Status of Laboratory Diagnosis on Tuberculosis, Taiwan, 2015

Status of Laboratory Diagnosis on Tuberculosis, Taiwan, 2015

Tuberculosis (TB) has the highest annual mortality and incidence among the National Notifiable Communicable Diseases in Taiwan. Timely diagnosis, proper treatment and effective public health management are essential components for TB control. Taiwan Centers for Diseases Control (Taiwan CDC) implemented the “Mobilization Plan to Halve Tuberculosis Incidence in Ten Years＂. The incidence of new TB cases has declined from 72.5 to 45.7 per 100,000 populations from 2005 to 2015. Approximately 40% of the annual new cases' sputum smear was positive for TB and 80% of that has bacteriological evidence. The laboratory service for TB diagnosis is organized in a 3-tiered infrastructure: the Taiwan CDC reference laboratory, accredited laboratories, and primary laboratories. Taiwan CDC implemented an authorization policy and 33 clinical laboratories were accredited in 2015. Of the 33 laboratories, 31 and 26 laboratories provide drug susceptibility testing and molecular testing, respectively. Based on a questionnaire survey conducted at hospitals above the regional level in 2015, 7 Taiwan CDC contracted TB laboratories examined approximately 30% of all specimens. Furthermore, by monitoring external quality indicators, conducting training, carrying out on-site visits, implementing internal quality control and self-management in clinical laboratories, the laboratory service system has made great progress and can serve as cornerstone for future TB elimination.