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Open Access Are sputum samples of retreatment tuberculosis reaching the reference laboratories? A 9-year audit in Tanzania

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SETTING: One reference and three zonal laboratories and 500 health facilities managing retreatment tuberculosis (TB) patients in Tanzania.

OBJECTIVES: The National Tuberculosis and Leprosy Programme (NTLP) requires that all notified cases of retreatment TB in Tanzania have sputum samples sent for culture and drug susceptibility testing (DST). This study determined 1) if the number of annually notified retreatment patients corresponded to the number of sputum samples received by the reference laboratories, and 2) the number of culture-positive samples and the number of cases undergoing DST.

DESIGN: Nine-year audit of country-wide programme data from 2002 to 2010.

RESULTS: Of the 40 940 retreatment TB patients notified by the NTLP, 3871 (10%) had their sputum samples received at the reference and zonal laboratories for culture and DST. A total of 3761 (97%) sputum samples were processed for culture, of which 1589 (42%) were found to be culture-positive and 1415 (89%) had DST performed.

CONCLUSIONS: There is a >90% shortfall between notified retreatment cases and numbers of sputum samples received, cultured and assessed for DST at reference and zonal laboratories. Steps needed to address this problem are discussed.
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Keywords: DST; Tanzania; operational research; retreatment TB; sputum

Document Type: Research Article

Affiliations: 1: National Institute for Medical Research, Muhimbili Medical Research Centre, Dar es Salaam, Tanzania; and Centre for International Health, University of Bergen, Norway 2: National Institute for Medical Research, Muhimbili Medical Research Centre, Dar es Salaam, Tanzania 3: National Tuberculosis and Leprosy Program, Dar es Salaam, Tanzania 4: National Tuberculosis and Leprosy Program, Dar es Salaam, Tanzania; and National Tuberculosis and Leprosy Program, Central TB Reference Laboratory, Dar es Salaam, Tanzania 5: International Union Against Tuberculosis and Lung Disease, New Delhi, India 6: Médecins Sans Frontières, Addis Ababa, Ethiopia 7: Institute of Tropical Medicine, Antwerp, Belgium 8: International Union Against Tuberculosis and Lung Disease, Paris, France; and London School of Hygiene & Tropical Medicine, London, UK 9: Médecins Sans Frontières, Brussels Operational Center, Luxembourg 10: Centre for International Health, University of Bergen, Norway

Publication date: June 21, 2013

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  • Public Health Action (PHA), The Union's quarterly open access on-line journal, provides a platform for its mission 'Health solutions for the poor'. PHA addresses the need for show-casing operational research that addresses issues in health systems and services. It publishes high-quality scientific research that provides new knowledge to improve access, equity, quality and efficiency of health systems and services.

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