All Title Author
Keywords Abstract


Population-Based Tuberculosis Disease Prevalence Survey in Ghana: The Role and Lessons Learnt from the Laboratory

DOI: 10.4236/jtr.2019.72009, PP. 95-108

Keywords: Prevalence Survey, Tuberculosis Laboratory, Lessons Learnt, Ghana

Full-Text   Cite this paper   Add to My Lib

Abstract:

Background: Bacteriologically-confirmed tuberculosis (TB) cases used in calculating TB prevalence in a country are obtained through laboratory examination of sputum specimens. Objective: This article describes laboratory processing of specimens, results overview, conclusions and key lessons learnt from the perspective of laboratory personnel involved in the conduct of TB disease prevalence survey in Ghana in 2013. Methods: Symptoms screening and Chest X-ray suggestive of TB were used to select participants who produced sputum to confirm TB cases using microscopy, culture and Xpert® MTB/RIF assay (GeneXpert). Results: A total of 15,935 single and paired sputum specimens were received from eligible participants. About half of Ziehl-Nielsen (129/263) and Auramine O (122/246) stained smear positives were scanty positive. Culture positivity rate for Mycobacterium tuberculosis complex was 266/14,994 (1.7%) and 100/15,179 (0.7%) in Mycobacterial Growth Indicator Tube (MGIT) and Lowenstein-Jensen (LJ) media respectively; while non-tuberculous mycobacterium was 294/14,994 (1.96%) and 167/15,179 (1.1%). Total contamination rates in MGIT (5.4%) were higher than in LJ (1.7%). Prevalence of smear positive TB and bacteriologically confirmed TB among adult population (≥15 years) was estimated at 111 (95% CI: 76 - 145) and 356 (95% CI: 288 - 425) per 100,000 population respectively. Conclusions and Lessons Learnt: Direct supervision of specimen collection by well-trained laboratory personnel, timely transportation of specimens from field to laboratory, prompt specimen processing and use of electronic data management systems are essential for a reliable TB disease prevalence survey data. More importantly, strengthening human and logistical capacity of the laboratory must be of utmost priority.

References

[1]  World Health Organization (2014) Global Tuberculosis Report.
https://www.who.int/tb/publications/global_report/gtbr14_executive_summary.pdf
[2]  World Health Organization (2015) Global Tuberculosis Report, 2015.
http://apps.who.int/iris/bitstream/10665/191102/1/9789241565059_eng.pdf
[3]  World Health Organization (2013) Global Tuberculosis Report, 2013.
http://apps.who.int/iris/bitstream/10665/91355/1/9789241564656_eng.pdf
[4]  World Health Organization (2010) Tuberculosis Prevalence Surveys: A Handbook. 2nd Edition, Geneva, 324.
[5]  Kebede, A.H., Alebachew, Z., Tsegaye, F., Lemma, E., Abebe, A., Agonafir, M., et al. (2014) The First Population-Based National Tuberculosis Prevalence Survey in Ethiopia, 2010-2011. International Journal of Tuberculosis and Lung Disease, 18, 635-639.
https://doi.org/10.5588/ijtld.13.0417
[6]  Federal Republic of Nigeria (2014) Report: First National Tuberculosis Prevalence Survey 2012, Nigeria. Abuja.
[7]  Kapata, N., Chanda-Kapata, P., Ngosa, W., Metitiri, M., Klinkenberg, E., Kalisvaart, N., et al. (2016) The Prevalence of Tuberculosis in Zambia: Results from the First National Tuberculosis Prevalence Survey, 2013-2014. PLoS ONE, 11, e0146392.
https://doi.org/10.1371/journal.pone.0146392
[8]  Adetifa, I.M.O., Kendall, L., Bashorun, A., Linda, C., Omoleke, S., Jeffries, D., et al. (2016) A Tuberculosis Nationwide Prevalence Survey in Gambia, 2012. Bulletin of the World Health Organization, 94, 433-441.
https://doi.org/10.2471/BLT.14.151670
[9]  Kim, S.J. (2017) Laboratory Works in TB Prevalence Survey.
http://www.who.int/tb/advisory_bodies/impact_measurement_taskforce/meetings/prevalence_ survey/psws_lab_works_kim.pdf?ua=1
[10]  Abraham, P.R., Sharma, V.D. and Shivannavar, C.T. (2012) Diagnosis of TB from Smear & Culture Negative Sputum Specimens by IS 6110 Based PCR. Indian Journal of Medical Research, 135, 249-251.
[11]  Eang, M.T., Okada, K., Yamada, N., Satha, P., Ota, M., Saint, S., et al. (2014) Cross-Sectional Studies of Tuberculosis Prevalence in Cambodia between 2002 and 2011. Bulletin of the World Health Organization, 92, 573-581.
https://doi.org/10.2471/BLT.13.131581
[12]  Law, I., Sylavanh, P., Bounmala, S., Nzabintwali, F., Paboriboune, P., Iem, V., et al. (2015) The First National Tuberculosis Prevalence Survey of LFM PDR (2010-2011). Tropical Medicine & International Health, 20, 1146-1154.
https://doi.org/10.1111/tmi.12536
[13]  Qadeer, E., Fatima, R., Yaqoob, A., Tahseen, S., Ul Haq, M., Ghafoor, A., et al. (2016) Population Based National Tuberculosis Prevalence Survey among Adults (> 15 Years) in Pakistan, 2010-2011. PLoS ONE, 11, e0148293.
https://doi.org/10.1371/journal.pone.0148293
[14]  Hoa, N.B., Sy, D.N., Nhung, N.V., Tiemersma, E.W., Borgdorff, M.W. and Cobelens, F.G. (2010) National Survey of Tuberculosis Prevalence in Vietnam. Bulletin of the World Health Organization, 88, 273-280.
https://doi.org/10.2471/BLT.09.067801
[15]  Chihota, V.N., Grant, A.D., Fielding, K., Ndibongo, B., van Zyl, A., Muirhead, D. and Churchyard, G.J. (2010) Liquid vs. Solid Culture for Tuberculosis: Performance and Cost in a Resource Constrained Setting. International Journal of Tuberculosis and Lung Disease, 14, 1024-1031.
[16]  Lee, J.J., Suo, J., Lin, C.B., Wang, J.D., Lin, T.Y. and Tsai, Y.C. (2003) Comparative Evaluation of the Bactec MGIT 960 System with Solid Medium for Isolation of Mycobacteria. International Journal of Tuberculosis and Lung Disease, 7, 569-574.
[17]  Muyoyeta, M., Schaap, J.A., De Haas, P., et al. (2009) Comparison of Four Culture Systems for Mycobacterium tuberculosis in the Zambian National Reference Laboratory. International Journal of Tuberculosis and Lung Disease, 13, 460-465.
[18]  Kent, P.T. and Kubica, G.P. (1985) Public Health Microbiology, a Guide for the Level III Laboratory. Centers for Disease Control, Division of Laboratory Training and Consultation, US Department of Health and Human Services, US Government Printing Office, Atlanta.

Full-Text

comments powered by Disqus