Structure and Organization of Tuberculosis Laboratory Networks in Latin America: Tuberculosis Laboratory Survey Carried out by the PAHO/WHO Regional Tuberculosis Program-Results of the Survey
This work describes the results of a cross-sectional survey that the PAHO/WHO TB Program carried out in 2007, with responses from the National TB Laboratory Networks in 19 countries, with the goal of determining if the organization and operations of the laboratories were adapted to the needs of case-finding for the National TB Programs (NTPs).
General Objective of the Survey: That the countries of the Region reverse TB incidence, prevalence, and mortality by applying the Stop TB Strategy.
- Obtain up-to-date information on the availability of TB laboratory services and on the organization of the networks that link them.
- Determine the type, usefulness, and real volume of testing and the scope of the techniques used in TB bacteriology, including facility installation and biosafety measures.
- Describe or become familiarized with network support activities (standardization, training, quality assurance, resources, funding sources).
The PAHO/WHO Regional TB Program prepared a Regional Plan for Tuberculosis for the period 2006-2015, based on the following:
Vision: TB-free Americas.
Mission: Ensure that each patient have full access to quality treatment and diagnosis, in order to diminish the social and economic impact and the inequity that TB imposes.
The components of this strategy are:
- Continue quality DOTS expansion and improve it.
- Deal with TB/HIV, multidrug-resistant tuberculosis, and the needs of poor and vulnerable populations.
- Help to strengthen the system of health workers based on primary health care.
- Involve all health providers.
- Empower people and communities affected by tuberculosis through partnerships.
- Enable and promote research.
The Importance of This Survey
Accordingly, one of the critical elements for the implementation and successful expansion of the DOTS strategy in a country is an adequate laboratory presence. WHO experts have made multiple recommendations with regard to the organization of TB laboratories in low- or medium-resource countries.
On the other hand, the increase in the number of TB cases associated with HIV, aggravated by the increase in the incidence of multidrug resistance, has called for a review of biosafety standards in TB laboratories.
The acquisition and analysis of data on the activities carried out by the National TB Laboratory Networks allow us to identify their operational characteristics for case-finding, evaluate opportunities to utilize appropriate techniques, evaluate performance in terms of diagnosis, assess network strengths and weaknesses, and verify if there are sufficient resources. The results of these analyses constitute a basis for planning future activities.