Presentation on theme: "Dr R Ramachandran 5 th Joint International Monitoring Mission to Review NTP Thailand 5th JMM Thailand."— Presentation transcript:
Dr R Ramachandran 5 th Joint International Monitoring Mission to Review NTP Thailand 5th JMM Thailand
Functional quality assured nationwide smear microscopy network (1081) Current 5 year plan for network of 66 culture labs, 32 FLDST labs is under progress, to be completed 2015 Second Line DST available (MGIT) at NTRL Bangkok (SRL) and Siriraj/Ramathibodi University Hospital (will need to be proficiency tested by NTRL /SRL Molecular diagnostics LPA (Hain – 12) (YD - 4) RT PCR (GeneXpert -14) (Seegene - 8) 5th JMM Thailand
National policy for sputum collection for diagnosis and follow-up during treatment not uniformly followed Quality of sputum, staining variable (volume, salivary specimen) Low smear positivity rate (use of kinyoun cold staining, low sensitivity of conventional light microscopy) Culture and DST facilities and molecular tools under- used for diagnosis and follow up of TB and DR TB Laboratory information systems not synchronized with clinical information systems Many laboratories outside DDC system perform TB diagnostics; not monitored or effectively included in policy dissemination Laboratories not accredited for TB diagnostic services (culture & DST) 5th JMM Thailand
Address sputum specimen quality, safety ◦ Strictly implement sputum collection policy (especially the 2 nd early morning specimen) ◦ Improve sputum quality by training and education of HCW and patients To improve smear microscopy sensitivity ◦ Replace Kinyoun cold staining with Ziehl-Neelsen staining ◦ Replace conventional microscopy with LED FM in appropriate settings Expand access and rational use of newer more sensitive molecular tools to improve case detection of all forms of TB including DR TB Optimally utilize the culture and DST facilities for management of TB and DR TB 5th JMM Thailand
Link the LMIS to electronic case record system and build capacity for analysis of laboratory indicators to improve performance and throughput Develop strategies to engage all laboratories with policy and quality standards, beyond DDC network Enhance quality supervision for EQA (smear) through NTRL/RRL Ensure that all laboratories providing TB diagnostic services are accredited 5th JMM Thailand
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