By ENNIO KUBLE
PNG needs properly-trained sputum microscopists if it is to effectively control the spread of tuberculosis (TB), the specialists said.
They said despite significant advancement in the world in its battle against the disease, it still claimed about 3,000 lives in PNG each year.
One specialist said the national TB programme detected only about 20% of the new sufferers each year and only about 60% of them were successfully treated.
“We should be detecting 70% and successfully treating 85%,” he told The National.
A senior clinician said early detection would improve successful treatment and urged the Government to send more sputum microscopists to the provinces.
“Sputum microscopy is essential in diagnosing patients who have infectious forms of TB, so that we can prioritise treatment,” he said.
He said that the 19 provincial laboratories and a number of district laboratories currently had only laboratory assistants.
He said district community health workers conducting the tests had only minimal training in diagnosing TB.
“Many laboratories throughout the country have been known for poor turnaround time for providing sputum test reports that delays treatment.
“The School of Medicine and Health Sciences offers a degree programme in laboratory science but the graduates do not like to work in the provincial and rural laboratories.
“As a result, we do not have adequate number of functional laboratories in the country,” he pointed out.
Other sources said the external quality assurance of sputum microscopy that required three types of assessment procedures showed that many laboratories were not performing to expectations.
Adding to the problem was the lack of provincial supervisory visits by the Central Public Health Laboratory, and lack of slides and re-agents in the laboratories.
“Provinces lacking adequate slides are using the same slides to examine more than one specimen which is dangerous because of high probability of falsely positive results,” one specialist said.
Meanwhile, another TB specialist said: “If patients do not have access to functional sputum microscopy centres, health workers will base their diagnosis of TB on clinical judgment or X-rays which can go wrong by as much as 50%-70%”.
“There may be over-diagnosis, and patients would be wrongly treated for TB when they do not have it,” he added.