利比里亚国家结核病控制规划实验室项目绩效。
The National Tuberculosis Control Programme of Liberia Laboratory Programme Performance.
机构信息
Department of Health Studies, University of South Africa, Pretoria, South Africa.
出版信息
J Environ Public Health. 2019 Jul 7;2019:5340263. doi: 10.1155/2019/5340263. eCollection 2019.
BACKGROUND
Tuberculosis (TB) is a major public health problem in Liberia. Little is known about the TB laboratory performance of Liberia and the challenges after the 14 years of civil war which ended in 2003. The purpose of the study was to evaluate the TB laboratory performance of Liberia.
METHODS
A cross-sectional study was conducted from 2014 to 2015. The study was conducted using quantitative data of TB case findings, sputum microscopy proficiency testing, and on-site assessment of sputum microscopy laboratories in Liberia. 80 laboratories participated in the proficiency testing. Besides, four years' (2012-2015) TB case finding data obtained from the National Leprosy and Tuberculosis Control Programme (NLTCP) were used to complement the study. The data were analysed using descriptive statistics.
RESULTS
From the 80 TB sputum microscopy testing laboratories participating in proficiency testing, only 20 (25%) scored acceptable performance. 46 (58%) TB microscopy laboratories reported quantification errors for the proficiency panel slide 6 which was 3+. The national TB smear-positive cases notified were 4342 in 2012 but decreased to 3820 and 2448 in 2013 and 2014, respectively. The TB smear case detection rate showed an increase from 68% in 2010 to 78% in 2011 and a decrease to 60%, 57%, and 42% in 2012, 2013, and 2014, respectively.
CONCLUSION
Between 2010 and 2013, the NLTCP succeeded in increasing the number of TB sputum microscopy laboratories. At most of the TB microscopy sites, the TB laboratory quality system was not implemented. The NLTCP of Liberia should develop strategies to overcome its challenges in TB laboratory testing.
背景
结核病（TB）是利比里亚的一个主要公共卫生问题。在 2003 年结束的 14 年内战之后，利比里亚的结核病实验室性能以及面临的挑战知之甚少。本研究的目的是评估利比里亚的结核病实验室性能。
方法
本研究于 2014 年至 2015 年进行了一项横断面研究。研究使用了利比里亚结核病病例发现、痰涂片显微镜检查能力验证和痰涂片实验室现场评估的定量数据。80 个实验室参加了能力验证。此外，还使用了国家麻风病和结核病控制规划（NLTCP）在 2012-2015 年获得的四年结核病病例发现数据来补充研究。使用描述性统计对数据进行分析。
结果
在参加能力验证的 80 个结核病痰涂片显微镜检测实验室中，只有 20 个（25%）的实验室得分可接受。46 个（58%）结核病显微镜实验室报告了能力验证板 6 上 3+的定量错误。2012 年全国登记的涂阳肺结核病例数为 4342 例，但在 2013 年和 2014 年分别下降至 3820 例和 2448 例。2010 年至 2011 年，利比里亚国家结核病控制规划（NLTCP）成功提高了结核分枝杆菌痰涂片镜检实验室的数量，结核分枝杆菌涂片检出率从 68%上升到 78%，而在 2012 年、2013 年和 2014 年分别下降到 60%、57%和 42%。
结论
在 2010 年至 2013 年期间，NLTCP 成功增加了结核分枝杆菌痰涂片镜检实验室的数量。在大多数结核分枝杆菌显微镜检查点，结核实验室质量体系没有得到执行。利比里亚的 NLTCP 应制定策略，克服结核实验室检测方面的挑战。
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