Обратная связьThe central level (Level III) offers testing that requires highly advanced skills, infrastructure and biosafety precautions. An important expectation at this level is to provide testing to resolve discordant results, troubleshooting, training support to other levels, QA and monitoring, and surveillance.
- HC-rNAATs, including the FL-LPA, SL-LPA and PZA-LPA (Table 2.1) tests, are all applicable at this level. The MC-aNAATs with high throughput could also be considered at this level, especially in urban settings where the workload is high.
- Culture and phenotypic DST using solid or liquid media should be available at this level. At a minimum, phenotypic DST for the new and repurposed drugs should be available.
- Establishing capacity for sequencing (targeted or WGS) is becoming increasingly important. Targeted NGS tests are high-complexity tests in their current format; hence, they are most suitable for centralized laboratories equipped with specialized skills and infrastructure, including information technology (IT) and data storage.
Fig. 4.2. Organization of a TB diagnostic testing network
