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Improving the diagnosis of TB and laboratory strengthening

Improving the diagnosis of TB and laboratory strengthening. Round table 3. Outline 1. Diagnosis and management 2. TB diagnosis 3. Policies. Challenges Improving diagnosis Stigmatization: accessing services Long turn around time Power

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Improving the diagnosis of TB and laboratory strengthening

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  1. Improving the diagnosis of TB and laboratory strengthening Round table 3

  2. Outline1.Diagnosis and management2. TB diagnosis3. Policies

  3. Challenges Improving diagnosis Stigmatization: accessing services Long turn around time Power Diagnosis of extra- pulmonary and sputum negative TB difficult Way forward Collocation of TB microscopy center and HIV testing sites Training in all the major diseases (TB, HIV, Malaria) TB poster in HIV center and vice versa Early results by any means (logistics, manpower, LIS) Pathologist should be part of the ref lab Acceptance of presumptive diagnosis (clinical only) Kenya Yes, India No, Cambodia Yes, Russia No Diagnosis and management

  4. Challenges Culture for what? First line Re-treatment HIV pos / smear neg Where? Way forward Triage for culture specimen Better define which specimens for culture Training and mentoring approaches (centralized, regional, supra national, regional training laboratories, twinning etc.) Novel ways of TA: Long-term assistance for training TB diagnosis

  5. Challenges Diagnosis of MDR / XDR QA Way forward Need for additional NRL and supra national labs Protocol, SOPs in place EQA Supervision or site visits TB diagnosis

  6. Challenges Fluorescent microscopy LED microscopy Others techniques (PCR-based tests) Way forward Equipment Training Power Administrative TB diagnosis / new technologies

  7. Challenges Non lab techs not authorized to perform HIV and TB tests Private lab participation Funding Way forward Integrated National lab strategic plan (TB, HIV and Malaria) Formulate a policy to enable non-lab expert testing Participation of private laboratories in the national lab network and strategic plan Need for accreditation of labs GF,WB,KNCV, MSF…etc Policies

  8. Thank you

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