Overview:
The NIMR-MMRC tuberculosis (TB) laboratory is a fully equipped state-of-the-art laboratory. Apart from standard TB-diagnostic methods like sputum smear microscopy after Ziehl-Neelsen staining and fluorescence microscopy, the laboratory performs solid culture using Löwenstein–Jensen medium (LJ) and liquid culture using BACTEC MGIT 960 system.
The diagnostic spectrum is completed by PCR based assays (Accu-probe, Line probe assays, GeneXpert MTB/RIF Assay and for detection and confirmation of Mycobacterium tuberculosis complex (MTBC) from culture by MPT64 antigen test (Capillia). As gold standard we perform drug susceptibility testing (DST) in liquid culture (BACTEC MGIT 960) using SIRE and PZA kits. The use of rapid methods such as Hain GenoType MTBDRplus and GeneXpert MTB/RIF Assay plays a crucial role for quick identification of MTBC and probing of resistance to rifampicin and isoniazid directly from sputum of TB-suspects.
Currently the laboratory have established and validated new methods for use in early bactericidal studies (EBA) and monitoring TB treatment response. These includes the colony count method in 7H10/7H11 media which was validated in the laboratory since 2011, and the Molecular bacterial load assay (MBL assay) which measures ribosomal RNA (16s RNA) specific to tuberculosis complex from sputum as surrogate marker to monitor TB treatment response has been established recently in 2014. Staff and Training: Every laboratory staff is trained according to the principles of Good clinical and laboratory practice (GCLP) as well as biosafety requirements. Continuing training the staff has been an important aspect to preserve and develop the knowledge and performance to our staff. Besides, MMRC TB lab provides its knowledge and competency to the community by providing training to laboratory staff from different health facilities in Mbeya. This training is mainly focused on sputum smear preparations, staining and AFB microscopy following the World health organization (WHO) recommendations. Theoretical training on culture based methods and rapid TB tests are part of the training.

Research:

Since the effective control of TB is based on rapid and accurate detection of TB bacilli, followed by the prompt implementation of adequate anti-tuberculosis therapy, TB lab (as part of NIMR-MMRC TB-Department) has interest on evaluation, performance and feasibility of new and rapid diagnostic methods for TB as well as new TB treatment regimens aimed at shortening TB treatments. The lab has a track record for evaluation of new diagnostic tests such as LAM in urine, trans-renal MTBC DNA, Line probe assays and Xpert MTB/RIF-assay in clinical trials. Likewise, the NIMR-MMRC TB Lab was part of the REMox TB trial that evaluated the use of moxifloxacine in a shortened standard TB- treatment regimen. The laboratory has also developed an EBA-facility to evaluate the bactericidal activity of new drugs to improve the treatment of TB and molecular methods useful for assessing TB treatment response at early stages of anti-tuberculosis therapy.

Current team members:

• Bariki Mtafya, BSc (Hons), MSc, Research Scientist and Co-Lab Manager

• Daniel Mapamba, BSc, Research Scientist and Co-Lab Manager

• Alice Shoo, BSc, Research Scientist

• Joseph John, BSc, Research Scientist

• Emanuel Sichone, BSc,Research Scientist

• Fred Njeleka, BSc. Research Scientist

• Johnisius O.Msigwa, BSc. Research Scientist

• Rahabu Mkoma, Diploma in Med. Lab Sciences, Lab Technician

• Husna Mbugi, Diploma in Med. Lab Sciences, Lab Technician

• Peter Tarmo, Diploma in Med. Lab Sciences, Lab Technician

• Isaya Wilson, Diploma in Laboratory Technology, Lab Technician

• Twasime Mwang’onda, Diploma in Med. Lab Sciences, Lab Technician

• Isaya Dickson, Diploma in Law, Lab Secretary