title: Implementation of liquid culture for tuberculosis diagnosis in a remote setting: lessons learned.
abstract: Although sputum smear microscopy is the primary method for tuberculosis (TB) diagnosis in low-resource settings, it has low sensitivity. The World Health Organization recommends the use of liquid culture techniques for TB diagnosis and drug susceptibility testing in low- and middle-income countries. An evaluation of samples from southern Sudan found that culture was able to detect cases of active pulmonary TB and extra-pulmonary TB missed by conventional smear microscopy. However, the long delays involved in obtaining culture results meant that they were usually not clinically useful, and high rates of non-tuberculous mycobacteria isolation made interpretation of results difficult. Improvements in diagnostic capacity and rapid speciation facilities, either on-site or through a local reference laboratory, are crucial.
authors.affiliation: Médecins Sans Frontières, Manson Unit, London, UK. Pamela.hepple@london.msf.org
authors.forename: P
authors.initials: P
authors.lastname: Hepple
authors.forename: J
authors.initials: J
authors.lastname: Novoa-Cain
authors.forename: C
authors.initials: C
authors.lastname: Cheruiyot
authors.forename: E
authors.initials: E
authors.lastname: Richter
authors.forename: K
authors.initials: K
authors.lastname: Ritmeijer
mesh_terms: D001431:Bacteriological Techniques; D003470:Culture Media; D006801:Humans; D008853:Microscopy / Q000379:methods; D009169:Mycobacterium tuberculosis / Q000302:isolation & purification*; D012680:Sensitivity and Specificity; D013183:Sputum / Q000382:microbiology; D013397:Sudan; D013997:Time Factors; D014376:Tuberculosis / Q000175:diagnosis* / Q000382:microbiology; D014397:Tuberculosis, Pulmonary / Q000175:diagnosis* / Q000382:microbiology; D014944:World Health Organization
chemical_list: D003470:Culture Media