Joining efforts to control two related global epidemics.

Associations between tobacco use and tuberculosis (TB) outcomes have long been suspected, but until recently the predominant view was that existing studies were not adequate to provide confirmation of any link. However, more recent studies and some recent reviews of existing studies have seemed to provide a better-evidenced link between active and passive tobacco smoking and a range of TB outcomes including infection, response to treatment, relapse rates and mortality.
This monograph was jointly prepared by WHO and The Union. A large number of international experts from various institutions and agencies were involved as contributors.

The World Health Organization recommends the DOTS strategy for tuberculosis (TB) control which has been adopted by many National Tuberculosis Programmes (NTPs). An effective TB control programme depends upon laboratories providing accurate, reliable, and timely detection of TB cases. Majority of smear positive cases that are infectious are detected with direct smear microscopy. Therefore, assuring high quality direct smear microscopy is the responsibility of TB control programmes and Ministries of Health working in partnership to provide training, support, and ongoing monitoring of testing in all levels of laboratories.
Acid-Fast Microscopy involves highly technical procedures and should follow standard methods developed by the international organizations. Recognizing that effective training is an important component of every NTP, WHO convened a workgroup with representatives from WHO, CDC, RIT, The Union, and APHL to develop standard materials that all countries could use to improve their training efforts.
Effective training for AFB direct smear microscopy requires a laboratory workshop that includes practical exercises with classroom presentations and discussions of the challenges and solutions for common problems. Therefore, these training materials are designed as a "workshop in a box" that includes all the presentations, exercises, and step by step guidance for convening and conducting a 4-5 day practical laboratory workshop. Implementation of this training will require a coordinated effort between the NTP and key partners to review, customize and adapt the materials to reflect the technical procedures and policies within each country.
Download the package
http://wwwn.cdc.gov/dls/ila/acidfasttraining/

The International Standards of Tuberculosis Care (ISTC) focuses on the contribution that good clinical care of individual patients and public-private collaborations make to TB control. A balanced approach emphasizing both patient care and public health is essential to reduce the suffering and economic losses from TB.

• Purpose: to describe a widely accepted level of care that all practitioners should seek to achieve in managing all patients
• Audience: all health care practitioners, public and private
• Scope: diagnosis, treatment, and public health responsibilities; intended to complement local and national guidelines
• Rationale: failure to reach goals in part relates to the failure to effectively engage all providers in providing high quality care and in collaborating with TB control programs

This document was developed by the Tuberculosis Coalition for Technical Assistance (TBCTA) in association with the following TBCTA Partners:

This training manual for trainers aims to help trainers conduct the practical training of Acid Fast Bacilli (AFB) microscopy. For this purpose, only the essential components of microscopy practice are described in the order of the training process and in the simplest and most practical manner. Also, This material will also help trainers and trainees to identify problems or weakness in their practice and determine ways to overcome them.
As a result, trainees should be able:

• To demonstrate uniform skills on smearing, staining and smear microscopy
• To demonstrate the proper manipulation and maintenance of the microscope
• To properly record and report results in the National Tuberculosis Programme (NTP) tuberculosis (TB) laboratory registry

This manual focuses on the more practical aspects of smear preparation and microscopy with a minimum of theory.
If you wish to receive a hard copy (CD-ROM included), please contact us.

A sturdy waterproof poster which shows, with illustrations, the good parts of the sputum to be smeared; examples of good and bad smears; good and bad staining, decolourisation and counterstaining; well and poorly stained AFB and their various appearances, and also some commonly met artifacts.
To order hard copies, please contact us. Offer available whilst stocks last. Printed and distributed with the grant support of the TBCTA, with funds from USAID.

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