Tb Cap

Through TB CAP, an activity called Diagnostic Capacity Improvement has been introduced to strengthen the capacity of NTP staff in TB diagnosis. The Diagnostic Capacity Improvement covers laboratory quarterly based EQA, strengthening culture and DST capacity, establishing diagnostic committees for smear negative TB cases. In 2006, before the start o... f this activity, only 54 of the total 201 TB laboratories were participating in quarterly based EQA, this increased to 115 laboratories by the end of 2007. With the technical assistance support from TB CAP and other partners, laboratory quarterly EQA has been successfully decentralized to provincial level and the EQA system was set up for implementation. It should be noted that no reliable data on laboratory performance is available for the baseline year 2006. The result from EQA shows that the total agreement rate is high as 97.9% in 2007 and 98.3% in 2008 and the number of laboratories performing TB microscopy with over 95% correct microscopy is 74% in 2007 and 74.3% in 2008. Furthermore, the quality of smear preparation has improved remarkably compared to baseline: quality of sputum increased from 53.4% to 68%, smear size from 39.2% to 70%, smear thickness from 36.5% to 50% and smear evenness from 32.2% to 40%. TB CAP has also strengthened the culture and DST services. Now the NTP has 3 regional culture centers with trained staff. CENAT/NTP central laboratory has capacity to conduct DST for Drug Resistance. To strengthen the diagnosis of sputum smear negative TB cases, TB CAP has supported NTP to improve the capacity of TB physicians by developing Term of Reference for the Diagnostic Committee, a referral system and a diagnosis schedule that were not previously available. As a result, many more sputum smear negative TB suspects were referred from remote health centers to referral hospitals for diagnosis. There is 2,6 fold increase in the number of referrals and more than twice the number of TB cases diagnosed in one year. The achievement above is the effort made ...Read More