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This strategy incorporates wide ranging health system improvements, political commitment to improving TB programmes, improved TB laboratory services, free TB drugs for all TB patients, and accurate documentation and monitoring of TB diagnosis and treatment outcomes (WHO 2002).
Their adoption in the developing world for both diagnosis and monitoring of TB is, however, hindered by a lack of fluorescence microscopy equipment [2], [6], [14] generally due to the cost of the equipment and cost of maintenance.
Infrastructure to support therapeutic drug monitoring of TB drugs and PK data for antituberculosis drugs in Malawian adults are not available.
2 9 This is usually performed using the tuberculin skin test (TST) which fulfils two important functions: monitoring of TB transmission (by identifying individuals needing prophylaxis or clinical evaluation and treatment) and evaluation of the institution's infection control measures.
In this study ELISA results showed a good agreement with culture and this assay has been a pivotal tool for the diagnosis and cost-effective large scale monitoring of TB in this area.
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Information on drug-related harms is destined to become more important when newer medicines are used ahead of the completion of phase III trials; pharmacovigilance could be routinely integrated in the monitoring framework of TB [ 180].
Routine surveillance of drug resistance allows for proper treatment of all patients with tuberculosis and is critical for accurate planning, budgeting, and monitoring of tuberculosis and MDR-TB control activities.
We argue that in low income countries such as Laos, active monitoring of DOTS TB patients - not just routine drug delivery - is particularly essential as initial efforts to diagnose and treat patients with TB would be otherwise wasted.
2) Joint programme review meetings [13, 27, 48] for ensuring close monitoring of MDR-TB and health insurance programme (UHIS), identifying and addressing critical bottlenecks, and to remove inequities by strengthening the public sector and regulating the private sector, are to be convened by the local stewards [27, 49] at state and district levels.
Treatment monitoring of MDR-TB cases should be performed based on sputum smear and culture on a monthly basis [ 34].
Also, additional drug resistance profiles are required for management and treatment monitoring of MDR-TB patients for which currently no alternatives to culture-based DST have been endorsed.
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