roles of laboratories and laboratory systems in effective tuberculosis control

Abstract

Laboratories and laboratory networks are a fundamental component of tuberculosis (TB) control, providing testing for diagnosis, surveillance and treatment monitoring at every level of the health-care system. New initiatives and resources to strengthen laboratory capacity and implement rapid and new diagnostic tests for TB will require recognition that laboratories are systems that require quality standards, appropriate human resources, and attention to safety in addition to supplies and equipment. To prepare the laboratory networks for new diagnostics and expanded capacity, we need to focus efforts on strengthening quality management systems (QMS) through additional resources for external quality assessment programmes for microscopy, culture, drug susceptibility testing (DST) and molecular diagnostics. QMS should also promote development of accreditation programmes to ensure adherence to standards to improve both the quality and credibility of the laboratory system within TB programmes. Corresponding attention must be given to addressing human resources at every level of the laboratory, with special consideration being given to new programmes for laboratory management and leadership skills. Strengthening laboratory networks will also involve setting up partnerships between TB programmes and those seeking to control other diseases in order to pool resources and to promote advocacy for quality standards, to develop strategies to integrate laboratories' functions and to extend control programme activities to the private sector. Improving the laboratory system will assure that increased resources, in the form of supplies, equipment and facilities, will be invested in networks that are capable of providing effective testing to meet the goals of the Global Plan to Stop TB.

Misdiagnosis of tuberculosis: Sputum culture is a useful diagnostic tool in Quetta, Pakistan

“…These red particles sometime match with tubercle bacilli and might cause false positive results (Kubica and Dye, 1967;Van et al, 2005). Such misleading diagnosis can be reduced by incorporating TB culture which is a more reliable and accurate method for TB diagnosis (Ridderhof et al, 2007). Moreover, the TB culture allows diagnosis of early stage of the disease and the identification of the mycobacterium species, which are not possible with sputum microscopy (Gandhi et al, 2006).…”

Drug-Resistant Tuberculosis, KwaZulu-Natal, South Africa, 2001–2007

“…Observers have concluded that dramatic improvements in baseline capacity are necessary to meet anticipated surveillance and treatment targets. 81,82,83,84,85 In 2005, the World Health Assembly passed a resolution requesting the DirectorGeneral "to implement and strengthen strategies for the effective control of, and management of persons with, drug-resistant tuberculosis." The 2006 Global Plan to Stop TB stresses the importance of laboratory services, stating that "every country should have a well-resourced and fully functioning national reference laboratory."…”

Atomic force microscopy fishing and mass spectrometry identification of gp120 on immobilized aptamers

“…Approximation of experimental density distribution of AFM visualized aptamers with heights ρ(h) (1) was carried out using function (2). It was obtained from this approximation that visualized objects form a group of objects with the maximum height h max (apt)=(0.9±0.1) nm, and a full width at half maximum was W=(0.5±0.1) nm.…”

“…Approximation of experimental density distribution of complexes with heights ρ(h) (1) was carried out using function (2). As a result, maximum heights of the visual ized complexes were 1) h max ( protein/apt)=(1.6±0.1) nm after incubation in 0.8×10 -9 M gp120 solution and 2) h max ( protein/ apt)=(1.4±0.1) nm after incubation in 0.8×10 -11 M gp120 solution.…”