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Background: India represents 3% related to the global malaria problem. Early diagnosis and treatment that are complete alongside preventive measures are modalities essential to managing the situation. Rapid diagnostic tests (RDTs) and polymerase chain reaction (PCR) that are malaria that is real-time be used to obtain an exceedingly really very early diagnosis in acutely febrile customers. Aims and Objectives: This study aims to gauge the effectiveness of RDT bloodstream that is utilized entire from clients clinically suspected of malaria and compare it with real-time PCR. Materials and Methods: The cross-sectional study is observationally done and made up of 158 patients admitted to Index Hospital, Indore, having a serious illness that is febrile and medical suspicion of malaria. RDT for malaria antigen and PCR that are real-time done in the bloodstream that is whole examples depending on kit guidelines. Results: There exists a difference that is significant the nice and examples which are negative by both techniques. RT-PCR is diagnostic PCR that is real-time RDT has been good in 62 (44%) clients, whereas, real-time PCR detected the parasite in 136 (91%) customers. RDT was in reality negative for malaria antigen in 16 (12.8%) consumers, in whom RT-PCR was good. RDT failed to identify Plasmodium falciparum antigen in RT-PCR samples that can be good. RT-PCR indicates basic greater sensitiveness (82.4–95% CI 79.2–84.5%) in diagnosing malaria set alongside the quick test is an antigen. The sensitiveness of RT-PCR in detecting P. falciparum had been also high (74.2%, 95% CI 71.4–77.2). This has greater specificity than RDT in detecting P. falciparum disease (91.3%, 95% CI 89.4–95.4) in detecting P. falciparum than RDT. Conclusion: RT-PCR has better efficacy to look for the presence of malaria parasites in acutely clients being febrile remain undiscovered by RDT. Therefore, it might be helpful for the verification of diagnoses and studies which are epidemiological.
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En diciembre 2019, en Wuhan, China, se registró un aumento inusual de casos de infección respiratoria aguda de rápida progresión y alta letalidad. Al poco tiempo es identificado el agente causal, un coronavirus denominado SARS-CoV-2 y se caracteriza una nueva enfermedad, COVID-19. En ausencia hasta el momento de tratamientos específicos, eficaces y seguros, se justifica explorar alternativas científicamente fundamentadas a nuestro alcance como el uso de Plasma de Convaleciente (PC-CoV19) como coadyuvante para el tratamiento de la COVID-19. El plasma de pacientes recuperados de una enfermedad infecciosa, Plasma de Convaleciente, ha sido utilizado en el tratamiento de patologías infecciosas. Hay antecedentes inmediatos de su uso en enfermedades producidas por otro tipo de coronavirus y se registran experiencias y estudios clínicos con resultados preliminares durante esta pandemia. Quimbiotec, empresa productora de hemoderivados y fármacos recombinantes del Estado venezolano, y el Banco Municipal de Sangre, definen un protocolo para promover condiciones para la aféresis, procesamiento, conservación, almacenamiento, distribución, transfusión y evaluación de la seguridad y eficacia del PC-CoV19 como alternativa en el tratamiento de la COVID-19 en Venezuela. Se incluye la identificación de capacidades y de talento, la estructura física, equipos y especialistas necesarios, así como la definición de procesos para establecer rutinas controladas y auditables para sentar bases del acceso y uso del PC-CoV19 en el Sistema Nacional de Salud de Venezuela y preparar el diseño y ejecución de estudios clínicos. Se presenta el Protocolo y algunos nudos críticos en su ejecución a la fecha, herramientas y estrategias utilizadas para su solución(AU)
On December 2019, in Wuhan, China, there was an unusual increase in cases of a fast-progressing acute respiratory infection with high fatality rate. Soon after, the causing agent is identiied, a coronavirus called SARS-CoV-2, and a new disease, COVID-19 is characterized. Currently, in the absence of specific, effective and safe treatments, it is justified to explore all scientifically based alternatives available to us, such as the use of Convalescent Plasma (PC-CoV19) as acoadjutant treatment of COVID-19.Plasma from patients who have recovered from an infectious disease, Convalescent Plasma, has been used in the treatment of other infectious disease. There is recent history of its use in diseases caused by another type of coronavirus, and clinical experiences and studies have already been published with preliminary results during this pandemic. Quimbiotec, a Venezuelan State public company that produces blood products and recombinant drugs, and Banco Municipal de Sangre, deined a protocol to promote conditions for aphaeresis, processing, conservation, storage, distribution, transfusion, and evaluation of safety and eficacy of PC-CoV19 as an alternative for the treatment of COVID-19 in Venezuela. This protocol includes identification of capacities, physical structure, equipment and skills, talent, professionals needed, as well as a definition of processes to establish controlled and auditable routines to lay the foundations for access and use of PC-CoV19 in the Venezuela Health System, and prepare the design and implementation of clinical studies. The protocol and currently critical points in its implementation, as well as tools and strategies used for its solution, are presented(AU)
Subject(s)
Humans , Plasma/immunology , Venezuela , Coronavirus Infections/prevention & control , Diagnostic Test ApprovalABSTRACT
Dengue fever is one of the most common arthropod-borne viral disease seen in humans. It is one of the major public health problems in developing countries including India. The signs and symptoms of dengue fever may range from moderate fever to thrombocytopenia, hemorrhagic manifestation and shock. Severe untreated cases may even prove to be fatal. The diagnosis of dengue fever may be made on the basis of detection NS1 antigen or IgM and IgG antibodies. This study was aimed at analyzing the sensitivity and specificity of RICT kit with ELISA for NS1 antigen and IgM, IgG detection so as to explore its suitability for regular use in any modest resource constrain laboratory or primary health center as a bedside test. Methods: This was a prospective cohort study conducted from August 2018 to Jan 2019 in a tertiary care private and teaching hospital. Informed written consent was taken from parents or caretakers of patients. The institutional ethical committee approved the study. Samples were collected during the acute phase of illness i.e. 1-5 days of fever. The samples were grouped into 2 categories according to the days of fever - 1-5days and 5-15 days. The NS1 Antigen, IgG and IgM antibodies tests were done by ELISA and ICT in all the cases. EDTA blood samples were collected & the platelet count was done. SSPE 21.0 software was used for statistical purpose. Results: A total of 200 blood samples were studied. Out of the 200 studied sample 132 (66%) belonged to male patients and remaining 68 (34%) belonged to female patients. The M: F ratio was found to be 1:0.51. Most common age group of the patients was between 4-10 years (66%) followed by 15-18 (14.5%) and 11-15 years (10.5%). The least common age group was found to be less than 4 years of age (9%). 102 (51%) patients were having platelet count of less than 1 lac/mm3. The analysis of blood samples for NS1 antigen positivity showed that out of 200 sample NS1 was positive in 51 (25.5%) patients by ELISA and 49 (24.5%) patients by ICT. IgG/IgM ELISA was positive in 81 (40.5%) samples whereas IgG/IgM ICT was positive in 79 (39.50%) samples. Presence of either NS1 antigen or IgG/IgM antibodies was positive in 122 (61%) by ELISA and 119 (59.50%) by ICT. The comparison of NS1 ELISA and NS1 ICT showed that the results were comparable for both the tests with no statistically significant difference (P>0.05). Similarly, there was no statistically significant difference in IgG/IgM ELISA and IgG/IgM ICT and a combination of NS1 and IgG/IgM by ELISA and ICT (P>0.05). Conclusion: Performance of rapid diagnostic tests to detect the presence of Dengue NS1 antigen & IgM & IgG antibodies to dengue virus in comparison to ELISA in present specimen was found to be satisfactory. Even though RDT is treated as screening test places where other advanced diagnostics are not available RDT can be used for the diagnosis of Dengue virus infection.
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ELISAs and rapid diagnostic tests (RDTs) are widely used for diagnosing dengue virus (DENV) infection. Using 138 single blood samples, we compared the ability to detect non-structural (NS)-1 antigen and anti-DENV IgM/IgG antibodies among (1) DENV Detect NS1 ELISA, DENV Detect IgM capture ELISA and DENV Detect IgG ELISA (InBios International, Inc.); (2) Anti-Dengue virus IgM Human ELISA and Anti-Dengue virus IgG Human ELISA (Abcam); (3) Dengue virus NS1 ELISA, Anti-Dengue virus ELISA (IgM) and Anti-Dengue virus ELISA (IgG) (Euroimmun); (4) Asan Easy Test Dengue NS1 Ag 100 and Asan Easy Test Dengue IgG/IgM (Asan Pharm); (5) SD BIOLINE Dengue Duo (Standard Diagnostics); and (6) Ichroma Dengue NS1 and Ichroma Dengue IgG/IgM (Boditech Med). For NS1 antigen detection, InBios and Euroimmun showed higher sensitivities (100%) than the RDTs (42.9–64.3%). All tests demonstrated variable sensitivities for IgM (38.1–90.5%) and IgG (65.7–100.0%). InBios and Boditech Med demonstrated higher sensitivity (95.6% and 88.2%, respectively) than the other tests for combined NS1 antigen and IgM antibody. Five NS1 antigen tests had good agreement (92.8–98.6%) without showing positivity for chikungunya. However, all IgG tests demonstrated potential false-positivity with variable ranges. Clinical laboratories should note performance variations across tests and potential cross-reactivity.
Subject(s)
Humans , Antibodies , Dengue Virus , Dengue , Diagnosis , Diagnostic Tests, Routine , Enzyme-Linked Immunosorbent Assay , Immunoglobulin G , Immunoglobulin MABSTRACT
Background and Objectives: The study aimed to evaluate the diagnostic performance of malaria through microscopy and rapid diagnostic test (RDT) analysis performed locally and the accuracy evaluated by nested polymerase chain reaction (PCR) for diagnosis of Plasmodium falciparum from hotspot regions of North East (NE) India. Materials and Methods: One thousand one hundred and seventy-three blood samples were collected for identification of P. falciparum infection using microscopy and RDT analysis. DNA was extracted from whole blood using QIAamp DNA blood mini kit, and nested PCR was performed to confirm P. falciparum for evaluating sensitivity and specificity from various epidemiological surveys and geographical areas of NE India. Results: Of 1173 symptomatic malaria suspected patients, 15.6% (183/1173) patients were diagnosed as malaria positive by RDT and 67.94% cases (53/78) with microscopy. Of 183 malaria-positive patients, 42.62% (78/183) were diagnosed with P. falciparum and 84.61% (66/78) further confirmed to be P. falciparum positive by nested PCR. High sensitivity (97.9%) and low specificity (2.03%) of the RDT and high sensitivity (99.1%) and low specificity (0.9%) in microscopy against nested PCR results was statistically significant (P < 0.05). Epidemiological comparisons expressed highest incidences in Manipur (51.11%) followed by Meghalaya (48.93%) and Assam (35.16%). Overall incidence rate among the genders was observed to be higher in males than in females. Conclusions: Our findings suggest that PCR, RDT and microscopy can potentially determine hotspots at moderate transmission intensities, but PCR testing has a diagnostic advantage as transmission intensity falls. Therefore, malaria control programs should consider PCR testing when the prevalence of infection is low.
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Cholera, caused by the Gram-negative bacterium Vibrio cholerae, has ravaged humanity from time immemorial. Although the disease can be treated using antibiotics along with administration of oral rehydration salts and controlled by good sanitation, cholera is known to have produced mayhems in ancient times when little was known about the pathogen. By the 21st century, ample information about the pathogen, its epidemiology, genetics, treatment and control strategies was revealed. However, there is still fear of cholera outbreaks in developing countries, especially in the wake of natural calamities. Studies have proved that the bacterium is mutating and evolving, out-competing all our efforts to treat the disease with previously used antibiotics and control with existing vaccines. In this review, the major scientific insights of cholera research are discussed. Considering the important role of biofilm formation in the V. cholerae life cycle, the vast availability of next-generation sequencing data of the pathogen and multi-omic approach, the review thrusts on the identification of suitable biofilm-inhibiting targets and the discovery of anti-biofilm drugs from nature to control the disease.
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Aims: This study compares the performance of routine malaria diagnostic tests, and explores the challenges of malaria diagnosis in paediatric patients in an endemic setting in South West Nigeria. Study Design: Cross sectional study Place and Duration of the Study: The study was conducted at the children’s outpatient and emergency units of the University College Hospital, Ibadan, Nigeria. Patients seen between May and August, 2013 were enrolled in the study. Methodology: The records of all 532 children aged six months to12 years who received treatment for an acute febrile illness at the hospital during the study period were reviewed. The proportion of children classified as having malaria by clinical diagnosis, Rapid Diagnostic Test (RDT) and blood smear microscopy were compared. Factors associated with test positivity were explored using multivariate analysis. Results: By clinical diagnosis 45.2% of children were diagnosed as having malaria, 37.6% tested positive to malaria parasite on RDT and 19.3% had positive blood smears on microscopy. Logistic regression showed that with RDTs, younger children were less often found to be positive than older children [OR: 0.594 (0.401-0.879)]. A similar lower probability of positivity was found for younger children on microscopy [OR0.624 (0.391-0.996)]. Positive smears were however recorded 3.9 times more often for those who gave a history of fever compared to those who did not [OR: 3.882 (1.154- 13.057)]. Conclusion: The true malaria morbidity among these paediatric patients remains questionable due to the differences in the results produced by the different diagnostic methods. The clinical implication of RDT-positive but microscopy-negative samples may be grave if microscopy results are erroneous. Quality control systems and surveillance of routine malaria diagnostics are imperative to limit misdiagnosis of malaria in this endemic setting.
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Background: Morbidity and mortality resulting from malaria remains a serious obstacle for social and economic development. Accurate diagnosis and prompt treatment are therefore essential components of case management strategy. The aim of this study therefore was to examine the diagnostic procedure of uncomplicated malaria, and patients’ understanding and satisfaction of treatment in Community Health Care Facilities, three years after the deployment of Malaria Rapid Diagnostic Tests in Ghana. Methodology: A prospective and data collation was done randomly, by means of cluster and stratified multistage surveyat three government hospitals and three private pharmacies in Kumasi, Ghana, between July and September, 2013. Patients treated for uncomplicated malaria, while leaving the health facility, upon consent, were selected and requested to answer questionnaires which served as a source of data to address the objective of the study. Bivariate statistics from the SPSS v 19 was employed to predict the relationships between health institutions and mode of diagnosis, patients’ understanding and satisfaction of services. Results: Fifty-three (53) out of 65 patients responded. The study indicated presumptive diagnosis [44 (83.0%)] to be predominantly used over test-based diagnosis [9 (17.0%)]. The mean age of patients was 34.44±14.8 years (Range 17-66). Out of 52 patients who provided information on educational level, those with tertiary education were 24 (46.2%), secondary were 9 (17.3%), primary were 14 (26.9%) and no formal education were 14 (26.9%). Male patients were 25 (47.2%) and female 28 (52.8%). All 53 patients were given Artemisinin-based Combination Therapy at the various health facilities. Of 35 patients at hospitals/clinics, 15 (42.9%) rated “very good value” to explain their understanding and satisfaction of services provided, and of 18 patients from private pharmacies, 10 (55.6%) rated as “very good value”. Patients with tertiary education [14/25 (56.0%)] showed better understanding and satisfaction of services than those with no formal education [1/25 (4.0%)]. Not a single use of Malaria Rapid Diagnostic Tests for diagnosis was recorded. Conclusion: Diagnosis of malaria at the periphery of health systems is still mainly presumptive three years after deployment of the Malaria Rapid Diagnostic Test. Patients’ good rating on the diagnosis of uncomplicated malaria at private pharmacies, should be an advantage to introducing the Malaria Rapid Diagnostic Tests by healthcare practitioners.
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<p><b>OBJECTIVE</b>To establish the appropriateness of malaria case management at health facility level in four districts in Zambia.</p><p><b>METHODS</b>This study was a retrospective evaluation of the quality of malaria case management at health facilities in four districts conveniently sampled to represent both urban and rural settings in different epidemiological zones and health facility coverage. The review period was from January to December 2008. The sample included twelve lower level health facilities from four districts. The Pearson Chi-square test was used to identify characteristics which affected the quality of case management.</p><p><b>RESULTS</b>Out of 4 891 suspected malaria cases recorded at the 12 health facilities, more than 80% of the patients had a temperature taken to establish their fever status. About 67% (CI 95 66.1-68.7) were tested for parasitemia by either rapid diagnostic test or microscopy, whereas the remaining 22.5% (CI 95 21.3.1-23.7) were not subjected to any malaria test. Of the 2 247 malaria cases reported (complicated and uncomplicated), 71% were parasitologically confirmed while 29% were clinically diagnosed (unconfirmed). About 56% (CI 95 53.9-58.1) of the malaria cases reported were treated with artemether-lumefantrine (AL), 35% (CI 95 33.1-37.0) with sulphadoxine-pyrimethamine, 8% (CI 95 6.9-9.2) with quinine and 1% did not receive any anti-malarial. Approximately 30% of patients WHO were found negative for malaria parasites were still prescribed an anti-malarial, contrary to the guidelines. There were marked inter-district variations in the proportion of patients in WHOm a diagnostic tool was used, and in the choice of anti-malarials for the treatment of malaria confirmed cases. Association between health worker characteristics and quality of case malaria management showed that nurses performed better than environmental health technicians and clinical officers on the decision whether to use the rapid diagnostic test or not. Gender, in service training on malaria, years of residence in the district and length of service of the health worker at the facility were not associated with diagnostic and treatment choices.</p><p><b>CONCLUSIONS</b>Malaria case management was characterised by poor adherence to treatment guidelines. The non-adherence was mainly in terms of: inconsistent use of confirmatory tests (rapid diagnostic test or microscopy) for malaria; prescribing anti-malarials which are not recommended (e.g. sulphadoxine-pyrimethamine) and prescribing anti-malarials to cases testing negative. Innovative approaches are required to improve health worker adherence to diagnosis and treatment guidelines.</p>
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Objective: To establish the appropriateness of malaria case management at health facility level in four districts in Zambia. Methods: This study was a retrospective evaluation of the quality of malaria case management at health facilities in four districts conveniently sampled to represent both urban and rural settings in different epidemiological zones and health facility coverage. The review period was from January to December 2008. The sample included twelve lower level health facilities from four districts. The Pearson Chi-square test was used to identify characteristics which affected the quality of case management.Results:Out of 4891 suspected malaria cases recorded at the 12 health facilities, more than 80% of the patients had a temperature taken to establish their fever status. About 67% (CI95 66.1-68.7) were tested for parasitemia by either rapid diagnostic test or microscopy, whereas the remaining 22.5% (CI95 21.3.1-23.7) were not subjected to any malaria test. Of the 2247 malaria cases reported (complicated and uncomplicated), 71% were parasitologically confirmed while 29% were clinically diagnosed (unconfirmed). About 56% (CI95 53.9-58.1) of the malaria cases reported were treated with artemether-lumefantrine (AL), 35% (CI95 33.1-37.0) with sulphadoxine-pyrimethamine, 8% (CI95 6.9-9.2) with quinine and 1% did not receive any anti-malarial. Approximately 30% of patients WHO were found negative for malaria parasites were still prescribed an anti-malarial, contrary to the guidelines. There were marked inter-district variations in the proportion of patients in WHOm a diagnostic tool was used, and in the choice of anti-malarials for the treatment of malaria confirmed cases. Association between health worker characteristics and quality of case malaria management showed that nurses performed better than environmental health technicians and clinical officers on the decision whether to use the rapid diagnostic test or not. Gender, in service training on malaria, years of residence in the district and length of service of the health worker at the facility were not associated with diagnostic and treatment choices.Conclusions:Malaria case management was characterised by poor adherence to treatment guidelines. The non-adherence was mainly in terms of: inconsistent use of confirmatory tests (rapid diagnostic test or microscopy) for malaria; prescribing anti-malarials which are not recommended (e.g. sulphadoxine-pyrimethamine) and prescribing anti-malarials to cases testing negative. Innovative approaches are required to improve health worker adherence to diagnosis and treatment guidelines.
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Objective: To establish the appropriateness of malaria case management at health facility level in four districts in Zambia. Methods: This study was a retrospective evaluation of the quality of malaria case management at health facilities in four districts conveniently sampled to represent both urban and rural settings in different epidemiological zones and health facility coverage. The review period was from January to December 2008. The sample included twelve lower level health facilities from four districts. The Pearson Chi-square test was used to identify characteristics which affected the quality of case management. Results: Out of 4 891 suspected malaria cases recorded at the 12 health facilities, more than 80% of the patients had a temperature taken to establish their fever status. About 67% (CI
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Objective: To compare the two methods of rapid diagnostic tests (RDTs) and microscopy in the diagnosis of malaria. Methods: RDTs and microscopy were carried out to diagnose malaria. Percentage malaria parasitaemia was calculated on thin films and all non-acute cases of plasmodiasis with less than 0.001% malaria parasitaemia were regarded as negative. Results were simply presented as percentage positive of the total number of patients under study. The results of RDTs were compared to those of microscopy while those of RDTs based on antigen were compared to those of RDTs based on antibody. Patients' follow-up was made for all cases. Results:All the 200 patients under present study tested positive to RDTs based on malaria antibodies (serum) method (100%). 128 out of 200 tested positive to RDTs based on malaria antigen (whole blood) method (64%), while 118 out of 200 patients under present study tested positive to visual microscopy of Lieshman and diluted Giemsa (59%). All patients that tested positive to microscopy also tested positive to RDTs based on antigen. All patients on the second day of follow-up were non-febrile and had antimalaria drugs. Conclusions: We conclude based on the present study that the RDTs based on malaria antigen (whole blood) method is as specific as the traditional microscopy and even appears more sensitive than microscopy. The RDTs based on antibody (serum) method is unspecific thus it should not be encouraged. It is most likely that Africa being an endemic region, formation of certain levels of malaria antibody may not be uncommon. The present study also supports the opinion that a good number of febrile cases is not due to malaria. We support WHO’s report on cost effectiveness of RDTs but, recommend that only the antigen based method should possibly, be adopted in Africa and other malaria endemic regions of the world.
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Trypanosoma cruzi infection is often not detected early on or actively diagnosed, partly because most infected individuals are either asymptomatic or oligosymptomatic. Moreover, in most places, neither blood banks nor healthcare units offer diagnostic confirmation or treatment access. By the time patients present clinical manifestations of advanced chronic Chagas disease, specific treatment with current drugs usually has limited effectiveness. Better-quality serological assays are urgently needed, especially rapid diagnostic tests for diagnosis patients in both acute and chronic phases, as well as for confirming that a parasitological cure has been achieved. Some new antigen combinations look promising and it is important to assess which ones are potentially the best, together with their requirements in terms of investigation and development. In August 2007, a group of specialized researchers and healthcare professionals met to discuss the state of Chagas infection diagnosis and to build a consensus for a plan of action to develop efficient, affordable, accessible and easy-to-use diagnostic tests for Chagas disease. This technical report presents the conclusions from that meeting.
A infecção pelo Trypanosoma cruzi não é comumente detectada cedo ou diagnosticada ativamente, em parte porque a maioria dos infectados é assintomática ou oligossintomática e nem os bancos de sangue nem as unidades de saúde oferecem, na maioria dos lugares, nem a confirmação do diagnóstico nem o acesso ao tratamento. Habitualmente, quando os pacientes apresentam manifestações clínicas avançadas da doença crônica o tratamento específico com os medicamentos atuais tem efetividade limitada. São necessárias urgentemente provas sorológicas de melhor qualidade, e em especial provas diagnósticas rápidas, para diagnosticar pacientes na fase aguda e crônica, assim como para confirmar a cura parasitológica. Algumas novas combinações de antígenos são promissoras e é importante avaliar as potencialmente melhores, assim como as suas necessidades em nível de pesquisa e desenvolvimento. Em agosto 2007, um grupo de pesquisadores especializados e profissionais da área da saúde se reuniu para discutir a situação do diagnóstico da infecção chagásica e elaborar um consenso sobre um plano de ação em prol do desenvolvimento de testes diagnósticos eficientes, acessíveis e fáceis de usar. Este informe técnico apresenta as conclusões da reunião.
Subject(s)
Animals , Humans , Chagas Disease/diagnosis , Diagnostic Techniques and Procedures/standards , Acute Disease , Chronic Disease , Reagent Kits, DiagnosticABSTRACT
BACKGROUND: Although tuberculosis has often been referred to as diseases of the past, the current prevalence of active tuberculosis is still about 1% and it is 10th leading cause of death in Korea. In United States where tuberculosis has resurged since 1985, mycobacteriology laboratories have been playing a pivotal role in the control of tuberculosis by providing sensitive and rapid diagnostic tests. In Korea, the extent of mycobacteriology services at hospital laboratories has never been documented, although they too should play a central role in controlling tuberculosis. The purpose of this survey is to assess the facility and testing methods of mycobacteriology laboratories and the turnaround times of diagnostic tests. METHOD: In January 1997, the mycobacteriology laboratory of 40 tertiary or university hospitals in Korea were asked to complete a questionnaire involving mycobacterial test methods, test volume, turnaround time (TAT) for AFB stain. TATs for isolation, identification, and susceptibility testing were collected from the laboratory of Asan Medical Center. RESULTS: Of the 40 laboratories participating in this survey, AFB mciroscopy was performed at 40, cultures at 38, and susceptibility tests only at two laboratories. 38 laboratories referred susceptibility tests to other non-hospital laboratories. TATs for AFB microscopy were < or =24 hrs at 34 laboratories and 24-36 hrs in 6 laboratories. Isolation/identification and susceptibility tests for mycobacteria took 40.4+/-13.2 days and 45.7+/-12.4 days, respectively. All but one laboratory used solid media, mostly Ogawa media, for primary culture, and for AFB stain, 37 laboratories were using Ziehl-Neelsen method. For identification of AFB, only 4 laboratories were using a nucleic acid probe method, 18 laboratories biochemical tests, and 16 laboratories no identification test except AFB stain. CONCLUSION: Long TATs were the common and serious problems in mycobacteriology laboratories in Korea. There are urgent needs for optimizing their testing procedures if they were to play a role in the control of tuberculosis in this country. They include introduction of broth media for cultures and susceptibility tests as well as rapid methods for identification.