A novel sputum transport solution eliminates cold chain and supports routine tuberculosis testing in Nepal

DOI

10.1016/j.jegh.2016.04.002How to use a DOI?

Keywords

Culture contamination; Long-term sputum transport; OMNIgene SPUTUM

Abstract

This preliminary study evaluated the transport reagent OMNIgene SPUTUM (OMS) in a real-world, resource-limited setting: a zonal hospital and national tuberculosis (TB) reference laboratory, Nepal. The objectives were to: (1) assess the performance of OMS for transporting sputum from peripheral sites without cold chain stabilization; and (2) compare with Nepal’s standard of care (SOC) for Mycobacterium tuberculosis smear and culture diagnostics. Sixty sputa were manually split into a SOC sample (airline-couriered to the laboratory, conventional processing) and an OMS sample (OMS added at collection, no cold chain transport or processing). Smear microscopy and solid culture were performed. Transport was 0–8 days. Forty-one samples (68%) were smear-positive using both methods. Of the OMS cultures, 37 (62%) were positive, 22 (36%) were negative, and one (2%) was contaminated. Corresponding SOC results were 32 (53%), 21 (35%), and seven (12%). OMS “rescued” six (i.e., missed using SOC) compared with one rescue using SOC. Of smear-positives, six SOC samples produced contaminated cultures whereas only one OMS sample was contaminated. OMS reduced culture contamination from 12% to 2%, and improved TB detection by 9%. The results suggest that OMS could perform well as a no cold chain, long-term transport solution for smear and culture testing. The findings provide a basis for larger feasibility studies.

Copyright

© 2016 Ministry of Health, Saudi Arabia, Production and hosting by Elsevier Ltd.

Open Access

This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/)

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TY  - JOUR
AU  - Bhagwan Maharjan
AU  - Bhabana Shrestha
AU  - Alexandra Weirich
AU  - Andrew Stewart
AU  - Cassandra D. Kelly-Cirino
PY  - 2016
DA  - 2016/04/27
TI  - A novel sputum transport solution eliminates cold chain and supports routine tuberculosis testing in Nepal
JO  - Journal of Epidemiology and Global Health
SP  - 257
EP  - 265
VL  - 6
IS  - 4
SN  - 2210-6014
UR  - https://doi.org/10.1016/j.jegh.2016.04.002
DO  - 10.1016/j.jegh.2016.04.002
ID  - Maharjan2016
ER  -