Volume 14, Number 5—May 2008
Perspective
Scale-up of Multidrug-Resistant Tuberculosis Laboratory Services, Peru
Sonya S. Shin*
, Martin Yagui†, Luis Ascencios†, Gloria Yale‡, Carmen Suarez‡, Neyda Quispe†, Cesar Bonilla‡, Joaquin Blaya§, Allison Taylor¶, Carmen Contreras#, and Peter Cegielski¶
, Martin Yagui†, Luis Ascencios†, Gloria Yale‡, Carmen Suarez‡, Neyda Quispe†, Cesar Bonilla‡, Joaquin Blaya§, Allison Taylor¶, Carmen Contreras#, and Peter Cegielski¶Table 4
Considerations for decentralized drug susceptibility testing (DST) capacity for first-line drugs, Peru
| Criterion | Ideal situation |
|---|---|
| Drugs to test | First-line DST; isoniazid and rifampin most important because empiric treatment regimen and further DST may follow |
| Reproducibility | Because drug-resistant samples identified by regional DST, then referred to National Reference Laboratory for DST to second-line drugs, sensitivity most important |
| Sample source | Direct method optimal for processing at local health clinic to minimize turnaround time |
| Cost per sample | Low cost |
| Time to obtain result | Rapid |
| Technical demand | Less technically demanding, less processing time |
| Biologic safety risk | Low biosecurity risk |
| Required equipment | Limited additional equipment (refridgerated centrifuge) procured and maintained in local site |
| Reagents and supplies | Commonly used reagents and supplies available through local vendors is preferable |
