Scale-up of tuberculosis laboratory services in Gujarat, India.

ABSTRACT

M. tuberculosis has been classified as risk group 3 pathogen and has to be handled at appropriate containment level. The IRL, Ahmedabad got WHO accreditation in March 08 for Lowenstein-Jensen solid culture and first line anti-tuberculosis drug sensitivity. Immediately after WHO endorsement of line probe assay (LPA) for rapid MDR-TB testing in 2008, Gujarat state leaped forwarded and started research on “Genotype MTB DR Plus assay” in collaboration with WHO. In 2009 this effort gained momentum when the IRL, Ahmedabad was radically upgraded to BSL 3 facility. BSL 3 facility like this can balance risk of air-borne infection. As a minimum, countries embarking on drug-resistant tuberculosis programmes should establish laboratory capacity to diagnose MDR-TB and monitor culture conversion of patients on Category IV treatment. Gujarat has set the example of a truly dynamic tuberculosis management, demonstrating that rapid scale-up of laboratory services for MDR-TB diagnosis is feasible even at regional level, in resource-constrained settings.