Reducing delays to multidrug-resistant tuberculosis case detection through a revised routine surveillance system
Abstract Background Implementation of an effective Tuberculosis Routine Surveillance System in low-income countries like Tanzania is problematic, despite being an essential tool for the detection and effective monitoring of drug resistant tuberculosis. Long delays in specimen transportation from the...
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doaj-18b9aa7bd2a7484eb9dce029e24405422020-11-25T03:12:01ZengBMCBMC Infectious Diseases1471-23342020-08-0120111110.1186/s12879-020-05298-8Reducing delays to multidrug-resistant tuberculosis case detection through a revised routine surveillance systemBasra Esmail Doulla0Stephen Bertel Squire1Eleanor MacPherson2Esther Stanslaus Ngadaya3Beatrice Kemilembe Mutayoba4Ivor Langley5Ministry of Health, Community Development, Gender, Elderly and Children; National Tuberculosis and Leprosy ProgrammeLiverpool School of Tropical Medicine, Centre for Applied Health Research and DeliveryLiverpool School of Tropical Medicine, Centre for Applied Health Research and DeliveryNational Institutes for Medical Research, Muhimbili Medical Research CentreMinistry of Health, Community Development, Gender, Elderly and Children; National Tuberculosis and Leprosy ProgrammeLiverpool School of Tropical Medicine, Centre for Applied Health Research and DeliveryAbstract Background Implementation of an effective Tuberculosis Routine Surveillance System in low-income countries like Tanzania is problematic, despite being an essential tool for the detection and effective monitoring of drug resistant tuberculosis. Long delays in specimen transportation from the facilities to reference laboratory and results dissemination back to the health facilities, result in poor patient management, particularly where multidrug-resistant tuberculosis disease is present. Methods Following a detailed qualitative study, a pilot intervention of a revised Tuberculosis Routine Surveillance System was implemented in Mwanza region, Tanzania. This included the use of rapid molecular methods for the detection of both tuberculosis and drug resistance using Xpert MTB/RIF in some Mwanza sites, the use of Xpert MTB/RIF and Line Probe Assay at the Central Tuberculosis Reference Laboratory, a revised communication strategy and interventions to address the issue of poor form completion. A before and after comparison of the intervention on the number of drug resistant tuberculosis cases identified and the time taken for results feedback to the requesting site was reported. Results The revised system for previously treated cases tested at the Central Reference Laboratory was able to obtain the following findings; the number of cases tested increased from 75 in 2016 to 185 in 2017. The times for specimen transportation from health facilities to the reference laboratory were reduced by 22% (from 9 to 7 days). The median time for the district to receive results was reduced by 36% (from 11 to 7 days). Overall the number of drug resistant tuberculosis cases starting treatment increased by 67% (from 12 to 20). Conclusion Detection of drug resistance could significantly be enhanced, and delays reduced by introduction of new technologies and improved routine surveillance system, including better communication using mobile applications such as ‘WhatsApp’ and close follow-ups. A larger scale study is now merited to ascertain if these benefits are robust across different contexts.http://link.springer.com/article/10.1186/s12879-020-05298-8Reference laboratoryRoutine surveillance systemPreviously treated casesSpecimensTuberculosis |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Basra Esmail Doulla Stephen Bertel Squire Eleanor MacPherson Esther Stanslaus Ngadaya Beatrice Kemilembe Mutayoba Ivor Langley |
spellingShingle |
Basra Esmail Doulla Stephen Bertel Squire Eleanor MacPherson Esther Stanslaus Ngadaya Beatrice Kemilembe Mutayoba Ivor Langley Reducing delays to multidrug-resistant tuberculosis case detection through a revised routine surveillance system BMC Infectious Diseases Reference laboratory Routine surveillance system Previously treated cases Specimens Tuberculosis |
author_facet |
Basra Esmail Doulla Stephen Bertel Squire Eleanor MacPherson Esther Stanslaus Ngadaya Beatrice Kemilembe Mutayoba Ivor Langley |
author_sort |
Basra Esmail Doulla |
title |
Reducing delays to multidrug-resistant tuberculosis case detection through a revised routine surveillance system |
title_short |
Reducing delays to multidrug-resistant tuberculosis case detection through a revised routine surveillance system |
title_full |
Reducing delays to multidrug-resistant tuberculosis case detection through a revised routine surveillance system |
title_fullStr |
Reducing delays to multidrug-resistant tuberculosis case detection through a revised routine surveillance system |
title_full_unstemmed |
Reducing delays to multidrug-resistant tuberculosis case detection through a revised routine surveillance system |
title_sort |
reducing delays to multidrug-resistant tuberculosis case detection through a revised routine surveillance system |
publisher |
BMC |
series |
BMC Infectious Diseases |
issn |
1471-2334 |
publishDate |
2020-08-01 |
description |
Abstract Background Implementation of an effective Tuberculosis Routine Surveillance System in low-income countries like Tanzania is problematic, despite being an essential tool for the detection and effective monitoring of drug resistant tuberculosis. Long delays in specimen transportation from the facilities to reference laboratory and results dissemination back to the health facilities, result in poor patient management, particularly where multidrug-resistant tuberculosis disease is present. Methods Following a detailed qualitative study, a pilot intervention of a revised Tuberculosis Routine Surveillance System was implemented in Mwanza region, Tanzania. This included the use of rapid molecular methods for the detection of both tuberculosis and drug resistance using Xpert MTB/RIF in some Mwanza sites, the use of Xpert MTB/RIF and Line Probe Assay at the Central Tuberculosis Reference Laboratory, a revised communication strategy and interventions to address the issue of poor form completion. A before and after comparison of the intervention on the number of drug resistant tuberculosis cases identified and the time taken for results feedback to the requesting site was reported. Results The revised system for previously treated cases tested at the Central Reference Laboratory was able to obtain the following findings; the number of cases tested increased from 75 in 2016 to 185 in 2017. The times for specimen transportation from health facilities to the reference laboratory were reduced by 22% (from 9 to 7 days). The median time for the district to receive results was reduced by 36% (from 11 to 7 days). Overall the number of drug resistant tuberculosis cases starting treatment increased by 67% (from 12 to 20). Conclusion Detection of drug resistance could significantly be enhanced, and delays reduced by introduction of new technologies and improved routine surveillance system, including better communication using mobile applications such as ‘WhatsApp’ and close follow-ups. A larger scale study is now merited to ascertain if these benefits are robust across different contexts. |
topic |
Reference laboratory Routine surveillance system Previously treated cases Specimens Tuberculosis |
url |
http://link.springer.com/article/10.1186/s12879-020-05298-8 |
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