Tuberculosis is the No. 1 killer among communicable diseases in the Western Pacific Region. Although TB has long been curable, every year around 2 million people in the Region and 9 million worldwide develop the disease. In Viet Nam, about 100,000 people develop TB and 20,000 succumb to the disease annually. Although Viet Nam achieved the global targets for case detection and cure in 1997, there has been no decline in the number of TB cases reported each year.
Serious challenges lie ahead. Neglect of laboratories has made them the weakest link in the chain of TB control, causing a range of problems from low morale to incorrect results. Laboratories are often underrated by programme managers, disregarded by doctors and forgotten by donors and others providing funds. Yet the laboratory is the foundation of TB control.
"High quality and appropriate diagnostic tools are absolutely critical for effective TB control and more must be done in Viet Nam to equip laboratories with the right tools to face the challenges that lie ahead," said Dr. Jean-Marc Olivé, WHO Representative in Viet Nam. "The rapidly changing field of TB diagnostic tests cannot be ignored any longer," he added.
In Viet Nam, a few pilot project areas have implemented an effective and reliable sputum smear quality control system. Efforts are now underway by the National Hospital of Tuberculosis and Respiratory Diseases to expand the same system to the rest of the country within 2008.
Facing the threat of multidrug-resistant tuberculosis (MDR-TB) and the escalating HIV epidemic, Viet Nam is also planning a rapid scale-up in the number of hospitals where culture will be available, helping to improve access to quality TB care for those who need it. Culture is an essential step in identifying MDR-TB and determining the true scope of the problem. Similarly culture is needed to help diagnose TB in people with HIV/AIDS. Without it, thousands go undiagnosed and untreated. TB advances more rapidly in people with AIDS, leading to a very high mortality rate in persons co-infected with TB and HIV.
"Strengthening laboratories for better TB care will benefit a broad range of laboratory services, improving diagnosis and clinical follow-up of many conditions, including threats like Avian Influenza, and other serious infections," Olivé added. "Laboratories must optimize the use of current tools available which involves improving infrastructure, equipment, bio-safety measures, quality management systems and training. In addition, laboratory services and networks must be strengthened and upgraded. "