PIH Lesotho Opens New TB Reference Lab

The burden of tuberculosis in Lesotho, a small landlocked country surrounded by South Africa, is among the highest in the world.

Today Partners In Health Co-founder Dr. Paul Farmer and Executive Director Ophelia Dahl celebrated the opening of Lesotho’s National TB Reference Lab, the first biosafety level 3 lab in the country and one of only two such state-of-the art tuberculosis testing facilities in southern Africa.

The burden of tuberculosis in Lesotho, a small landlocked country surrounded by South Africa, is among the highest in the world. There are 633 new cases of TB per 100,000 people each year. Located in the capital city Maseru, the lab will allow cases of extensively drug-resistant tuberculosis (XDR-TB) to be identified without having to send samples outside of the country. Until now, identifying XDR-TB required samples to be shipped to labs in South Africa, a cumbersome and costly process that hindered care.

“This facility will help us diagnose tuberculosis sooner, thereby reducing transmission and decreasing mortality,” said Dr. Hind Satti, Lesotho country director for PIH. “The lab also provides the capacity to run a national drug resistance survey for the first time and conduct ongoing surveillance for TB throughout the whole country.”

Cases of multidrug-resistant tuberculosis (MDR-TB) and XDR-TB pose significant challenges in the resource-poor and geographically rugged country, where patients often have to travel hours through mountain paths to see a doctor. One study by PIH’s sister organization Partners In Health/Lesotho found that about 70 percent of adult MDR-TB patients also had HIV, and about half had low Body Mass Index, suggesting that they were extremely ill.

PIH/L takes an aggressive approach to fighting TB. If patients are extremely sick, clinicians will often treat them for MDR-TB based on their symptoms and history before tests results come back to ensure nobody dies while waiting for the results of diagnostic tests. After treatment has begun (treating MDR-TB typically takes two years), paid community health workers visit patients daily to make sure they’re taking their medications properly and to monitor for side effects.

This thoroughness has paid off. PIH/L has treated more than 800 MDR-TB patients with a success rate of 63 percent, similar to the success rates seen in settings where far fewer patients have both MDR-TB and HIV. Perhaps most impressive is that less than 1 percent of MDR-TB patients treated by PIH/L refused follow-up care.