interference from novel biologic therapies and the evolving role of mass spectrometry as a confirmatory orthogonal method. Strengthening laboratory–clinician dialogue and embedding interference awareness into daily practice are essential for safeguarding diagnostic accuracy and patient safety.

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Infectious disease diagnostics has entered an era in which laboratories must respond simultaneously to clinical, epidemiological, operational, and economic demands. The COVID-19 pandemic, the resurgence of vaccine-preventable and travel-associated infections, the global burden of viral hepatitis and HIV, and recent outbreaks such as mpox have all demonstrated that diagnostic systems are not merely tools for individual patient care, but essential components of public health preparedness. Within this context, centralized infectious disease testing remains a cornerstone of modern laboratory medicine.

Central laboratories provide standardized workflows, automated sample processing, high analytical reproducibility, robust quality control, and the ability to manage large volumes of specimens across broad diagnostic menus. Fully automated chemiluminescence immunoassay platforms, such as MAGLUMI systems, illustrate how central laboratory infrastructure can support large-scale infectious disease testing, including viral hepatitis panels, HIV screening, syphilis, respiratory infections, TORCH pathogens, tuberculosis-related immune assays, and emerging or tropical diseases.

A key advantage of centralized testing is its capacity to combine diagnostic accuracy with operational efficiency. High-throughput analyzers can process large numbers of samples with reduced manual intervention, supporting consistent turnaround times and improving laboratory productivity. Centralization also enables stronger governance of pre-analytical, analytical, and post-analytical phases, including standardized sample transport, traceability, internal quality control, external quality assessment, result validation, and integration with laboratory information systems. These features are particularly relevant for infectious disease diagnostics, where false-positive or false-negative results may have consequences not only for individual patients, but also for transmission control, outbreak management, and antimicrobial or antiviral stewardship.

Although centralized platforms require significant initial investment in instrumentation, infrastructure, automation, connectivity, and trained personnel, they may offer lower cost per test at scale compared with decentralized or point-of-care testing.

Examples from COVID-19 illustrate this balance clearly. During pandemic waves, centralized laboratories enabled mass testing, variant surveillance support, serological monitoring, and large-scale reporting to public health authorities. At the same time, rapid antigen and molecular POCT improved access to immediate results in emergency departments, community settings, and screening programs. Similar lessons apply to other infectious threats, including influenza, RSV, hepatitis, HIV, tuberculosis, dengue, Zika, and mpox, where diagnostic strategy must be adapted to disease dynamics, clinical urgency, population needs, and laboratory capacity.

The future of infectious disease diagnostics should therefore be based on integrated testing ecosystems, where central laboratories, point-of-care technologies, digital reporting, and public health surveillance work together to improve patient outcomes, outbreak response, and health system sustainability.

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Laboratory test interpretation in children presents unique challenges that extend beyond the application of conventional reference intervals. Physiological changes associated with growth and development result in dynamic variations in biochemical and haematological markers throughout childhood. This presentation will discuss key principles in paediatric laboratory medicine, including age- and sex-specific reference intervals, developmental physiology, and common pitfalls in interpretation. Through selected clinical case studies, the session will demonstrate how laboratory professionals and clinicians can derive meaningful clinical insights that support accurate diagnosis and patient management in paediatric care.

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Abstract available soon

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Allergen immunotherapy (AIT) is the only disease-modifying treatment for IgE-mediated allergic diseases. However, monitoring of treatment response remains limited to clinical symptoms and conventional serological markers such as IgE and IgG₄. There is an unmet need for objective, quantitative, and mechanistically informative biomarkers to assess therapeutic efficacy. This talk highlights the use of peripheral blood mononuclear cell (PBMC) profiling by multiparameter flow cytometry as a cellular immunoassay platform for monitoring immune responses following AIT. AIT is shown to induce a coordinated immune shift from a pro-allergic effector state to a regulatory state. This is characterised by the suppression of T helper 2 and IL-4⁺/IL-21⁺ T follicular helper cell responses, and the induction of regulatory T cells, follicular regulatory T cells, and IL-10-producing regulatory B cells. These dynamic changes define a composite immune signature that can be translated into candidate biomarker panels, including effector-regulatory ratios, to enable objective and longitudinal monitoring of treatment response. These studies highlight the importance of cellular immune profiling as a key approach for future evaluation within the Brunei healthcare setting, with the potential to support the development of precision immune monitoring in noncommunicable diseases.

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Point-of-care testing (POCT) is revolutionising modern healthcare, delivering rapid, actionable diagnostic results at the patient's side and empowering clinicians to make faster, better informed decisions. Realising this potential, however, demands a quality system that is robust, accountable, and built around patient safety.

The Department of Laboratory Services, Ministry of Health, Brunei Darussalam has done exactly that. Through the development of a nationally governed POCT Quality Management System aligned with ISO 15189, Brunei has established a standard in POCT delivery that encompasses rigorous management accountability, quality control and continual improvement, and a structured operator competency programme that ensures only qualified personnel perform testing, using approved devices, within a fully auditable system.

This commitment to excellence was formally recognised through ISO 15189:2022 accreditation awarded by SAC-SINGLAS, Singapore, in October 2024, covering Blood Gas Analysis and INR Testing at RIPAS Hospital. With ambitious plans to expand its accredited test scope and achieve full electronic result traceability across all POCT sites facilities, Brunei's POCT programme stands as a benchmark for quality-driven, patient-centred diagnostic services.

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Behind every reliable laboratory result is a continuous journey of maintaining quality, building competency, and sustaining trust. This session shares the experience of the Department of Scientific Services (DSS), Ministry of Health, Brunei Darussalam, in navigating the challenges and responsibilities of maintaining internationally recognised laboratory standards across public health and forensic science laboratories.

From ensuring metrological traceability and managing critical equipment, to strengthening staff competency and responding to accreditation requirements, the journey reflects the realities of balancing technical excellence with operational demands. It also highlights how leadership commitment, teamwork, continuous learning, and a strong quality culture play an essential role in sustaining reliable laboratory services.

Through the DSS experience, this session offers practical insights into how accreditation and continual improvement extend beyond compliance, forming the foundation of resilient and sustainable laboratory systems. As the national provider of scientific analytical support services for public health and law enforcement agencies in Brunei Darussalam, DSS remains committed to delivering reliable scientific services that uphold quality, technical competence, and stakeholder confidence.

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