Tuberculosis in Laos: Fight against an emerging resistance

October 10, 2011 - Vientiane (Laos)


The Christophe Mérieux Centre in Laos (CCML), part of the Ministry of Health, has a mission of training and applied research on infectious diseases, in particular tuberculosis, HIV, and respiratory diseases.

Fondation Mérieux has supported the CCML since it’s inception in order for it to become financially and functionally autonomous. Through support in training and project management, the CCML has been able to develop an important line of work on tuberculosis, notably with the study of resistance to anti-tuberculosis drugs.

Laos has a high prevalence of tuberculosis and a slowly increasing prevalence of HIV. Microscopic examination of sputum is the only method routinely used for diagnosing pulmonary tuberculosis but it can detect only one in three cases among patients with HIV (PLWH). The method of bleach treatment of sputum significantly improves the screening performance but its effectiveness in patients co-infected with HIV in Laos remained to be determined.

The aim of the research project set up by Fondation Mérieux (Emergening Pathogens Laboratory in Lyon), in collaboration with the Institut de la Francophonie pour la Médecine Tropicale in Vientiane, and the Christophe Mérieux Centre in Laos, was to determine the performance of microscopy with or without bleach treatment of the sample compared to culture in the detection of pulmonary tuberculosis patients with HIV and to assess its cost effectiveness in Laos.

The results obtained from 92 patients and 174 sputum smear samples were culture-positive for Mycobacterium tuberculosis in 17 patients. The sensitivity of the direct method and the bleach method was respectively 59% and 93%.

The bleach method is simple, inexpensive, easy to perform and cost effective in PLWH. Its implementation in laboratories involved in routine screening of pulmonary tuberculosis among PLWH would allow practitioners to start the treatment of this co-infection earlier.