The Research Institute for Tropical Medicine – National Tuberculosis Reference Laboratory (RITM-NTRL) celebrates 17 years of conducting research, training, providing specialized laboratory services, and support to the Department of Health National Tuberculosis Program (DOH-NTP) for the control and elimination of Tuberculosis (TB) in the country.

For more than a decade, one of NTRL’s major contributions to TB control is its efforts in the expansion of the national TB laboratory network. This is composed of public and private laboratories that provide various TB diagnostic tests at different levels of the health system, following NTP protocols.

“The expansion of the TB lab network is a requirement in the diagnosis and treatment of TB patients. This network of labs provides access to quality  laboratory tests for TB detection, diagnosis and monitoring of treatment response. It also makes possible the provision of universal drug susceptibility testing to TB patients to determine the presence of resistance to TB drugs,” said RITM-NTRL Head Dr. Ma. Cecilia Ama as she emphasized the importance of establishing more laboratories, and implementing new diagnostics in the network.

As the laboratory arm of the NTP, NTRL oversees the expansion of the laboratory network. This began with planning at the central level among key stakeholders such as DOH NTP, National Center for Health Facilities Development,  Centers for Health Development, and the World Health Organization. Things considered included the availability, suitability, accessibility, and quality assurance of different diagnostic tests.

TB lab network expansion was rolled out in line with the Philippine Plan for Action to Control TB (PhilPACT) 2010-2015, and the Laboratory Network Strategic Plan (2013-2016). This is supported by the Global Fund.

Based on the plans, the regions were assessed as to the need for access to TB diagnostics to identify and select sites for TB lab network expansion. NTRL then provided capacity building activities to ensure that the laboratories will be able to provide quality diagnostic services.

In 2010, NTRL, then headed by Dr. Noel Macalalad, along with the RITM Biomedical Engineering Department has equipped engineers and medical technologists from 17 regions in designing and constructing a TB culture laboratory. To date, there are 28 established TB culture laboratories across the national laboratory network.

Towards the latter part of 2011, the semi-automated diagnostic test, Xpert MTB/RIF assay was rolled out in phases reaching a total of 323 laboratories nationwide. Dr. Ama mentioned that NTRL plans to increase this  number to over 1000 Xpert laboratories by 2022.

NTRL then rolled out the expansion of TB drug susceptibility testing (DST) among TB culture laboratories in 2016 through training, mentoring, monitoring, and provision of proficiency testing prior to officially starting their operations. The expansion resulted to nine established TB DST laboratories in the network as of date.

In the recent years, two molecular-based laboratories – the Line Probe Assay (LPA) laboratories were established – one in NTRL, and another in the Northern Mindanao TB Reference Laboratory in Cagayan de Oro. An additional  two LPA labs are to be established.

“We will ensure that the laboratories are maintained and that services as sustained because the long-term plan is to eliminate TB by 2035,” Dr. Ama ended.

Moving forward, NTRL continues to spearhead activities that will ensure the sustainability, and support the expansion of the TB laboratory network guided by the Laboratory Network Strategic Plan – a sub-plan of the Philippine Strategic TB Elimination Plan Phase 1 (PhilSTEP1 2019-2020).

by Allenor R. Enciso, Communication and Engagement Office