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Volume 23, Issue 3

Original Article

Implementation of External Quality Control for First Line Antituberculous Drug Susceptibility Testing: A Preliminary Study

İsmail Ceyhan
Affiliations
  • Refi k Saydam Hıfzıssıhha Merkezi Başkanlığı, Ulusal Tüberküloz Referans ve Araştırma Laboratuvarı, Ankara, Türkiye
,
Hülya Şimşek
Affiliations
  • Refik Saydam Hıfzıssıhha Merkezi Başkanlığı, Ankara, Türkiye
,
Gülnur Tarhan
Affiliations
  • Refi k Saydam Hıfzıssıhha Merkezi Başkanlığı, Ulusal Tüberküloz Referans ve Araştırma Laboratuvarı, Ankara, Türkiye
,
Uğur Güner
Affiliations
  • Refi k Saydam Hıfzıssıhha Merkezi Başkanlığı, Ulusal Tüberküloz Referans ve Araştırma Laboratuvarı, Ankara, Türkiye
  • antitubercular agents
  • Mycobacterium tuberculosis
  • quality control

Abstract

Objective: Antituberculous drug resistance is a major problem in ensuring the achievement of Tuberculosis Control Programs (TCP). World Health Organization (WHO) has stressed that the quality assurance for the Drug Susceptibility Tests (DST) used for obtaining confidential results and to form the true resistance profile should be ensured. Therefore, it was aimed that the quality control system for DST was established within the National TCP. 

Methods: Sixteen voluntary laboratories were included in the preliminary study with two rounds between 2005 and 2008. The panel tests containing 20 strains, which were approved for implementation by WHO Supranational Reference Tuberculosis Laboratory, were sent from our center to the participant laboratories.

Results: The test results reported by the laboratories were evaluated by making a classification scoring according to the WHO suggestions. Only 1 of 15 laboratories attained 100% success for streptomycin (SM), isoniazid (INH), rifampicin (RIF), and ethambutol (EMB) in terms of susceptibility, specificity, efficiency, and reproducibility. One laboratory’s rate was 100% for SM, INH, and RIF, while EMB was observed as ≥84.6%. The success rate of 7 laboratories for only INH and RIF was 100%, while that of another laboratory was detected as 88.8%. One laboratory showed ≥60% success for INH and RIF in the first round, whereas it increased to ≥75% in the second round. One laboratory did not send its results to our center.

Conclusions: The application of External Quality Control (EQC) is useful to measure the test standardization and efficiency of the laboratories performing DST. Therefore, it is necessary that all the laboratories performing DST are enforced to join the EQC programmes by law or by performance applications.

  • 110-115
  • 10.5152/kd.2010.30
  • July 23, 2019
  • 2038
  • 632
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  • This work is licensed under a Creative Commons Attribution-Non Commercial 4.0 International License. CC BY-NC
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