Microbiology Laboratory, Epidemiology and Clinical Departments, National Institute for Infectious Diseases Lazzaro Spallanzani, Rome, Italy.
PLoS One. 2012;7(8):e44109. doi: 10.1371/journal.pone.0044109. Epub 2012 Aug 27.
Low-income countries with high Tuberculosis burden have few reference laboratories able to perform TB culture. In 2006, the Zanzibar National TB Control Programme planned to decentralize TB diagnostics. The Italian Cooperation Agency with the scientific support of the "L. Spallanzani" National Institute for Infectious Diseases sustained the project through the implementation of a TB reference laboratory in a low-income country with a high prevalence of TB. The implementation steps were: 1) TB laboratory design according to the WHO standards; 2) laboratory equipment and reagent supplies for microscopy, cultures, and identification; 3) on-the-job training of the local staff; 4) web- and telemedicine-based supervision. From April 2007 to December 2010, 921 sputum samples were received from 40 peripheral laboratories: 120 TB cases were diagnosed. Of all the smear-positive cases, 74.2% were culture-positive. During the year 2010, the smear positive to culture positive rate increased up to 100%. In March 20, 2010 the Ministry of Health and Social Welfare of Zanzibar officially recognized the Public Health Laboratory- Ivo de Carneri as the National TB Reference Laboratory for the Zanzibar Archipelago. An advanced TB laboratory can represent a low cost solution to strengthen the TB diagnosis, to provide capacity building and mid-term sustainability.
低收入国家结核病负担重，能够进行结核培养的参考实验室很少。2006 年，桑给巴尔国家结核病控制规划计划将结核病诊断工作分散化。意大利合作署在“L. Spallanzani”国家传染病研究所的科学支持下，通过在一个结核病高发的低收入国家建立结核病参考实验室来支持该项目。实施步骤如下：1）根据世界卫生组织标准设计结核病实验室；2）配备显微镜检查、培养和鉴定所需的实验室设备和试剂；3）对当地工作人员进行在职培训；4）基于网络和远程医疗的监督。从 2007 年 4 月到 2010 年 12 月，40 个周边实验室共收到 921 份痰样本：诊断出 120 例结核病病例。所有涂片阳性病例中，有 74.2%培养阳性。2010 年，涂片阳性与培养阳性的比例上升到 100%。2010 年 3 月 20 日，桑给巴尔卫生和社会福利部正式承认伊沃·德·卡内里公共卫生实验室为桑给巴尔群岛国家结核病参考实验室。一个先进的结核病实验室可以作为一种低成本的解决方案，加强结核病诊断，提供能力建设和中期可持续性。
