BackgroundTuberculosis is a major public health problem in Liberia. According to the World Health Organization (WHO), the incidence of tuberculosis in Liberia is significantly increasing from year to year. However, little is known about the performance of the programme and the challenges after the 14 years of civil war which ended in 2003.The purpose of the study was to evaluate the performance of the TB programme of Liberia.MethodsThe study utilised mixed research design; both quantitative and qualitative methods were used in this study conducted from 2013 to 2014. For the quantitative part of the study, a questionnaire, laboratory performance and eleven years TB programme data (2003–2013) were used. For the performance of tuberculosis laboratory testing, all the 107 functional tuberculosis microscopy centers in Liberia were included. For the qualitative part of the study, an interview of 10 informants and two focus group discussions (FGDs) were also conducted, each comprising of eight people. Themes and subthemes emerged from the two FGDs. Data was analysed in line with the Donabedian model. Quantitative findings were analysed and presented using both descriptive and inferential statistics.ResultsThe study findings pointed out that there was overall improvement in the performance of the tuberculosis control programme in Liberia from 2003 to 2013. The percentage of cured patients was 60% in 2005 and 62% in 2013. Percentage of treatment completed was 16% in 2005 and 21% in 2013. The case detection rate was 57% and treatment success rate 80% in 2013. The default rate was 11% in 2013. Of the 139 participants, 120 (86%) completed TB treatment while 19 (14%) did not.ConclusionBetween 2003 and 2013, the National Leprosy and Tuberculosis Control Programme (NLTCP) succeeded in restoring the TB services and improving some of the TB treatment outcomes including the Directly observed treatment short courses(DOTS) coverage. Despite these improvements, the TB treatment, laboratory services and human resource capacity lagged behind. The TB programme of Liberia needs to develop new strategies to address its challenges.
BackgroundLiberia is among the three west African countries which were crippled by the Ebola Virus Disease (EVD) outbreak of 2014. One of the programs which was affected by the EVD outbreak was the National Leprosy and Tuberculosis Control Program (NLTCP). Determining the magnitude of the impact of EVD on the NLTCP performance is crucial in restoring the service and in devising effective post EVD strategies. The purpose of the study was to analyse the impact of EVD outbreak on the performance of the NLTCP of the Ministry of Health (MOH) OF Liberia.MethodsA cross sectional study design was conducted in 2016 using both quantitative and qualitative methods. Quantitative data was used for the Tuberculosis (TB) program evaluation before EVD (2012–2013) and during EVD (2014–2015). Qualitative data was used to complement the data obtained for the quantitative study. Descriptive statistical analyses of quantitative data were conducted using Microsoft Excel.ResultsNotified TB cases of all forms decreased from 7822 in 2013 to 4763 and 6118 in 2014 and 2015 respectively. The number increased to 7180 and 7728 in 2016 and 2017 respectively. The TB treatment success rate was 71 and 61% in 2014 and 2015 respectively compared to the 83% in 2013. The treatment success rate was 77% in 2016. The loss to follow up (LTFU) was as high as 47% in some regions which were highly affected by the EVD outbreak. The national average LTFU was 5–10% in 2012–2013 and 16 and 21% in 2014 and 2015 respectively. The percentage of TB patients with known HIV result decreased from 75% in 2013 to 74 and 42% in 2014 and 2015 respectively. TB culture and drug susceptibility testing service was interrupted throughout the outbreak. The results of the focal group discussions and interviews conducted in our study also indicated that the TB case finding and the TB treatment outcome was significantly affected by the EVD outbreak.ConclusionNotified TB cases and treatment outcome was significantly affected by the EVD outbreak which occurred in 2014 and 2015 in Liberia. Effective restoration strategies should be developed in order to improve the TB case finding and treatment outcome.
Background. Tuberculosis (TB) is a major public health problem in Liberia. Little is known about the TB laboratory performance of Liberia and the challenges after the 14 years of civil war which ended in 2003. The purpose of the study was to evaluate the TB laboratory performance of Liberia. Methods. A cross-sectional study was conducted from 2014 to 2015. The study was conducted using quantitative data of TB case findings, sputum microscopy proficiency testing, and on-site assessment of sputum microscopy laboratories in Liberia. 80 laboratories participated in the proficiency testing. Besides, four years’ (2012–2015) TB case finding data obtained from the National Leprosy and Tuberculosis Control Programme (NLTCP) were used to complement the study. The data were analysed using descriptive statistics. Results. From the 80 TB sputum microscopy testing laboratories participating in proficiency testing, only 20 (25%) scored acceptable performance. 46 (58%) TB microscopy laboratories reported quantification errors for the proficiency panel slide 6 which was 3+. The national TB smear-positive cases notified were 4342 in 2012 but decreased to 3820 and 2448 in 2013 and 2014, respectively. The TB smear case detection rate showed an increase from 68% in 2010 to 78% in 2011 and a decrease to 60%, 57%, and 42% in 2012, 2013, and 2014, respectively. Conclusion. Between 2010 and 2013, the NLTCP succeeded in increasing the number of TB sputum microscopy laboratories. At most of the TB microscopy sites, the TB laboratory quality system was not implemented. The NLTCP of Liberia should develop strategies to overcome its challenges in TB laboratory testing.
Background: The capacity for molecular testing of Human Immunodeficiency Virus (HIV) Viral load, Tuberculosis (TB) and epidemic prone disease was very limited in Liberia prior to the Ebola Virus Diseases (EVD) outbreak. The use of point of care and near point of care machines for multiple disease testing of HIV, TB and EVD was adopted as a solution to these challenges. The purpose of this study was to evaluate the integrated use of the GeneXpert for the three diseases testing. Methods: A previously collected and reported GeneXpert testing data was used to evaluate the integrated use of GeneXpert platform for TB, HIV viral load and EVD testing. All the laboratory GeneXpert secondary data available since the machines were installed and started testing were analyzed. Besides; Field observation report on the operation, coordination and impact of the integrated testing was included. Results: The integrated testing of HIV Viral load, Mycobacterium Tuberculosis/Rifampicin (MTB/RIF) and EVD using the GeneXpert platform has played a significant role in Liberia. A total of 706 HIV viral load, 3695 MTB/RIF and 2309 EVD GeneXpert tests were conducted since the start of the integrated testing. Conclusion: The integrated use of the GeneXpert platform for TB, HIV and EVD is very crucial as it helped in enhancing the services and coordinating resources in a sustainable way. Lessons learnt from this integration will help to effectively scale up the integrated testing.
Background: The capacity for molecular testing of the Human Immunodeficiency Virus (HIV) Viral load, Tuberculosis (TB) and epidemic- prone disease was very limited in Liberia prior to the Ebola Virus Diseases (EVD) outbreak. The use of point of care and near point of care machines for multiple disease testing of HIV, TB and EVD was adopted as a solution to these challenges. The purpose of this study was to evaluate the integrated use of GeneXpert for the three disease testing. Methods: A previously collected and reported GeneXpert testing data was used to evaluate the integrated use of the GeneXpert platform for TB, HIV viral load and EVD testing. All the laboratory GeneXpert secondary data available since the machines were installed and started testing were analyzed.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.