Regional Lab Strategy

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Regional Lab Strategy

• 11th NTP managers meeting Cairo - Egypt
• Dr. Samiha Baghdadi
• MO-STB
• WHO/EMRO

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Situation analysis-DSM

• Direct smear microscopy network usually is
  planned according to
• The estimated incidence rate of new positive
  smear. (one lab when EI is 50/100000)
• The workload the lab technician should be able
  to see positive slide each two days at least
  i.e.,
• Not less than 140 pos slide per year (280 working
  days)
• Not more than 15 per day for multipurpose lab
  technician
• The geographical distances
• Travel not more than 2 hours by car for two
  consecutive days/diagnosis

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NRL

• In the region there are 15 countries with NRL, 2
  without NRL, and 5 with no response (Bah, Kwt,
  Pal, Qtr, UAE).
• NRLs in four countries of the region (Egypt,
  Syria, SAA, and Tunisia) are doing supervision
  and training.

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Situation analysis-culture DST

• The questionnaire
• In the region there are 15 countries with NRL, 2
  without NRL, and 5 with no response (Bah, Kwt,
  Pal, Qtr, UAE).
• All of the 15 are doing culture and sensitivity.
• Four of the 15 NRL is responsible also of
  supervision and training.
• The global report
• The use of culture for routine diagnosis is done
  in all units in 7 countries Bahrain, Kuwait,
  Libya, Morocco, Oman, Qatar, and Tunisia.
• The use of culture for routine diagnosis is done
  in some units in 4 countries Iraq, Jordan, Saudi
  Arabia and UAE.
• The remaining countries do not use culture for
  routine diagnosis.
• Comment
• There should be one culture lab for each 5-10 M
• There should be facilities for specimens
  transportation.

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Situation analysis-EQA/Q
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Situation analysis-EQA/GR
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Strategic directions-1

• Technical capacity
• DSM
• Lab network 100 (inventory, needs)
• QA 100 (system, manual, maintenance plan)
• Training 100
• ME including supervision 100
• Culture DST 40 of population in 15 countries.
• Bio-safety 100 (SOP guidelines, plan)

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Strategic directions-2

• Resources (Human, financial) Plans, coordination
  between NTP/NRL, funds raising, staff development
  plan.
• Advocacy and partnership
• Supportive activities (new diagnostic tools, HSS)

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Objectives- by 2009

• All countries will achieve full coverage of TB
  laboratory services in in the region by 2009 as
  planned.
• All countries will have well-functioning QA
  programmes in all TB microscopy centres.
• At least 40 of the eligible population in 15 EMR
  countries will have access to culture and DST
  services.

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Objectives-by 2009

• All National reference laboratories (NRL) in the
  region will be linked with the Supranational
  Laboratories (SRL).
• Increase the number of the SRLs in EMRO.
• All countries will finalise at least one drug
  resistance survey.
• Engage all private laboratories in the region to
  report their data to the NTP.

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Work plan

• By mid 2007 Country lab plan, addressing lab
  network, EQA, Culture and sensitivity.
• By mid 2008 build capacity for DSM, Culture in
  all countries (full coverage lab network, EQA in
  place)
• By 2009 40 of population covered by culture and
  DST

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Work Plan
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Indicators

• Lab network
• Number of planned diagnostic laboratories
• Number of functioning diagnostic laboratories
• Population per lab
• No slides/suspect
• QA
• Coverage (QA implemented /planned)
• Functional (QA reports/planned)
• Concordance rate