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Interregional workshop for heads of regional TB laboratories from North-West Russia in St. Petersburg 2008-2010 - part II

Project title Interregional workshop for heads of regional TB laboratories from North-West Russia in St. Petersburg 2008-2010 - part II
Database Data inserted through the NDPHS Project Pipeline
ID in the source database 40
Thematic area Tuberculosis
Topic In order to enhance networking between regional TB laboratories and improve bacteriological diagnostics in North-West Russia the project will organize in autumn 2009 the second two-and-half-day workshop in St. Petersburg. From 10 to 15 heads of regional TB laboratories in civilian and penitentiary sector will be invited to this workshop.
Project geographical area Russia
Substate level / administrative units /regions
  • Arkhangelsk Oblast
  • Kaliningrad Oblast
  • Karelia Republic
  • Komi Republic
  • Leningrad Oblast
  • Murmansk Oblast
  • Nenets AO
  • Novgorod Oblast
  • Pskov Oblast
  • St. Petersburg
  • Vologda Oblast
Lead partner (organisation) Filha (Finnish Lung Health Association)
Lead partner (owner or/and project manager) no data
Partner organisations
Start date 2009-01-01
End date 2009-11-30
Duration (months) 11
Target audience 1. Direct beneficiaries:
a) Regional TB Programmes in North-West Russia,
b) Filha;

2. Indirect beneficiaries:
a) TB patients,
b) TB laboratory staff in civilian and penitentiary care in North-West Russia,
c) Finnish TB programme;

3. Other stakeholders:
a) St. Petersburg City TB Dispensary,
b) St. Petersburg Research Institute of Tuberculosis and Lung Diseases,
c) WHO Office in Moscow,
d) Ministry of Social Affairs and Health of Finland,
e) Ministry for Foreign Affairs of Finland,
f) Mycobacterial Reference Laboratory of the Finnish National Public Health Institute
Summary The tuberculosis (TB) situation has remained difficult in Russia. In recent years, the emergence of multidrug-resistant tuberculosis (MDR TB) and human immunodeficiency virus (HIV) has aggravated the situation. A major constrain for development of effective tuberculosis control programmes in Russia has been the insufficient tuberculosis laboratory services. In 2004, 2005 and 2007 Filha has organised interregional laboratory workshops for the heads of the laboratories working in Filha assisted TB cooperation projects. Such training has proved to be successful and enhanced networking among the participating parties. Russian parties (St.Petersburg City TB Dispensary, Murmansk TB Dispensary, TB Dispensary of the Republic of Karelia and St. Petersburg Research Institute of Tuberculosis and Lung Diseases) have expressed the need to continue these training activities and to expand the focus area to cover the whole territory of North-West Russia. The WHO has expressed the continuous need for training in this field and supports this project initiative.

The overall objective of the project is to strengthen the regional TB control programmes. The purpose is to improve the knowledge of and networking between the heads of the regional TB laboratories both in civilian and penitentiary sector in North-West Russia. A two and half-day workshop will be organised in September 2008, 2009 and 2010 in St. Petersburg. It will be offered to heads of TB laboratories working in both civilian and penitentiary TB services in North-West Russia. The project will be implemented by Filha in collaboration with the WHO, the Central TB laboratory of the St. Petersburg City TB Dispensary and the Mycobacterial Reference Laboratory, the National Public Health Institute of Finland. The total budget for 2009 is 51 650 euros. The applied amount of support from the Ministry for Foreign Affairs is 41 100 euros.

The proposed project contributes to the prevention of infectious diseases in the Neighbouring Areas of Finland in the frame of the Northern Dimension Partnership Programme. The knowledge gained will also benefit the Finnish TB Programme.
Background In the early 1990s, the incidence of TB started to increase in the Russian Federation and by 2000, at its peak, the TB incidence had more than doubled. Since then TB incidence rates have slightly decreased or reached a plateau. In recent years the emergence of multidrug-resistant tuberculosis (MDR TB) and human immunodeficiency virus (HIV) has aggravated the situation. In North-West Russia the average rate of MDR among new detected TB cases has increased from 16,8 % in 2005 to 20,8 % in 2006.

Laboratory services are a fundamental component of a national or regional TB control programme and a core part of the internationally recommended TB control strategy. Diagnosis of TB and monitoring of treatment progress relies on effective microbiology services, including sputum smear microscopy, culture examination and drug susceptibility testing (DST).

TB is an airborne infection and it is of vital importance to isolate infectious patients as soon as possible from the society and also from other patients. With emergence of MDR cases and further more of extensively drug-resistant (XDR) cases, for which we do not have any effective treatment, the need for fast and reliable diagnosis is further increased.

The Russian Federation has an expanded network of tuberculosis laboratory services in both Primary Health Care services and TB services. Often the number of primary laboratories performing TB microscopic examinations is so large that qualitatively good work cannot be performed due too small number of examinations per unit. On the other hand in many regions the culture confirmation rate remains far too low in international comparison meaning also low capacity in detecting drug resistance. This can be caused either by insensitive culture methods or negligence in collecting and submitting sputum specimens for culture. A clear vision on what is important in development of an effective network of services is needed. In organisation of internal and external quality assessments and reorganisation of the infrastructure the experiences of neighbouring areas can be of great value.

The bacteriological methods used for cultivation and drug susceptibility testing have in many regions remained unchanged for well over 30-40 years. Thus laboratory verification of tuberculosis, which using modern methodology optimally takes 2-3 weeks, takes 2-3 months, and drug resistance testing against first line drugs takes another 4 weeks while the modern gene technology would allow a fast detection of MDR in few days. These delays are severely hampering the prevention of spread of MDR tuberculosis. At present improved laboratory technology which allows both rapid confirmation of tuberculosis and rapid detection of drug resistance, already in wide use in Western Europe, is rigorously marketed in Russia. The Federal authorities also seem to support their purchase. The new methods have proven demanding in any laboratory when first taken in use. The heads of the TB laboratories whose basic knowledge on these technologies is limited face a huge challenge in deciding which methods are applicable in their circumstances, and which are the means to learn to master them.

The TB laboratory network faces a serious shortage of staff, in many places only roughly half of the positions are filled. One factor affecting the willingness of young laboratory professionals to seek employment in TB sector is fear of occupational tuberculosis, another factor the lack of updated infrastructure and equipments. There is a clear need to improve biosafety standards as well as existing infrastructure and equipment.

All above mentioned factors favour a closer cooperation between the heads of regional TB laboratories in this rapidly changing environment. Human resource capacity building through training and development of a model for effective laboratory services at the central level should lead to improvements in laboratory diagnosis at all levels.

Filha has already with success organised interregional workshops for heads of laboratories of, St.Petersburg city, Leningrad region, Murmansk region and the Republic of Karelia. Several actors have expressed the need to expand this activity to cover whole North-West Russia. St.Petersburg forms the natural centre of North-West Russia with good traffic connections from all regions of the area as well as from Finland. The previous workshops in 2004 and 2005 were organised in Helsinki and in St. Petersburg. In 2007, the City TB Dispensary provided the meeting rooms and assistance in organisation of these workshops. The coming workshop in autumn 2008 will also be organized in St. Petersburg. The City TB Dispensary does have experience in co-organising large federal conferences yearly in the field of infectious diseases in St. Petersburg. There are certain risks regarding the project as stated in chapter 8.

The experiences of Filha in TB cooperation project in North-West Russia indicate that local parties, despite their expanded practical experiences in performing TB examinations, need external assistance especially in the field of organisation the services of a regional TB laboratory with reference laboratory level. Filha can provide this.

The proposed project contributes to the prevention of infectious diseases in the Neighbouring Areas of Finland in the frame of the Northern Dimension Partnership Programme, and enhances cooperation in the field. It will also benefit the Finnish TB programme by increasing the capacity of Finnish experts regarding conductance of training, but also due improving existing TB diagnostics enabling better prevention of spread of MDR tuberculosis in our close neighbourhood.
Objectives The general objective of the project is to strengthen regional TB programmes.
Specific objectives/indicators The specific objective of the project is to improve services of Regional TB laboratories both in civilian and penitentiary care in North-West Russia. Monitoring indicators:
1) geographical coverage,
2) number of heads of laboratories participating in workshops,
3) perceived changes in personal performance.
Results Expected results:
1) increased networking between regional TB laboratories in North-West Russia,
2) increased understanding of effective organisation of laboratory services,
3) Strengthened skills and abilities to apply updated knowledge in regional TB laboratories.
Total foreseen budget EUR 51,650
Total implementation costs
(for completed projects, if available)
no data
Conversion to € was done on
(according to the relevant
exchange rate at
Infoeuro Monthly Files)
no data
Financing agencies / organisations Ministry for Foreign Affairs of Finland
Project's URL / project's website no data
Papers associated with this project no data
Further information no data
Last posted: on 2011-03-21 at 10:02:30

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