title: Are sputum samples of retreatment tuberculosis reaching the reference laboratories? A 9-year audit in Tanzania.
abstract: METHODS
  One reference and three zonal laboratories and 500 health facilities managing retreatment tuberculosis (TB) patients in Tanzania.
  
  
  OBJECTIVE
  The National Tuberculosis and Leprosy Programme (NTLP) requires that all notified cases of retreatment TB in Tanzania have sputum samples sent for culture and drug susceptibility testing (DST). This study determined 1) if the number of annually notified retreatment patients corresponded to the number of sputum samples received by the reference laboratories, and 2) the number of culture-positive samples and the number of cases undergoing DST.
  
  
  METHODS
  Nine-year audit of country-wide programme data from 2002 to 2010.
  
  
  RESULTS
  Of the 40 940 retreatment TB patients notified by the NTLP, 3871 (10%) had their sputum samples received at the reference and zonal laboratories for culture and DST. A total of 3761 (97%) sputum samples were processed for culture, of which 1589 (42%) were found to be culture-positive and 1415 (89%) had DST performed.
  
  
  CONCLUSIONS
  There is a >90% shortfall between notified retreatment cases and numbers of sputum samples received, cultured and assessed for DST at reference and zonal laboratories. Steps needed to address this problem are discussed.
authors.affiliation: National Institute for Medical Research, Muhimbili Medical Research Centre, Dar es Salaam, Tanzania ; Centre for International Health, University of Bergen, Norway.
authors.forename: A M
authors.initials: AM
authors.lastname: Kilale
authors.affiliation: National Institute for Medical Research, Muhimbili Medical Research Centre, Dar es Salaam, Tanzania.
authors.forename: B J
authors.initials: BJ
authors.lastname: Ngowi
authors.affiliation: National Institute for Medical Research, Muhimbili Medical Research Centre, Dar es Salaam, Tanzania.
authors.forename: G S
authors.initials: GS
authors.lastname: Mfinanga
authors.affiliation: National Tuberculosis and Leprosy Program, Dar es Salaam, Tanzania.
authors.forename: S
authors.initials: S
authors.lastname: Egwaga
authors.affiliation: National Tuberculosis and Leprosy Program, Dar es Salaam, Tanzania ; National Tuberculosis and Leprosy Program, Central TB Reference Laboratory, Dar es Salaam, Tanzania.
authors.forename: B
authors.initials: B
authors.lastname: Doulla
authors.affiliation: International Union Against Tuberculosis and Lung Disease (The Union), New Delhi, India.
authors.forename: A M V
authors.initials: AM
authors.lastname: Kumar
authors.affiliation: Médecins Sans Frontières, Addis Ababa, Ethiopia.
authors.forename: M
authors.initials: M
authors.lastname: Khogali
authors.affiliation: Institute of Tropical Medicine, Antwerp, Belgium.
authors.forename: J
authors.initials: J
authors.lastname: van Griensven
authors.affiliation: The Union, Paris, France ; London School of Hygiene & Tropical Medicine, London, UK.
authors.forename: A D
authors.initials: AD
authors.lastname: Harries
authors.affiliation: Médecins Sans Frontières (MSF), Brussels Operational Center, Luxembourg.
authors.forename: R
authors.initials: R
authors.lastname: Zachariah
authors.affiliation: Centre for International Health, University of Bergen, Norway.
authors.forename: S G
authors.initials: SG
authors.lastname: Hinderaker
keywords: DST; Tanzania; operational research; retreatment TB; sputum