TUBERCULOSIS LABORATORY NETWORK - UGANDA

1. TUBERCULOSIS LABORATORY NETWORK - UGANDA Dr. Achilles Katamba Zone TB/Leprosy Supervisor, Kampala City

2. Outline of presentation • Introduction • The Uganda Tuberculosis (TB) laboratory network • Personnel at different Health Unit Levels – Uganda • Training and Supervision • Supplies for TB laboratory services • Quality Control for sputum smear Microscopy • Problems encountered in relation to microscopy network • Way forward

3. Introduction • 9 TB Operational zones (regions) each headed by a zone (region) TB & Leprosy Supervisor (ZTLS) • Each zone is made up of several districts and TB services in each district are supervised by a district TB & Leprosy supervisor (DTLS) • Population approximately 25m (2002 pop. & housing census) • 440 diagnostic TB diagnostic units (average of 57,000 people per diagnostic center)

4. The Uganda TB Laboratory Network • Both government and non-government Health facilities make up the laboratory network • Health Unit (Health Center III & IV lab. • District lab • Regional lab. • National Reference lab. NB: TB laboratory services are integrated with other laboratory services, no stand alone laboratories for TB except for the National reference laboratory

5. Personnel at different Health Unit Levels - Uganda • Health Center III – Lab. Assistant • Health Center IV – Lab. Technician • District/Regional/Reference lab. – Lab. Technologist

6. Training and Supervision • Trained lab. Staffs are recruited and posted to the various health facilities, however, due world bank embargo to recruitment of civil servants the number of staffs currently is lower than required to provide quality services • Through supervision various government programs (TB, Malaria, HIV) would access the training needs and plan for appropriate training, however, this is not taking place due to certain constraints • TB program has a training center (Buluba) where staffs are sent to train on sputum microscopy

7. Supplies for TB laboratory Services • Supplies are decentralized to the various zones (regions), form where they are distributed to the districts and finally to the health facilities • The Uganda NTLP has had a fairly regular supply of laboratory supplies except sputum microscopy cups, slides and slide boxes • Recently the Canadian International Development Agency (CIDA) through the IUATLD has supplied the required materials

8. Quality Control for smear sputum Microscopy • Both internal and external quality control have not been conducted in majority of the laboratories in the network except in the TB program training center (Buluba) • Recently, quality control services have been started in one of the 9 regions (zones) with the hope that this will spread to cover the whole country (German Leprosy Relief Association)

9. Problems encountered in relation to microscopy network • Leadership • Resources! • Training • Insurgency in some parts of the country!

10. Way Forward • CDC Uganda has agreed to sponsor the post of a leader for the National TB laboratory services • Training – currently we are undergoing training to address the gaps of quality control of sputum smear microscopy • Resources – some resources e.g. training materials will be offered at the end of this course and further support both technical and material will be provided on request • Government with assistance from the neighboring countries and other donor countries are finding solutions to end the insurgency

11. Thank You for Listening