Subject: Scale-up of Multidrug-Resistant Tuberculosis Laboratory Services, Peru
This article was published in May 2008 in the Emerging Infectious Diseases Journal. It is available full text at this link: http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=2600242
Interesting tables from the article:
- Strategies to reduce turnaround time of culture and DST, Peru <http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=2600242&rendertype=ta
- Description and costs of the direct Griess method in Peru.
- Considerations for decentralized drug susceptibility testing (DST) capacity
for first-line drugs, Peru
- Baseline laboratory capacity for diagnosis of tuberculosis, Peru, 1996-2000
Over the past 10 years, the Peruvian National Tuberculosis (TB) Program, the National Reference Laboratory (NRL), Socios en Salud, and US partners have worked to strengthen the national TB laboratory network to support treatment of multidrug-resistant TB. We review key lessons of this experience. The preparation phase involved establishing criteria for drug susceptibility testing (DST), selecting appropriate DST methods, projecting the quantity of DST and culture to ensure adequate supplies, creating biosafe laboratory facilities for DST, training laboratory personnel on methods, and validating DST methods at the NRL. Implementation involved training providers on DST indications, validating
conventional and rapid first-line DST methods at district laboratories, and eliminating additional delays in specimen transport and result reporting. Monitoring included ongoing quality control and quality assurance procedures. Hurdles included logistics, coordinating with policy, competing interests, changing personnel, communications, and evaluation. Operational research guided laboratory scale-up and identified barriers to effective capacity building.