Abstract
Diagnosing tuberculosis in low-resource settings mostly relies on sputum smear microscopy. Improvement through capacity building is a priority. This project aimed to strengthen tuberculosis diagnosis at an intermediate level laboratory. The Italian National Institute for Infectious Diseases and the Italian Development Cooperation closely collaborated with regional and national institutions and reference laboratories to provide laboratory setup, equipment and reagents, personnel training, and the implementation of culture and quality assessment programs at Dodoma Regional Hospital, Dodoma, Tanzania. Microscopy sensitivity was increased, personnel were trained, and culture techniques and quality assessment programs were introduced. Implementing tuberculosis diagnosis in resource-constrained settings is feasible and represents a basis for further strengthening.
Highlights
Diagnosing tuberculosis in low-resource settings mostly relies on sputum smear microscopy
In resource-limited settings, tuberculosis diagnosis relies on sputum smear microscopy [2,3], with low and variable sensitivities (20-80%) [4], especially in paucibacillary pediatric and HIV-associated TB patients [5]
In Tanzania, all level laboratories perform smear microscopy to diagnose TB, culture is performed in six intermediate laboratories, and drug-susceptibility testing is available at the Central Tuberculosis/Leprosy Reference Laboratory in Dar-es-Salaam
Summary
Diagnosing tuberculosis in low-resource settings mostly relies on sputum smear microscopy. Improvement through capacity building is a priority This project aimed to strengthen tuberculosis diagnosis at an intermediate level laboratory. Methodology: The Italian National Institute for Infectious Diseases and the Italian Development Cooperation closely collaborated with regional and national institutions and reference laboratories to provide laboratory setup, equipment and reagents, personnel training, and the implementation of culture and quality assessment programs at Dodoma Regional Hospital, Dodoma, Tanzania. Results: Microscopy sensitivity was increased, personnel were trained, and culture techniques and quality assessment programs were introduced. In Tanzania, all level laboratories perform smear microscopy to diagnose TB, culture is performed in six intermediate laboratories (either public or private), and drug-susceptibility testing is available at the Central Tuberculosis/Leprosy Reference Laboratory in Dar-es-Salaam. The aim of the project was to improve the quality of TB diagnosis through laboratory organization, personnel training, and the implementation of concentrated sputum smear, culture techniques, and quality assessment programs.
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