Session 2 Laboratory strengthening The Ninth Technical Advisory Group and National TB Programme Managers Meeting Manila Philippines, 9 -11 December 2014 Dr Cornelia Hennig Stop TB and Leprosy Elimination World Health Organization Regional Office for the Western Pacific World Health Organization, Western Pacific Regional Office
Laboratory questionnaire • LED/FM implementation • Xpert MTB/Rif introduction and roll-out, impact • NRL/SRL: Strengthening and coordinating technical assistance Methodology: structured questions / inviting comments CAM, CHN, LAO PDR, MAL, MNG, PHL, PNG, VTN World Health Organization, Western Pacific Regional Office
LED FM WHO policy recommendation 2011 • LED microscopy more sensitive than conventional ZN light microscopy • Qualitative, operational and cost advantages • Phase in LED FM as an alternative World Health Organization, Western Pacific Regional Office
Laboratory confirmation notified % pulmonary bacteriologically Country Total bacteriologically clinically confirmed 14, 9, 2 60. 8 Cambodia 082 069 3, 151 275, 512, 78 35. 0 China 915 469 8, 384 3, 84. 7 Lao. PDR 004 541 3, 545 13, 5, 1 70. 7 Malaysia 641 640 9, 281 1, 68. 9 Mongolia 622 733 2, 355 Papua New 3, 9, 1 25. 1 Guinea 150 390 2, 540 97, 123, 22 44. 1 Philippines 353 510 0, 863 50, 24, 7 67. 2 Global TB report 2014 Viet. Nam 067 403 4, 470 458, 685, 1, 144, 40. 1 World 834 HBC WPR Health Organization, Western Pacific Regional Office 755 589
Status LED FM 2014 8 countries • Validation: CHN, Lao PDR, VTN WPR – only gradual switch to LED • 17 % of microscopy centers (range: 0 to 30 %) • No further expansion in 5/8 • Further expansion in 2/8 with focus on only high workload laboratories World Health Organization, Western Pacific Regional Office
Role of WHO Preparing and disseminating – Technical specifications for the purchase – Standard operating procedures for LED microscopy – Programmes for internal quality control and external quality assurance (EQA) for LED microscopy Facilitate a coordinated approach for standardized training on LED microscopy on country level World Health Organization, Western Pacific Regional Office
Identified issues / obstacles towards expansion • Training duration – 5 days (5), 3 days (2), NA (1) – training modules • Staining solution – Commercial kits (5/8) vs in-house preparation (2/8) – Expiry of staining solution • EQA: – 3/8 no EQA – restaining / re-reading • Maintenance World Health Organization, Western Pacific Regional Office
LED FM • Comments from – TAG focal persons – Other SRL / observers World Health Organization, Western Pacific Regional Office
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