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| Reference: | 5061 |
| Country: | Nepal |
| Multiple country event: | No |
| Region: | SEARO |
| City: | Kathmandu |
| Start date: | 23 June 2013 |
| End date: | 1 July 2013 |
| Estimated duration: | |
| Status: | TA Request |
| | (This is a request for technical assistance) |
| TA request for: |
Expert
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| Title: | Programme Review of NTP - Nepal CONSULTANT FOR THE LABORATORY COMPONENT |
| Type: | Mission |
| Terms of Reference: | Background
Microscopic examination of sputum specimens is still the mainstay of TB diagnosis and should be obtained from all patients suspected of having TB. In most settings, the diagnosis of TB is confirmed by the presence of acid-fast bacilli (AFB) in sputum smear examination. For smear-negative and extra-pulmonary TB, a diagnosis by a clinician specially trained in TB is required, in addition to radiographic examination and clinical response to a course of broad-spectrum antibiotics. Where quality-assured laboratory facilities are available, the evaluation of patients with negative sputum smears should also include diagnosis by molecular biology (Xpert, LPA) or culture, as foreseen by national algorithms. Since HIV is responsible for a large increase in the proportion of patients with smear-negative pulmonary and extra-pulmonary and the mortality in patients with the double infection is very high unless adequate treatment is timely initiated, diagnostic algorithms including sputum testing by Xpert and clinical assessment for HIV are necessary. Patients and their contacts identified as MDR-TB suspects should be screened for drug-resistance by rapid diagnostic technologies and, if found positive, started on treatment and have the result confirmed by conventional culture & DST.
In Nepal, DST for all new TB cases is neither feasible nor recommended, therefore designing adequate treatment regimens for drug-resistant TB requires population-representative picture of drug resistance among new, previously treated patients and other high-risk groups obtained through periodic drug-resistance surveys (DRS).
Objective
Against the above background, the reviewer should comment on:
• coverage of laboratory services, including underserved areas and logistics
• feasibility and relevance of the section of PMDT Expansion Plan on laboratory;
• existence, quality and adherence to SOPs, including diagnostic algorithms;
• laboratory data Recording & Reporting system;
• existence and actual implementation of mechanisms for EQA (microscopy and culture/DST)
• validation of recent DRS for MDR and XDR tuberculosis
• cost-effectiveness of establishing culture/DST in regional labs vs. strengthening sputum specimen transport for laboratory coverage expansion.
MINIMUM REQUIRED QUALIFICATIONS OF THE CONSULTANT
Educational qualifications
- University degree in health-related science
- Master in Public Health or specialization in microbiology or equivalent working experience
- Training on TB control and/or TB laboratory techniques
Work experience
- At least 10 years of employment in organizations engaged in public health and disease control
- At least 7 years of international experience in low-income countries
- Previous experience as consultants for NTP or other programme reviews
Skills
- Excellent knowledge of spoken and written English and capacity to produce high level formal documents and effective presentations in this language
- Capacity to produce results working in a team, under pressure and within a limited time frame.
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| Training Opportunity: | Yes |
| Website: | www.nepalntp.gov.np |
| Purpose 1: | Laboratory strengthening |
| Purpose 2: | |
| Purpose 3: | |
| Other purpose: | |
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| Entered by: | NTP |
| Partner 1: | WHO/SEARO |
| Partner 2: | RIT/JATA |
| Partner 3: | Other |
| Contact name: | Dr Giampaolo Mezzabotta, MO/TUB |
| Contact email: | mezzabottag@searo.who.int |
| Other agencies: | LHL, JANTRA. |
|
| Funding needs: | No |
| Funding source: | Global Fund - Fonds Mondial |
| Other funding source: | LHL, RIT |
| Available funding: | $ 0 |
| Funding gap: | $ 0 |
| Global Fund reference: | |
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| Comments: | Applications (CV + motivation letter) should be sent to the contact person no later than April 21, 2013.
Consultancy fees are as for WHO remuneration scale for Nepal, depending on the seniority and qualification of the consultant.
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There are no experts (roster) associated with this event. There are no experts (non-roster) associated with this event.
Date Created: 28 March 2013
Entered By: Nepal
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