Roles of laboratories and laboratory systems in effective tuberculosis programmes

摘要

Laboratories and laboratory networks are a fundamental component of tuberculosis (TB) control, providing testing foruddiagnosis, surveillance and treatment monitoring at every level of the health-care system. New initiatives and resources to strengthenudlaboratory capacity and implement rapid and new diagnostic tests for TB will require recognition that laboratories are systems thatudrequire quality standards, appropriate human resources, and attention to safety in addition to supplies and equipment. To prepareudthe laboratory networks for new diagnostics and expanded capacity, we need to focus efforts on strengthening quality managementudsystems (QMS) through additional resources for external quality assessment programmes for microscopy, culture, drug susceptibilityudtesting (DST) and molecular diagnostics. QMS should also promote development of accreditation programmes to ensure adherence toudstandards to improve both the quality and credibility of the laboratory system within TB programmes. Corresponding attention must beudgiven to addressing human resources at every level of the laboratory, with special consideration being given to new programmes forudlaboratory management and leadership skills. Strengthening laboratory networks will also involve setting up partnerships between TBudprogrammes and those seeking to control other diseases in order to pool resources and to promote advocacy for quality standards, touddevelop strategies to integrate laboratories’ functions and to extend control programme activities to the private sector. Improving theudlaboratory system will assure that increased resources, in the form of supplies, equipment and facilities, will be invested in networksudthat are capable of providing effective testing to meet the goals of the Global Plan to Stop TB.