Inbuilt quality control for diagnosis and treatment

Damien Foundation has inbuilt quality control system to support TB detection and patient centered care for Drug sensitive and Drug resistant (DR-TB). Damien Foundation has an extensive well-trained network of diagnostic support for TB and Leprosy which is functional within the National system. The diagnosis and care continuously adopt the recent updates along with the global and national standards which includes Molecular Diagnosis (mWRD), Culture and Drug-sensitivity for diagnosis of TB.

The Damien Foundation Culture laboratory located at Netrakona district, started phenotypic culture in 2002 under close supervision of the Mycobacteriology laboratory of Institute of Tropical Medicine (ITM), Antwerp, Belgium. As a rapid tool, FDA staining and slide culture DST for detection of MDR TB was introduced as locally adaptable technology.

Since 2012, Gene Xpert machine was made available in all Damien foundation’s hospital-based laboratories. This technology can detect the presence of MTB in sputum specimen and the presence of Rifampicin resistance. Damien Foundation diagnostic network includes 82 Gene Xpert (MTB-RIF), 2 Xpert XDR, and 18 Trunat machines for TB diagnosis, mostly placed in Government premises.

Quality Assurance (QA) system for all other laboratories has been developed through a regular monitoring mechanism by the Reference laboratory at Netrakona, which is working with the technical support of SRL, Antwerp, Belgium. Samples are sent to Antwerp supra-national reference lab (SRL) for quality control of culture and DST and demonstrated quality performance in proficiency test. Netrakona laboratory has been serving at the central role for laboratory aspects of all researches and capacity development in Damien Foundation in Bangladesh.

Damien Foundation’s reference laboratory has also been serving as the external quality assessment site of skin smears from leprosy patients examined at other project laboratories. External Quality assessment (EQA) system for sputum microscopy and recently included EQA of mWRDs are functional according to National Protocol at all laboratories of Damien foundation supported area and the quality is closely monitored.

Damien foundation ensures patient centered care working closely with the community groups, TB survivors and informal providers (village doctors). Patient centered care and quality monitoring helps to improve treatment outcome.