Joloba Moses, Mwangi Christina, Alexander Heather, Nadunga Diana, Bwanga Freddie, Modi Nelson, Downing Robert, Nabasirye Agnes, Adatu Francis E, Shrivastava Ritu, Gadde Renuka, Nkengasong John N
College of Health Sciences, Makerere University National Tuberculosis Reference Laboratory.
Centers for Disease Control and Prevention (CDC)-Uganda.
J Infect Dis. 2016 Apr 15;213 Suppl 2(Suppl 2):S41-6. doi: 10.1093/infdis/jiw035.
Diagnosis of multidrug-resistant tuberculosis and prompt initiation of effective treatment rely on access to rapid and reliable drug-susceptibility testing. Efficient specimen transport systems and appropriate training on specimen referral contribute to optimal and timely access to tuberculosis diagnostic services.
With support and technical assistance from a public-private partnership (PPP) between Becton Dickinson and the US President's Emergency Plan for AIDS Relief, the Uganda National TB Reference Laboratory (NTRL) and National TB and Leprosy Program redesigned the tuberculosis specimen transport network and trained healthcare workers with the goal of improving multidrug-resistant tuberculosis detection.
Between 2008 and 2011, the PPP mapped 93% of health facilities and trained 724 healthcare and postal staff members covering 72% of districts. Strengthening the tuberculosis specimen referral system increased referrals from presumptive multidrug-resistant tuberculosis cases by >10-fold, with 94% of specimens reaching the NTRL within the established target transport time.
This study demonstrates the potential of PPP collaborations with ministries of health to positively influence patient care by strengthening laboratory systems through increased access to drug-susceptibility testing in Uganda. Ongoing efforts to integrate specimen transport networks will maximize resources and improve patient management.
耐多药结核病的诊断以及有效治疗的迅速启动依赖于快速可靠的药敏试验。高效的标本运输系统以及关于标本转诊的适当培训有助于最佳且及时地获得结核病诊断服务。
在贝克顿·迪金森公司与美国总统艾滋病紧急救援计划之间公私合营伙伴关系的支持与技术援助下，乌干达国家结核病参比实验室（NTRL）和国家结核病与麻风病防治计划重新设计了结核病标本运输网络，并对医护人员进行培训，目的是改善耐多药结核病的检测。
在2008年至2011年期间，该公私合营伙伴关系绘制了93%的医疗机构地图，并培训了724名医护和邮政工作人员，覆盖72%的地区。加强结核病标本转诊系统使疑似耐多药结核病例的转诊增加了10倍以上，94%的标本在既定的目标运输时间内送达国家结核病参比实验室。
本研究表明，公私合营伙伴关系与卫生部合作，通过在乌干达增加药敏试验的可及性来加强实验室系统，从而对患者护理产生积极影响。持续整合标本运输网络的努力将使资源最大化并改善患者管理。
