Timor-Leste is estimated to have the second-highest incidence of TB in the Asia-Pacific region with approximately 5700 new cases each year in its population of one million people. By comparison Australia has an estimated 1500 new cases each year. It is estimated that 720 people lose their lives to TB in Timor-Leste each year.
Rapid and accurate diagnosis of TB leads to effective treatment and better outcomes for patients. Currently, the diagnosis of TB in Timor-Leste relies solely on clinical assessment with microscopy examination of sputum. This has been the frontline test for TB since the bacterium was first identified in 1882 by Robert Koch.
Microscopy has significant limitations:
- It is not able to detect TB in all patients and therefore many TB cases are not diagnosed.
- It requires trained laboratory staff and quality control measures. The gold standard test for TB diagnosis is culture (i.e. grow Mycobacterium tuberculosis in a special TB laboratory).
Culture takes up to six weeks for a result and can confirm the diagnosis and determine if the TB organism is resistant to TB antibiotics. It is routine to perform culture on all TB samples in resource-rich countries such as Australia. TB culture is not available in Timor-Leste due to the specialised skills and infrastructure required. The rates of drug-resistant TB are therefore unknown which leads to delays in starting effective treatment for drug-resistant TB and to prolonged transmission of TB to others.
The World Health Organization (WHO) approved new technology called Xpert MTB/RIF test for the diagnosis of TB in 2010, and there has been considerable investment in rolling out this technology in resource-limited settings.
The Xpert MTB/RIF test is able to diagnose TB in a sample with greater accuracy than microscopy, is safe, easy to use and provides a result, including of drug- resistant TB, within two hours.
Xpert MTB/RIF equipment was purchased and installed at the National Health Laboratory in Dili, Baro Pite Clinic in Dili, and Klibur Domin in Liquiçá,
April 2015 – April 2019