Abstract

BackgroundA delay is evident between the development of new policies on TB diagnostics and their implementation at country level. The Stop TB Partnership would benefit from information from national TB program (NTP) managers on progress towards implementation of new recommendations as well as the opportunities and challenges encountered in the process.Methods and FindingsTo solicit information on the introduction of new TB diagnostics at country level, questionnaires were sent out to NTP managers of high-burden TB countries and a subset of managers was interviewed. The results indicate that about 50% of high-burden TB countries are using the TB diagnostic tools newly recommended by the World Health Organization (WHO). Most NTP managers reported that new diagnostics would only be implemented when officially endorsed by the WHO. All countries have plans to adopt newly endorsed diagnostics at reference laboratory level, while approaches to optimize smear microscopy at lower levels of the health service are given less attention. NTP managers reported diverse challenges to the implementation of new diagnostics.ConclusionsMore information on the obstacles and advantages of introducing new diagnostic tools should be provided to NTP managers to ensure the rational adoption of new diagnostics. A single recommendation covering the introduction of a package of diagnostic tools might be preferable to NTP managers and facilitate implementation in high-burden TB countries.

Highlights

  • Tuberculosis (TB) is a leading global cause of morbidity and mortality and control efforts have so far failed to substantially reduce the burden of disease

  • More information on the obstacles and advantages of introducing new diagnostic tools should be provided to national TB program (NTP) managers to ensure the rational adoption of new diagnostics

  • A single recommendation covering the introduction of a package of diagnostic tools might be preferable to NTP managers and facilitate implementation in high-burden TB countries

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Summary

Introduction

Tuberculosis (TB) is a leading global cause of morbidity and mortality and control efforts have so far failed to substantially reduce the burden of disease. National TB control programmes (NTPs) are beginning to introduce these new diagnostic tools in their diagnostic services and integrate them in national control activities - a process referred to as ‘‘retooling’’. Diagnostic retooling for control of other infectious diseases has often been slow and significant delays can occur between tools becoming available and their application in control activities. In 2006, the Stop TB Partnership created a Task Force on Retooling to produce a roadmap and other information to facilitate the process and to help reduce this delay [2]. The Stop TB Partnership would benefit from information from national TB program (NTP) managers on progress towards implementation of new recommendations as well as the opportunities and challenges encountered in the process

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