Apr 5, 2014 - preparing laboratories to achieve ISO 15189 Standards and accred- itation, and the Strengthening Laboratory Management Toward.
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16th ICID Abstracts / International Journal of Infectious Diseases 21S (2014) 1–460
Type: Poster Presentation
Type: Poster Presentation
Final Abstract Number: 59.053 Session: Diagnosis Date: Saturday, April 5, 2014 Time: 12:45-14:15 Room: Ballroom
Final Abstract Number: 59.054 Session: Diagnosis Date: Saturday, April 5, 2014 Time: 12:45-14:15 Room: Ballroom
Missed opportunities for the diagnosis of pulmonary tuberculosis - polymerase chain reaction: A better tool
Improving the quality of laboratory systems through Strengthening Laboratory Management Towards Accreditation (SLMTA) in Rwanda, 2010-2013
A.A. Annan ∗ , E. Owusu-Dabo, F. Bonsu, E. Frimpong, J. Larbi, L. Anakwa Kwame Nkrumah University of Science and Tecnology, Kumasi, Ghana
I. Nzabahimana 1,∗ , S. Sebasirimu 2 , C.M. Muvunyi 3 , C. Kayobotsi 4 , J. Serumondo 5 1
RWANDA BIOMEDICAL CENTER, Kigali, Rwanda Rwanda Biomedical center National Reference Laboratory, Kigali, Rwanda 3 University of Rwanda, Huye, Rwanda 4 Single project Implimentation unit, Kigali, Rwanda 5 Rwanda Biomedical Center, National reference Laboratory, Kigali, Rwanda 2
Background: The diagnosis of Pulmonary Tuberculosis (PTB) has mainly relied on sputum microscopy and culture. The use of molecular techniques such as the Polymerase Chain Reaction (PCR) and its overwhelming advantages compared with conventional diagnostic methodologies cannot be overemphasized. The main aim of this work was to compare the diagnostic sensitivities of microscopy, culture and PCR. Methods & Materials: Suspected PTB sputum samples were prospectively collected from six hospitals in the Ashanti and Western regions of Ghana. Microscopy was carried out on all samples at the field sites. Apart from culture and PCR, repeat sputum microscopy was carried out in the laboratories of the Kumasi Centre for Collaborative Research (KCCR). Results: Out of the total 425 cases recruited for the study, 123 (29.0%) were smear positive on site in contrast to 275 (64.7%) positivity rate at KCCR. Regarding culture, 254 (59.9%) samples were culture positive whilst PCR technique using INS 1&2 and PR 8&9 primers were positive in 59.9% and 56% of cases respectively. The proportion of missed positive cases of microscopy were 131 (51%) compared with culture and 1.1% missed cases when compared with PCR. The sensitivity and specificity of microscopy were 123/254 (48.4%) and 154/302 (50.99%). Conclusion: The study confirms the superiority of PCR in the diagnosis of PTB and indicates that a substantial proportion of PTB cases are missed when microscopy alone is used. In areas where the incidence of PTB is high and at referral hospitals, PCR can be done to augment the diagnosis of TB. http://dx.doi.org/10.1016/j.ijid.2014.03.1215
Background: Efficient and reliable laboratory services and networking are essential components of effective, well functioning health systems in disease surveillance. Therefore, improving the performance of clinical and public health laboratories is one of the main goals of strengthening health system. In July 2009, in Kigali, Rwanda saw the concurrent launch of World Health Organization Regional Office for Africa (WHO AFRO) stepwise framework for preparing laboratories to achieve ISO 15189 Standards and accreditation, and the Strengthening Laboratory Management Toward Accreditation (SLMTA) program. This study describes the achievements of Rwanda laboratories in the implementation of the SLMTA Program after 4 years of program implementation. Methods & Materials: The SLMTA programme in Rwanda was implemented since 2010, with three cohorts, each composed of 5 laboratories. A baseline laboratory audit, and exit audit was conducted in January 2010 and May 2011 where by a follow up audit took place in May 2012 for cohort 1 laboratories. In Nov 2011, a second cohort of district hospital laboratories (satellite) were enrolled with a baseline audit in November 2011, exit audit done in December 2012 and a recent follow up was in November 2013. In March 2013, a third cohort comprising another five district hospital laboratories has been enrolled with a baseline audit. Results: Audit results showed that one of the 15 enrolled laboratories had one star rating at baseline audit out of a maximum of 5 stars. However, after three sessions of SLMTA workshops and interspersing improvement projects, ten laboratories with exit audit, two achieved 1 star, two achieved 2 stars, five laboratories reach 3 stars and 1 laboratory reached 4 stars rating. At follow up audit in 2 cohorts, five laboratories reached four stars, five laboratories had three stars and one laboratory had two stars Conclusion: Rwanda laboratories enrolled in the accreditation process, achieved significant improvement in quality performance and disease surveillance. The SLMTA workshops, mentorship and quarterly performance based financing (PBF) audit played a big role in the accelerating improvements of Rwanda laboratories http://dx.doi.org/10.1016/j.ijid.2014.03.1216
