Date Published: March 31, 2017
Author(s): Philip C. Onyebujoh, Ajay K. Thirumala, Amy Piatek.
The recent transition from the Millennium Development Goals to the Sustainable Development Goals highlights a major paradigm shift in the global fight against tuberculosis.1 The World Health Organization (WHO) End TB Strategy, approved by the World Health Assembly in 2014, calls for a 90% reduction in tuberculosis deaths and an 80% reduction in tuberculosis incidence rates by 2030, compared with 2015.2 Globally, tuberculosis death rates have dropped by 22%, and an estimated 49 million lives were saved between 2000 and 2015.3 In Africa, since 2000, the downward trends in tuberculosis prevalence, incidence and death rates are notable. Between 1990 and 2012, the Central African Republic, Egypt, Eritrea, Ghana, Malawi, Niger, Rwanda and Uganda were some of the best-performing countries, recording reductions of more than 50% in all three indicators. By contrast, Cameroon, Equatorial Guinea, Lesotho, Liberia, Mauritania, Sierra Leone, South Africa and Swaziland all more than doubled their 1990 rates for at least two of the above tuberculosis indicators.4
Public health laboratory organisational structures and services for the diagnosis of infectious diseases, including tuberculosis, are heterogeneous and suffer from several challenges in Africa.5,6 Assessment of the strengths, weaknesses, opportunities and threats regarding tuberculosis laboratory services provide possibilities for objective interventions at both the country and the regional level in Africa (Table 1).