Annual Report March 2006 – March 2007
Mycobacteriology Laboratory
Head: Dr H Poswa
Departmental Staff Compliment
Pathologist: Dr Xoliswa Poswa. Qualifications: MBChB, DTM&H, FCPath Micro. Appointed:
1/11/03
Laboratory Manager: Ms Violet Gabashane Qualifications: MT, BSc (anatomy), Higher
Certificate in Production and Supervision, Diploma in Production Management. Appointed:
1/04/2004
Supervisor: Ms Nomsa Moloi. Qualifications: MT. Appointed 1/11/2006. Medical Technologist:
Ms Minty van der Meulen. Qualifications: MT. Appointed: 1/11/2002. Medical Technologist: Ms
Joey Ebonwu. Qualifications: MT. Appointed 1/09/2004. Medical Technologist: Ms Tebogo
Pholo. Qualifications: MT. Appointed 1/11/2006. Medical Technologist: Ms Glynnis Duse.
Qualifications: MT. Appointed 1/11/2006. Student Scientist: Mr John Ratabane Qualifications:
Student Scientist Appointed: 1/02/2007 Senior Technician: Ms Dimakatso Choshi.
Qualifications: Senior Technician. Appointed 1/09/2005. Technician: Ms Jacqueline Kolobe.
Qualification: Technician. Appointed: 1/11/2003 Technician: Mr Neeshan Ramdin. Qualification:
Technician. Appointed: 17/11/2003. Laboratory Aid: Ms Sharon Poonan. Qualification: Lab Aid.
Appointed: 22/11/1999. Laboratory Aid: Ms Gertrude Motaung. Qualification: Lab Aid.
Appointed: 21/10/1999. Laboratory Aid: Ms Barbara Motlanthe Qualification: Lab Aid.
Appointed: 01/01/1999. Laboratory Aid: Ms Catherine Thusi. Qualification: Lab Aid. Appointed:
29/29/1986. Laboratory Aid: Mr Vusi Tshabalala. Qualification: Lab Aid. Appointed: 01/06/1990.
Laboratory Aid: Ms Nomaswazi Kolodi. Qualification: Lab Aid. Appointed: 1/08/2006.
Laboratory Aid: Ms Pauline Mamabolo. Qualification: Lab Aid. Appointed: 1/09/2006.
Laboratory Aid: Mr Mthokozisi Duduene. Qualification: Lab Aid. Appointed: 1/11/2006.
Laboratory Aid: Ms Ms Ntombi Chonco. Qualification: Lab Aid. Appointed: 1/08/2006.
Laboratory Aid: Ms Sphesihle Myeza. Qualification: Lab Aid. Appointed: 1/11/2006. Laboratory
Aid: Mr Thapelo Ntlatseng. Qualification: Lab Aid. Appointed: 1/11/2006. Laboratory Aid: Ms
Yolande Ngwenya. Qualification: Lab Aid. Appointed: 1/06/2006. Laboratory Aid: Mzothule
Ngemq. Qualification: Lab Aid.
Departmental Research Interests
Evaluation of rapid diagnostic assays for mycobacterial disease including real time PCR and line
probe assays. Evaluation of automated instruments for specimen processing and comparison of
liquid culture media with solid media for diagnosis for mycobacteria.
Diagnostic Services
Diagnostic services that have been conducted by the department between March 2006 and
March 2007 have been the implementation of a new, fully automated BACTEC 9240 system for
the diagnosis of micobacterial diseases from blood culture. The implementation of an automated
system for staining of smears. The extension of operational hours to 22h00, the introduction of a
molecular test for the direct detection of TB from sputum and molecular identification system for
TB and MOTTS and the laboratory is central to the response to XDR in the Gauteng region,
providing the relevant statistics and expert advice. Diagnostic Service: Workload Microscopy only:
Sputum (95706); Culture (138 883); Sputum (90 140); Plueral Fluid (2 155); FNA (5 799); Blood
(20600); CSF (5764); Gastric Washing (9888); OTHER: urine, other fluids, biopsy etc (4537);
Susceptibility test: First line (6621) Second line (1449).
Research Projects
Evaluation of the performance of an in-house light cycler assay for the direct detection of
M.tuberculosis, M.kansasii and M.avium in sputum samples.
Researcher: X Poswa. Ongoing: Commenced August 2006 and Completed November 2006.
Collaborators: A Whitelaw, W Sturm, C Clay, G Weldhagen, H Koornhof, G Koetzee, M
Dove. Sources of Funding: Roche
This ongoing study compares the sensitivity and specificity of the LC assay against microscopy
and culture in detection of micobacteria from sputum specimens as performed in different
laboratory settings and to determine the ability of the LC assay to detect M. tuberculosis, M
kansasii and M. avium using culture as the “gold standard.”
Evaluation of Genotype MTBDR assay directly on sputum specimens.
Researchers: X Poswa and V Gabashane. Commenced October 2006 and Completed
January 2007. Collaborators: G Coetzee.Sources of Funding: HAIN Technology
This study compares the performance Genotype MTBDR with culture and drug susceptibility
testing in detecting M. tuberculosis complex and multiple drug resistance directly from sputum
specimen.
Improving the detection and short term outcomes of smear negative pulmonary TB among
South African gold miners: a comparison of liquid (MGIT) versus solid (LJ) culture
systems.
Co-Investigator: X Poswa. Commenced August 2006. Collaborators: THIBELA/FIND
Principal Investigator- Professor Gavin Churchyard Sources of Funding: THIBELA/FIND
The study compares the use of LJ to MGIT culture in terms of laboratory and cost effectiveness
outcomes in the investigation of smear negative TB suspects using a cross-sectional study
design. The study is nested in a cluster-randomized study to determine the effectiveness of
community wide TB preventive therapy among South African gold miners (thibela TB) conducted
at Anglogold Ashanti, Harmony and Gold Fields gold mines in the Gauteng, North West and Free
State provinces. The cross sectional study is a laboratory-based study comparing LJ and MGIT
cultures with respect to yield and time to positive culture on the same sputum samples. All
sputum smear negative specimens obtained from TB suspects during screening for TB prior to
offering IPT and from those investigated routinely by the health service are included in the study.
Genotype Diversity of Extensively Resistant Tuberculosis (XDR-TB) in South Africa.
Co-Investigator: X Poswa. Commenced November 2006. Ongoing. Collaborators: E Mare, C
Mlambo, T Victor, R Warren, AG Duse. Sources of Funding NHLS
M. tuberculosis strains are not equal in terms of their transmission and ability to acquire
resistance (Burgos et al, 2003). It is therefore important to use molecular methods to characterize
the strains in order to understand the population structure, mechanism of resistance development
and possible modes of transmission. Very little information is available on XDR-TB in general and
it is only recently that XDR-TB has been investigated in one of the 9 provinces of South Africa.
This study was designed to obtain a snap-shop molecular view of the XDR-TB strains circulating
in South Africa.
Other Departmental Activities
Training site for BD Diagnostics in the use of MGIT Systems of the African region. Member of the
TB crisis committee of the Department of Health and member of the expert committee of the
response to XDR, Department of Health, Gauteng.
Postgraduate Teaching
Course: Co-Supervisor of PHD student.
Number of Students: 1
Course: Microbiology
Number of Students: 4
External Teaching Activities
Company: Federation of Infectious Diseases of South Africa- Topic: MDRTB and XDRTB.
Company: Sedibeng District-Topic: Challenged in the diagnosis of drug resistant TB. Company:
SinofiAventis-uMthatha, Port Elizabeth-Topic: An update on XDRTB/Challenges in diagnosis of
drug resistant TB. Company: City of Johannesburg D.O.H/Hillbrow Hospital-Topic:
MDRTB/XDRTB. Company: D.O.H National-Topic: Drug resistant TB/ Diagnostic challenges.
Company: SABC Housecall-Topic: Tuberculosis Company: D.O.H (Gauteng Province) Report
back of expert committee on response to XDRTB) - Topic: Management of MDRTB.
Courses obtained from External Institutions
Ms Violet Gabashane attended DISA Super User, Accreditation: ISO Guide, TB Workshop, Dr
westguard Rules, Order Management. Ms Esther Molaoa attended TB Workshop and
Management skills. Mr Meeshan Ramdin attended DISA Super User and Oracle Order
Management. Ms Minty van de Meulen attended DISA basic skills, Dr Westguard Rules,
Accreditation:ISO Guide and Management skills. Ms Jacqueline Kolobe attended TB microscopy,
Accreditation: ISO Guide. Mr Andrew Rampe attended DISA basic skills. Mr Robin McCulloch
attended a first aid course. Ms Rebecca Nkoane attended a first aid course. Dimakatso Choshi
attended First Aid, Autoclave and Tb microscopy. Zaheeda Bhyat attended Dr Westguard Rules.
Joy Ebonwu attended the TB Workshop. Nomsa Moloi received Accreditation: ISO Guide and
management skills. Yolande Ngwenya attended order management, Oracle requisitioning and
recipting. Gertrude Motaung received accreditation :ISO GUIDE. Catherine Thusi received
Accreditation: ISO Guide.