The National Tuberculosis Reference Laboratory (NTRL) of the Research Institute for Tropical Medicine (RITM) convened the Tuberculosis (TB) Culture Laboratory Network together with their Regional TB Laboratory Coordinators through the third Convectus last June 20-23, 2023 at Midas Hotel, Pasay City.
This marked the return of the annual Convectus from its hiatus since 2020 because of the COVID-19 pandemic.
With this year’s theme, “Convectus 20-23: Leveraging lessons learned, transcending to a TB-free tomorrow”, the national convention covered the experiences of the different TB Culture Laboratories (TBCLs) from 2020-2023 and provided high-quality technical assistance to further strengthen the network and its response to challenging times.
46 participants from 16 Department of Health (DOH) Centers for Health Development (CHD) and 29 TBCLs participated in Convectus 20-23 which consisted of lecture discussions and interactive workshops concerning TBCL operations.
RITM Officer-in-Charge Director Atty/Dr. Ana Liza Hombrado-Duran formally opened the convention, remarking how NTRL, through Convectus, fulfills its mandate by supporting the different TBCLs, unifying and strengthening the network, and carrying all as one network towards the end goal: a TB-free Philippines.
Launching of the Reference Guide and Compendium of Standard Requirements
One of the highlights of the national convention was the launching of the Reference Guide and Compendium of Standard Requirements in Establishing TB Laboratories on June 21, 2023.
In his key message, USAID TB Innovations and Health Systems Strengthening (TBIHSS) Project – Family Health International (FHI) 360 Country Director / Chief of Party Dr. Soliman Guirgis explained that the document serves as a comprehensive guide which provides a systematic compilation of available information and technical and regulatory requirements in putting up a TB laboratory in the country.
“The development of this compendium is a [testament] to our collaborative spirit, shared vision, and unwavering commitment to improve diagnostic capabilities and patient outcomes. It is a valuable resource that will empower laboratory professionals; strengthen their knowledge; and, enhance their capacity to deliver accurate and reliable TB testing service” said Dr. Guirgis.
FHI 360 Emerging Infectious Diseases and Health Security Director Janet Robinson shared the highlights and the major categories detailed in the document that will reinforce the standards and consistency across the TB laboratories in the network.
The Compendium was made possible through the collaboration among NTRL, USAID TBIHSS Project, FHI 360, DOH Disease Prevention and Control Bureau (DPCB), Health Facilities and Services Regulatory Bureau (HFSRB), select CHD, and regional TB laboratories.
It was symbolically handed over by Dr. Guirgis and Dr. Robinson to Atty./Dr. Hombrado-Duran and NTRL Head Dr. Ramon Basilio.
Leveraging lessons learned
Dr. Basilio kickstarted the lecture discussions as he enumerated the achievements of the TB Laboratory Network with reference to the 2018-2022 Philippines TB Laboratory Network Strategic Plan (LNSP).
He reiterated its four objectives — (1) increasing access to quality-assured TB laboratory services, (2) sustaining operations of TB laboratories, (3) strengthening TB laboratory quality management systems, and (3) improving utilization of TB laboratory information and conduct of research — the roadblocks, and the actions taken to fulfill targets.
Dr. Basilio ended his talk with the way forward, highlighting the transition to the Philippine Acceleration Action Plan for TB and the possibility of developing another TB LNSP.
The second discussion was led by NTRL Research Management Section Program Officer Mr. Joseph Bascuña. He gave a summary of the operational research (OR) using the drug-resistant TB regimen composed of Bedaquiline, Pretomanid and Linezolid (BPaL), and the transition to its programmatic use.
Mr. Bascuña also briefed the participants on how NTRL is working on expanding drug susceptibility testing (DST) capacity within the TB laboratory network in line with the transition.
Laboratory Network Strengthening Section Program Officer Ms. Paola Arbilo discussed the final lecture of the day providing inputs on enhancing mechanisms for TB culture and DST specimen referral.
“A reliable specimen referral plays a crucial role in facilitating access to laboratory services and allows patients to receive comprehensive care and treatment in a single occasion,” explained Ms. Arbilo.
The lecture discussions were continued the following day, starting with a refresher on solid TB culture processing led by NTRL Learning and Development Section Science Research Specialist Ms. Arcdel Urcia.
In this session, Ms. Urcia reviewed the participants on specimen processing and subculture key points so these can be applied by TB culture laboratory staff in improving their performance.
NTRL Laboratory Network Strengthening Section Monitoring and Evaluation Lead Ms. Brassicae Mabansag then presented feedback from the desktop analysis of TB laboratory network data.
She showed different trends on TB laboratory testing, including gaps and accomplishments. Ms. Mabansag ended her talk with recommendations on how TB laboratory performance can be improved based on findings from the desktop analysis.
Lastly, other pertinent TB laboratory network updates were discussed with topics on the revised NTRL specimen acceptance and rejection guidelines by NTRL Laboratory Services Section Quality Assurance Unit Head Ms. Catherine Ann Sacopon, and training advisories by Learning and Development Section Head Mr. Louis Olazo.
Transcending to a TB-free tomorrow
Two (2) interactive workshops were facilitated in between the lecture discussions with the objective of (1) improving specimen referral mechanisms for TB Culture and DST and (2) analyzing laboratory performance indicators (LPI) and planning for continual improvement.
During each workshop, the participants were divided into four (4) breakout groups, each one supervised by a lead facilitator from the NTRL Laboratory Network Strengthening Section: Ms. Sheena Jennifer Lee, Mr. Vince Carlo Carandang, Ms. Ray Anne Bianca Barkin, and Ms. Paola Arbilo.
At the end of the workshops, the participants were able to assess their existing TB culture and DST specimen referral systems, describe their laboratory performance using indicators measured quarterly, and develop action plans to enhance specimen referral mechanisms, and improve laboratory performance. Alternate laboratories were also identified as part of the contingency plan for each region.
Certificates of appreciation acknowledging the efforts of all TBCLs during the COVID-19 pandemic were also awarded during the convention. Recognition was given by Dr. Basilio and Philippine Business for Social Progress (PBSP) ACCESS TB Project Director Mr. Arnyl Araneta to TB laboratories that demonstrated good performance on TB culture (TBC), phenotypic DST (pDST) and genotypic DST (gDST):
- Sterling TB Laboratory Performance (silver award):
- Ilocos Training and Regional Medical Center (TBC)
- Jamelarin Hospital (TBC)
- Davao Regional Medical Center (TBC)
- Batangas Medical Center (TBC)
- National TB Reference Laboratory – Laboratory Services Section (TBC)
- Davao TB Reference Laboratory (TBC)
- Cebu TB Reference Laboratory (pDST)
- Western Visayas Medical Center (pDST and gDST)
- Exemplary TB Laboratory Performance (gold award):
- Cagayan de Oro Polymedic Medical Plaza (TBC)
- Ospital ng Palawan (TBC)
- Caraga CHD Regional TB Laboratory (TBC)
- Davao TB Reference Laboratory (gDST)
- Zamboanga City Medical Center (gDST)
The convention concluded with a discussion of the synthesis and agreements led by NTRL Laboratory Network Strengthening Section Officer-in-Charge Mr. Earl Christian Mantes, and closing remarks from Dr. Basilio.
Dr. Basilio thanked the different TBCLs, Regional TB Laboratory Coordinators, and all development partners for making Convectus 20-23 possible, and their contribution in achieving the vision of a TB-free Philippines, while Mr. Mantes teased the resumption of the yearly gathering.
“See you all again at Convectus 2024,” quipped Mr. Mantes.
The first Convectus was held in 2018, and was followed in 2019. The third one, Convectus 20-23, is supported by the PBSP ACCESS TB Project and USAID TBIHSS Project/FHI 360.
by Allenor R. Enciso and Earl Christian P. Mantes